title: Validation of the RobotiX Mentor Robotic Surgery Simulator.
abstract: OBJECTIVE
  To assess face, content, and construct validity of the RobotiX Mentor virtual reality simulator, to assess its acceptability as a robotic surgery training tool and feasibility of its use, and to develop a supplementary training curriculum.
  
  
  METHODS
  This prospective, observational, and comparative study recruited novice (n = 20), intermediate (n = 15), and expert (n = 11) robotic surgeons as participants from institutions across the United Kingdom and at the 30th European Association of Urology Annual Meeting. Each participant completed nine surgical tasks across two modules on the simulator, followed by a questionnaire to evaluate subjective realism (face validity), task importance (content validity), feasibility, and acceptability. Outcome measures of novice, intermediate, and expert groups were compared using Mann-Whitney U-tests to assess construct validity.
  
  
  RESULTS
  Construct validity was demonstrated in a total of 17/25 performance evaluation metrics (p < 0.001). Experts performed better than intermediates with regard to time taken to complete the first (p = 0.002) and second (p = 0.043) module, number of instrument collisions (p = 0.040), path length (p =  .049), number of cuts >2 mm deep (p = 0.033), average distance from suture target (p = 0.015), and number of suture breakages (p = 0.038). Participants determined both the simulator console and psychomotor tasks as highly realistic (mean: 3.7/5) and important for surgical training (4.5/5), with system pedals (4.2/5) and knot tying task (4.6/5) scoring highest, respectively. The simulator was also rated as an acceptable (4.3/5) tool for training and its use highly feasible (4.3/5).
  
  
  CONCLUSIONS
  Construct, face, and content validity was established for the RobotiX Mentor, and feasibility and acceptability of incorporation into surgical training were ascertained. The RobotiX Mentor shows potential as a valuable tool for training and assessment of trainees in robotic skills. Investigation of concurrent and predictive validity is necessary to complete validation, and evaluation of learning curves would provide insight into its value for training.
authors.affiliation: 1 School of Medical Education, King's College London , London, United Kingdom .
authors.forename: George
authors.initials: G
authors.lastname: Whittaker
authors.affiliation: 2 MRC Centre for Transplantation, King's College London , London, United Kingdom .
authors.forename: Abdullatif
authors.initials: A
authors.lastname: Aydin
authors.affiliation: 2 MRC Centre for Transplantation, King's College London , London, United Kingdom .
authors.forename: Nicholas
authors.initials: N
authors.lastname: Raison
authors.affiliation: 3 Department of Urology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Francesca
authors.initials: F
authors.lastname: Kum
authors.affiliation: 3 Department of Urology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Ben
authors.initials: B
authors.lastname: Challacombe
authors.affiliation: 2 MRC Centre for Transplantation, King's College London , London, United Kingdom .|3 Department of Urology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Muhammed Shamim
authors.initials: MS
authors.lastname: Khan
authors.affiliation: 2 MRC Centre for Transplantation, King's College London , London, United Kingdom .|3 Department of Urology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: 2 MRC Centre for Transplantation, King's College London , London, United Kingdom .|3 Department of Urology, Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D003198:Computer Simulation / Q000592:standards*; D003479:Curriculum; D006801:Humans; D059032:Learning Curve; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D065287:Robotic Surgical Procedures / Q000193:education*; D000066908:Simulation Training / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D013520:Urologic Surgical Procedures / Q000193:education*; D014572:Urology / Q000193:education*; D014584:User-Computer Interface; D055815:Young Adult