Sankaranarayanan Ganesh, Lin Henry, Arikatla Venkata S, Mulcare Maureen, Zhang Likun, Derevianko Alexandre, Lim Robert, Fobert David, Cao Caroline, Schwaitzberg Steven D, Jones Daniel B, De Suvranu
Department of Mechanical, Aerospace, and Nuclear Engineering, Rensselaer Polytechnic Institute, Troy, New York, USA.
J Laparoendosc Adv Surg Tech A. 2010 Mar;20(2):153-7. doi: 10.1089/lap.2009.0030.
The Virtual Basic Laparoscopic Skill Trainer (VBLaST) is a developing virtual-reality-based surgical skill training system that incorporates several of the tasks of the Fundamentals of Laparoscopic Surgery (FLS) training system. This study aimed to evaluate the face and construct validity of the VBLaST system.
Thirty-nine subjects were voluntarily recruited at the Beth Israel Deaconess Medical Center (Boston, MA) and classified into two groups: experts (PGY 5, fellow and practicing surgeons) and novice (PGY 1-4). They were then asked to perform three FLS tasks, consisting of peg transfer, pattern cutting, and endoloop, on both the VBLaST and FLS systems. The VBLaST performance scores were automatically computed, while the FLS scores were rated by a trained evaluator. Face validity was assessed using a 5-point Likert scale, varying from not realistic/useful (1) to very realistic/useful (5).
Face-validity scores showed that the VBLaST system was significantly realistic in portraying the three FLS tasks (3.95 +/- 0.909), as well as the reality in trocar placement and tool movements (3.67 +/- 0.874). Construct-validity results show that VBLaST was able to differentiate between the expert and novice group (P = 0.015). However, of the two tasks used for evaluating VBLaST, only the peg-transfer task showed a significant difference between the expert and novice groups (P = 0.003). Spearman correlation coefficient analysis between the two scores showed significant correlation for the peg-transfer task (Spearman coefficient 0.364; P = 0.023).
VBLaST demonstrated significant face and construct validity. A further set of studies, involving improvement to the current VBLaST system, is needed to thoroughly demonstrate face and construct validity for all the tasks.
虚拟基础腹腔镜技能训练器(VBLaST)是一种正在开发的基于虚拟现实的外科技能训练系统,它纳入了腹腔镜手术基础(FLS)训练系统的多项任务。本研究旨在评估VBLaST系统的表面效度和结构效度。
在贝斯以色列女执事医疗中心(马萨诸塞州波士顿)自愿招募了39名受试者,并将其分为两组:专家(住院医师第5年、研究员和执业外科医生)和新手(住院医师第1 - 4年)。然后要求他们在VBLaST和FLS系统上执行三项FLS任务,包括移钉、图案切割和内圈套扎。VBLaST的表现分数自动计算得出,而FLS分数由经过培训的评估人员评定。表面效度使用5点李克特量表进行评估,范围从不现实/无用(1)到非常现实/有用(5)。
表面效度分数显示,VBLaST系统在描绘三项FLS任务方面具有显著的现实性(3.95±0.909),以及在套管针放置和工具操作方面的现实性(3.67±0.874)。结构效度结果表明,VBLaST能够区分专家组和新手组(P = 0.015)。然而,在用于评估VBLaST的两项任务中,只有移钉任务在专家组和新手组之间显示出显著差异(P = 0.003)。两项分数之间的斯皮尔曼相关系数分析显示,移钉任务具有显著相关性(斯皮尔曼系数0.364;P = 0.023)。
VBLaST显示出显著的表面效度和结构效度。需要进一步开展一系列研究,包括对当前VBLaST系统进行改进,以全面证明所有任务的表面效度和结构效度。