title: The Fundamentals of Laparoscopic Surgery and LapVR evaluation metrics may not correlate with operative performance in a novice cohort.
abstract: BACKGROUND
  Considerable resources have been invested in both low- and high-fidelity simulators in surgical training. The purpose of this study was to investigate if the Fundamentals of Laparoscopic Surgery (FLS, low-fidelity box trainer) and LapVR (high-fidelity virtual reality) training systems correlate with operative performance on the Global Operative Assessment of Laparoscopic Skills (GOALS) global rating scale using a porcine cholecystectomy model in a novice surgical group with minimal laparoscopic experience.
  
  
  METHODS
  Fourteen postgraduate year 1 surgical residents with minimal laparoscopic experience performed tasks from the FLS program and the LapVR simulator as well as a live porcine laparoscopic cholecystectomy. Performance was evaluated using standardized FLS metrics, automatic computer evaluations, and a validated global rating scale.
  
  
  RESULTS
  Overall, FLS score did not show an association with GOALS global rating scale score on the porcine cholecystectomy. None of the five LapVR task scores were significantly associated with GOALS score on the porcine cholecystectomy.
  
  
  CONCLUSIONS
  Neither the low-fidelity box trainer or the high-fidelity virtual simulator demonstrated significant correlation with GOALS operative scores. These findings offer caution against the use of these modalities for brief assessments of novice surgical trainees, especially for predictive or selection purposes.
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada; snsteigerwald@gmail.com.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Steigerwald
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Krista M
authors.initials: KM
authors.lastname: Hardy
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Gillman
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Ashley S
authors.initials: AS
authors.lastname: Vergis
mesh_terms: D000818:Animals; D017081:Cholecystectomy, Laparoscopic / Q000193:education; D002983:Clinical Competence; D003198:Computer Simulation; D004521:Educational Measurement / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods; D010535:Laparoscopy / Q000193:education*; D008297:Male; D013552:Swine; D014584:User-Computer Interface
keywords: assessment; education; evaluation; novice; selection; simulation