Yoon Renai, Del Junco Michael, Kaplan Adam, Okhunov Zhamshid, Bucur Philip, Hofmann Martin, Alipanah Reza, McDougall Elspeth M, Landman Jaime
Department of Urology, University of California, Irvine, California.
Department of Urologic Sciences, University of British Columbia, Vancouver, Canada.
J Surg Educ. 2015 Jan-Feb;72(1):41-6. doi: 10.1016/j.jsurg.2014.06.011. Epub 2014 Jul 19.
We developed the iTrainer (iT) as a portable laparoscopic trainer, which incorporates the iPad tablet. We then compared the iT with a standard pelvic trainer (SPT) to assess surgical skills as well as its image quality, resolution, brightness, comfort, and overall performance.
We designed and constructed the iT to be compatible with the Apple iPad 3 and standard laparoscopic instruments. Participants were assigned to perform the thread-the-loops task on both trainers and were prospectively randomized to start on either the iT or the SPT. Each participant was allowed a 2-minute warm-up before the 2-minute testing period. We scored participants using the product of skill quality (0-4 scale) and quantity of loops threaded (0-10 scale). Participants then rated each trainer on image quality, resolution, brightness, comfort, and overall performance on a 5-point Likert scale.
A total of 45 subjects including 10 undergraduates, 10 medical students, 10 general surgery and urology residents, and 15 experts (fellows and attending surgeons) participated in this study. There was no significant difference between thread-the-loops task scores completed on the iT when compared with the SPT for all groups tested (p > 0.05) with the exception of the medical student group, who performed better on the SPT (p < 0.05). On evaluation of each trainer, participants rated the iT as having superior image quality and resolution when compared with the SPT (p < 0.05) but rated the SPT higher in overall performance (p < 0.05). Brightness and comfort were rated similarly for both trainers.
We have demonstrated face validity and criterion validity for the thread-the-loops task on the iT. The iT rated superior in image quality and resolution but inferior in overall performance compared with the SPT. The iT provides trainees a unique advantage over SPT as an additional resource to laparoscopic training as it is inexpensive, portable, and can be readily available for training.
我们研发了iTrainer（iT）作为一款便携式腹腔镜训练器，它集成了iPad平板电脑。然后，我们将iT与标准盆腔训练器（SPT）进行比较，以评估手术技能及其图像质量、分辨率、亮度、舒适度和整体性能。
我们设计并制造了与苹果iPad 3和标准腹腔镜器械兼容的iT。参与者被分配在两种训练器上执行穿线环任务，并被前瞻性随机分组，从iT或SPT开始。每个参与者在2分钟测试期前有2分钟的热身时间。我们根据技能质量（0 - 4级）和穿线环数量（0 - 10级）的乘积对参与者进行评分。然后，参与者根据图像质量、分辨率、亮度、舒适度和整体性能，在5分制李克特量表上对每种训练器进行评分。
共有45名受试者参与了本研究，包括10名本科生、10名医学生、10名普通外科和泌尿外科住院医师以及15名专家（研究员和主治外科医生）。除医学生组在SPT上表现更好（p < 0.05）外，所有测试组在iT上完成的穿线环任务得分与SPT相比均无显著差异（p > 0.05）。在对每种训练器的评估中，与SPT相比，参与者认为iT的图像质量和分辨率更高（p < 0.05），但SPT的整体性能评分更高（p < 0.05）。两种训练器在亮度和舒适度方面的评分相似。
我们已经证明了iT上穿线环任务的表面效度和效标效度。与SPT相比，iT在图像质量和分辨率方面评分较高，但在整体性能方面较差。iT为受训者提供了优于SPT的独特优势，作为腹腔镜训练的额外资源，因为它价格低廉、便于携带，并且可以随时用于训练。
