title: Robotic surgery simulation validity and usability comparative analysis.
abstract: The introduction of simulation into minimally invasive robotic surgery is relatively recent and has seen rapid advancement; therefore, a need exists to develop training curriculums and identify systems that will be most effective at training surgical skills. Several simulators have been introduced to support these aims-the daVinci skills simulator, Mimic dV-Trainer, Surgical Simulated Systems' RoSS, and Simbionix Robotix Mentor. While multiple studies have been conducted to demonstrate the validity of these systems, studies comparing the perceived value of these devices as tools for education and skills are lacking.
  
  
  
  Subjects who qualified as medical students or physicians (n = 105) were assigned a specific order to use each of the three simulators. After completing a demographic questionnaire, participants performed one exercise on the three simulators and completed a second questionnaire regarding their experience with the device. After using all systems, they completed a final questionnaire, which detailed their comparative preferences. The subject's performance metrics were also collected from each simulator.
  
  
  
  The data confirmed the face, content, and construct validity for the dV-trainer and skills simulator. Similar validities could not be confirmed for the RoSS. >80 % of the time, participants chose the skills simulator in terms of physical comfort, ergonomics, and overall choice. However, only 55 % thought the skills simulator was worth the cost of the equipment. The dV-Trainer had the highest cost preference scores with 71 % of respondents feeling it was worth the investment.
  
  
  
  Usability can affect the consistency and commitment of users of robotic surgical simulators. In a previous study, these simulators were objectively reviewed and compared in terms of their system capabilities. Collectively, this work will offer end-users and potential buyers a comparison of the perceived value and preferences of robotic simulators.
authors.affiliation: Florida Hospital Nicholson Center, 404 Celebration Place, Celebration, FL, 34747, USA. Alyssa.tanaka@flhosp.org.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Florida Hospital Celebration Health, Celebration, FL, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Graddy
authors.affiliation: Columbia University Medical Center, New York, NY, USA.
authors.forename: Khara
authors.initials: K
authors.lastname: Simpson
authors.affiliation: University of Lorraine-Nancy, Nancy, FR, USA.
authors.forename: Manuela
authors.initials: M
authors.lastname: Perez
authors.affiliation: Columbia University Medical Center, New York, NY, USA.
authors.forename: Mireille
authors.initials: M
authors.lastname: Truong
authors.affiliation: Florida Hospital Nicholson Center, 404 Celebration Place, Celebration, FL, 34747, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Smith
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D015203:Reproducibility of Results; D065287:Robotic Surgical Procedures / Q000193:education*; D011795:Surveys and Questionnaires
keywords: Robotic surgery; Simulation; Training; Usability; Validation