title: Evaluation of a precise and measurable model for learning laparoscopic tissue handling.
abstract: BACKGROUND
  Laparoscopic tissue handling is quite difficult to measure using virtual-reality laparoscopic simulators and box-trainer exercises, and therefore, completion time is the predominant performance measure for simulation-based laparoscopic training exercises. The purpose of this study was to evaluate the construct validity of a training and assessment model for precise laparoscopic handling of delicate tissue.
  
  
  METHODS
  Participants (n = 35) completed 2 progressively challenging laparoscopic tissue translocation exercises using delicate foam pieces and templates. Deidentified performances were scored using objective measures for tissue damage, accuracy, percentage complete, and completion time. Evaluation included multiple analysis of variance with repeated measures among the 3 groups as follows: medical students, residents and faculty who perform laparoscopic surgery less than once per week, and faculty members who perform laparoscopic surgery at least once per week.
  
  
  RESULTS
  The model demonstrated significant construct validity by discriminating performances between the types of shapes and templates and across the levels of surgical experience on all dimensions. A significant interaction effect between the level of expertise and the difficulty of the exercise revealed excellent discrimination between experienced laparoscopic surgeons and others.
  
  
  CONCLUSIONS
  This low-cost model provides an alternative or adjunct platform for laparoscopic training and assessment that requires precise and measurable handling of a delicate tissue.
authors.affiliation: From the Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI.
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Andreatta
authors.forename: David A
authors.initials: DA
authors.lastname: Marzano
authors.forename: Diana S
authors.initials: DS
authors.lastname: Curran
authors.forename: R Kevin
authors.initials: RK
authors.lastname: Reynolds
mesh_terms: D003198:Computer Simulation / Q000592:standards*; D003238:Connective Tissue / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008953:Models, Anatomic