title: Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons.
abstract: BACKGROUND
  The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons' psychomotor skills.
  
  
  METHODS
  Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand-eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach's α test.
  
  
  RESULTS
  Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels.
  
  
  CONCLUSIONS
  EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons.
authors.affiliation: Bioelectronics Section, Department of Electrical Engineering, Center for Research and Advanced Studies of the National Polytechnic Institute of Mexico (CINVESTAV - IPN), Av. Instituto Politécnico Nacional No. 2508, Col. San Pedro Zacatenco, 07360, Mexico City, Mexico. fperez@cinvestav.mx.
authors.forename: Fernando Pérez
authors.initials: FP
authors.lastname: Escamirosa
authors.affiliation: Department of Pediatric Surgery, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.
authors.forename: Ricardo Manuel Ordorica
authors.initials: RM
authors.lastname: Flores
authors.affiliation: Bioengineering and Telemedicine Centre (GBT), ETSI Telecommunication, Universidad Politécnica de Madrid (UPM), Madrid, Spain.
authors.forename: Ignacio Oropesa
authors.initials: IO
authors.lastname: García
authors.affiliation: Department of Pediatric Surgery, Hospital Infantil de Mexico Federico Gómez, Mexico City, Mexico.
authors.forename: Cristian Rubén Zalles
authors.initials: CR
authors.lastname: Vidal
authors.affiliation: Bioelectronics Section, Department of Electrical Engineering, Center for Research and Advanced Studies of the National Polytechnic Institute of Mexico (CINVESTAV - IPN), Av. Instituto Politécnico Nacional No. 2508, Col. San Pedro Zacatenco, 07360, Mexico City, Mexico.
authors.forename: Arturo Minor
authors.initials: AM
authors.lastname: Martínez
mesh_terms: D000328:Adult; D002983:Clinical Competence; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000193:education* / Q000295:instrumentation / Q000379:methods / Q000523:psychology; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011597:Psychomotor Performance; D000066908:Simulation Training / Q000379:methods*; D014741:Video Recording
keywords: Endoscopic orthogonal video system (EndoViS); Laparoscopic surgery; Motion metrics; Objective assessment; Surgical training; Validation