title: When experts are oceans apart: comparing expert performance values for proficiency-based laparoscopic simulator training.
abstract: BACKGROUND
  Surgical training is moving away from the operating room toward simulation-based skills training facilities. This has led to the development of proficiency-based training courses in which expert performance data are used for feedback and assessment. However, few expert value data sets have been published, and no standard method for generating expert values has been adopted by the field.
  
  
  METHODS
  To investigate the effect of different proficiency value data sets on simulator training courses, we (1) compared 2 published expert performance data sets for the LapSim laparoscopic virtual-reality simulator (by van Dongen et al. and Heinrichs et al.) and (2) assessed the effect of using either set on LapSim training data obtained from 16 local residents in surgery and gynecology.
  
  
  RESULTS
  Across all simulator tasks, the experts consulted by van Dongen et al. performed better on motion efficiency, but not on duration or damage control. Applying both proficiency sets to training data collected during a basic skills laparoscopic simulator course, residents would have graduated on an average in 1.5 fewer sessions using the Heinrichs expert values compared with the van Dongen expert values.
  
  
  CONCLUSIONS
  The selection of proficiency values for proficiency-based simulator training courses affects training length, skills level assessment, and training costs. Standardized, well-controlled methods are necessary to create valid and reliable expert values for use in training and research.
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Operating Rooms, Radboud Universty Medical Center, Nijmegen, The Netherlands. Electronic address: jan-maarten.luursema@radboudumc.nl.
authors.forename: Jan-Maarten
authors.initials: JM
authors.lastname: Luursema
authors.affiliation: Department of Operating Rooms, Radboud Universty Medical Center, Nijmegen, The Netherlands; Department of Epidemiology, Biostatistics & HTA, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Maroeska M
authors.initials: MM
authors.lastname: Rovers
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Alken
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: Kengen
authors.affiliation: Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D013502:General Surgery / Q000193:education*; D006176:Gynecology / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy / Q000193:education*; D008297:Male; D000066908:Simulation Training
keywords: Practice-Based Learning and Improvement; Professionalism; Systems-Based Practice; expert performance; laparoscopy; performance development; proficiency-based training; simulation; standardization