title: Motion Analysis-Based Skills Training and Assessment in Pediatric Laparoscopy: Construct, Concurrent, and Content Validity for the eoSim Simulator.
abstract: OBJECTIVE
  To validate the eoSim(®) (eoSurgical Ltd., Edinburgh, Scotland, United Kingdom) simulator for pediatric laparoscopy.
  
  
  METHODS
  Participants were stratified according to their pediatric laparoscopy expertise. Three tasks were tested on the Pediatric Laparoscopic Surgery (PLS) and adapted eoSim simulators. Skill assessment was undertaken using motion analysis software for eoSim tasks and an existing validated scoring system for PLS tasks. Content validity was determined using Likert scale graded feedback responses. Construct validity was evaluated by investigating the respective abilities of the eoSim and PLS assessment tools to differentiate levels of experience. Concurrent validity was investigated by assessing the relationship between PLS and eoSim task completion times.
  
  
  RESULTS
  In total, 28 participants (8 experts, 7 intermediates, and 13 novices) were recruited. Content validity results were comparable or more favorable for the eoSim. Construct validity for motion analysis parameters was established for instrument path length (objects transfer, P = .025; suturing, P = .012), speed (suturing, P = .034), acceleration (suturing, P = .048), and smoothness (suturing, P < .001). For all tasks, there were significant differences between level of experience groups for eoSim task completion times and PLS scores (P = .038 to < .001). Significant relationships were found between eoSim and PLS task completion times for the precision cutting and suturing tasks (ρ = 0.298 and ρ = 0.435, respectively).
  
  
  CONCLUSIONS
  This study demonstrates validity of the adapted eoSim simulator for training in pediatric laparoscopy. Future work should focus on implementing and evaluating the proficiency-based training curriculum that is proposed using construct validity-derived metrics.
authors.affiliation: 1 Department of Paediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust , London, United Kingdom .
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Retrosi
authors.affiliation: 2 Discipline of Surgery, University of Adelaide , Adelaide, South Australia, Australia .
authors.forename: Thomas
authors.initials: T
authors.lastname: Cundy
authors.affiliation: 1 Department of Paediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust , London, United Kingdom .
authors.forename: Munther
authors.initials: M
authors.lastname: Haddad
authors.affiliation: 1 Department of Paediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust , London, United Kingdom .
authors.forename: Simon
authors.initials: S
authors.lastname: Clarke
mesh_terms: D000328:Adult; D002648:Child; D002983:Clinical Competence; D003198:Computer Simulation; D005260:Female; D005762:Gastroenterology / Q000193:education*; D006801:Humans; D010535:Laparoscopy / Q000193:education*; D008297:Male; D010372:Pediatrics / Q000193:education*; D010820:Physicians / Q000592:standards*; D013996:Time and Motion Studies