title: Validation of a high-fidelity model in ureteroscopy incorporating hand motion analysis.
abstract: OBJECTIVE
  To establish the construct validity of a semirigid ureteroscopy in a high-fidelity simulation model, incorporating hand motion analysis as a paramount part of evaluation.
  
  
  METHODS
  Participants were divided into 3 groups: group 1 (9 junior residents, without experience in ureteroscopy), group II (9 senior residents, with variable experience in ureteroscopy) and group III (2 experts in endourologist); each group performed a single practice session in the high-fidelity bench model, which was previously prepared with small urinary stone phantom in the mid-ureter. Assessment was done using motion tracking device (ICSAD). Procedures were recorded in external vision and endoscopic vision and scored by two blinded evaluators using a Global Rating Scale and ureteral checklist (OSATS).
  
  
  RESULTS
  Significant differences were observed in time taken, path length, numbers of movements, Global Rating Scale and checklist in favor of the experts group. Subanalysis demonstrated no relevant differences between groups II and III in general dexterity parameters except for the non-dominant hand, where experts showed a significant less number of movement (34 vs 221; p = 0.03) and path length (12.1 vs 45.1; p = 0.03). The interrater reliability of the GRS was excellent (0.81; p < 0.001), while for checklist ICC was moderate (0.45; p = 0.03).
  
  
  CONCLUSIONS
  The incorporation of ICSAD into the construct validity of this ureteroscopy model complements traditional methods used to achieve construct validity (OSATS). To our knowledge, this study is the first report using motion analysis as a tool for performance evaluation in a simulated endourological procedure.
authors.affiliation: Pontificia Universidad Católica de Chile, Santiago, Chile.
authors.forename: José A
authors.initials: JA
authors.lastname: Salvadó
authors.forename: Felipe
authors.initials: F
authors.lastname: Oyanedel
authors.forename: Sebastian
authors.initials: S
authors.lastname: Sepúlveda
authors.forename: Hernán
authors.initials: H
authors.lastname: Toledo
authors.forename: Álvaro
authors.initials: Á
authors.lastname: Saavedra
authors.forename: Gaston
authors.initials: G
authors.lastname: Astroza
authors.forename: Lucas
authors.initials: L
authors.lastname: Consigliere
mesh_terms: D002983:Clinical Competence; D006225:Hand; D006801:Humans; D007396:Internship and Residency; D009048:Motor Skills / Q000502:physiology*; D015203:Reproducibility of Results; D018666:Ureteroscopy / Q000193:education*; D014572:Urology / Q000193:education*; D014584:User-Computer Interface