Korndorffer James R, Clayton John L, Tesfay Seifu T, Brunner William C, Sierra Rafael, Dunne J Bruce, Jones Daniel B, Rege Robert V, Touchard Cheri L, Scott Daniel J
Tulane Center for Minimally Invasive Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699, USA.
J Surg Res. 2005 Sep;128(1):114-9. doi: 10.1016/j.jss.2005.03.014.
The "Southwestern" videotrainer stations have demonstrated concurrent validity (transferability to the operating room). The purpose of this study was to evaluate the Southwestern stations for construct validity (the ability to discriminate between subjects at different levels of experience).
From two surgical training programs, Institutional Review Board approved protocol data were collected from 142 subjects, including novice (medical students and R1, n = 66), intermediate (R2-R4, n = 67), and advanced (R5 and expert surgeons, n = 9) groups. All participants performed three repetitions on each of five stations. Completion time was scored for each task. Laparoscopic experience was determined from residency case log databases and from expert surgeon personal case logs. Results for the three groups were compared using one-way ANOVA, including relevant pair-wise comparisons. Correlations between number of laparoscopic cases performed and task scores were determined by Pearson's and Spearman's rho-correlation coefficients.
The mean number of laparoscopic cases performed prior to completing the five tasks was 0 for novices, 9 for intermediates, and 431 for the advanced group. Significant differences (P < 0.001) were noted between groups for all five tasks and composite score. Task scores and composite scores significantly correlated with laparoscopic experience (P < 0.01).
These data suggest that differences in laparoscopic ability are detected by performance on the videotrainer; thus, construct validity is demonstrated. Moreover, scores accurately reflect laparoscopic experience. Further validation may allow such simulators to be used for testing and credentialing purposes.
“西南”视频训练站已证明具有同时效度（可转移至手术室）。本研究的目的是评估西南训练站的结构效度（区分不同经验水平受试者的能力）。
从两个外科培训项目中，收集了经机构审查委员会批准的方案数据，共142名受试者，包括新手组（医学生和第一年住院医师，n = 66）、中级组（第二年至第四年住院医师，n = 67）和高级组（第五年住院医师和专家外科医生，n = 9）。所有参与者在五个训练站各进行三次重复操作。记录每个任务的完成时间。通过住院医师病例记录数据库和专家外科医生个人病例记录确定腹腔镜手术经验。使用单因素方差分析比较三组结果，包括相关的两两比较。通过Pearson和Spearman相关系数确定腹腔镜手术病例数与任务分数之间的相关性。
在完成五项任务之前，新手组腹腔镜手术病例的平均数量为0，中级组为9，高级组为431。所有五项任务和综合评分在三组之间均存在显著差异（P < 0.001）。任务分数和综合评分与腹腔镜手术经验显著相关（P < 0.01）。
这些数据表明，视频训练器的操作表现能够检测出腹腔镜手术能力的差异；因此，证明了结构效度。此外，分数准确反映了腹腔镜手术经验。进一步验证可能会使此类模拟器用于测试和认证目的。
