title: Appraisal of face and content validity of a serious game improving situational awareness in surgical training.
abstract: BACKGROUND
  Equipment-related malfunctions during minimally invasive surgery (MIS) are common and threaten patient safety. As they occur in the periphery of the surgeon's vision, the surgical team requires a high level of situational awareness in order to intercept these errors timely. A serious game has been developed to train surgical residents to deal with equipment-related errors. This study investigates to what extent surgical educators and trainees would accept a serious game as a training method.
  
  
  METHODS
  A cross-sectional survey was conducted among 45 surgeons, surgical residents, and medical students who played the serious game at a scientific convention. The questionnaire contained statements on perceived realism, usefulness, teaching capability, user experience and application toward surgical training. RESULTS were analyzed according to participants' MIS experience ("expert," "intermediate," and "novice").
  
  
  RESULTS
  The majority found that important medical constructs are represented realistically (64.4%-88.9%) and indicated the game to be particularly useful for training operating room nurses and surgical residents (75%-86%). Both educators and trainees found the game to be useful for surgical training (53%). Serious gaming was viewed as positive (78%) and challenging (60%), and 66% would play the game in their leisure time. Licensed surgeons perceived the game more frequently as boring than the intermediate-level and trainee groups (23.5% versus 6.7% and 8.3%; P=.045).
  
  
  CONCLUSIONS
  This is the first study to show acceptance of a serious game as a training format in surgical training by educators and trainees. Future research should investigate whether the serious game indeed improves problem-solving and situational awareness in the operating room.
authors.affiliation: Department of Surgery, Academic Medical Centre , Amsterdam, The Netherlands .
authors.forename: Maurits
authors.initials: M
authors.lastname: Graafland
authors.forename: Willem A
authors.initials: WA
authors.lastname: Bemelman
authors.forename: Marlies P
authors.initials: MP
authors.lastname: Schijven
mesh_terms: D000328:Adult; D001364:Awareness / Q000502:physiology*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005149:Facial Expression; D005260:Female; D005717:Games, Experimental; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D010820:Physicians / Q000523:psychology*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires