Does laparoscopic simulation predict intraoperative performance? A comparison between the Fundamentals of Laparoscopic Surgery and LapVR evaluation metrics.

BACKGROUND

Considerable resources have been invested in low- and high-fidelity simulators in surgical training. To our knowledge, no investigation has compared the 2 head to head for operative assessment purposes. The purpose of this study was to assess the Fundamentals of Laparoscopic Surgery (FLS) low-fidelity video trainer and LapVR (high-fidelity virtual-reality simulator) for (1) construct and (2) predictive validity using a human cholecystectomy model.

METHODS

Twenty-six participants performed tasks from the FLS program and the LapVR simulator as well as a human laparoscopic cholecystectomy. Performance was evaluated using FLS and LapVR metrics and the Objective Structured Assessment of Technical Skills previously validated rating scale.

RESULTS

Construct and predictive validity were strongly demonstrated for FLS tasks but only incompletely for LapVR.

CONCLUSIONS

Efforts should be focused on using the well-validated lower-cost FLS video trainer for assessment of laparoscopic skills. The high-cost LapVR remains experimental in resource-constrained training programs.