Retrosi Giuseppe, Cundy Thomas, Haddad Munther, Clarke Simon
1 Department of Paediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust , London, United Kingdom .
2 Discipline of Surgery, University of Adelaide , Adelaide, South Australia, Australia .
J Laparoendosc Adv Surg Tech A. 2015 Nov;25(11):944-50. doi: 10.1089/lap.2015.0069. Epub 2015 Aug 10.
To validate the eoSim(®) (eoSurgical Ltd., Edinburgh, Scotland, United Kingdom) simulator for pediatric laparoscopy.
Participants were stratified according to their pediatric laparoscopy expertise. Three tasks were tested on the Pediatric Laparoscopic Surgery (PLS) and adapted eoSim simulators. Skill assessment was undertaken using motion analysis software for eoSim tasks and an existing validated scoring system for PLS tasks. Content validity was determined using Likert scale graded feedback responses. Construct validity was evaluated by investigating the respective abilities of the eoSim and PLS assessment tools to differentiate levels of experience. Concurrent validity was investigated by assessing the relationship between PLS and eoSim task completion times.
In total, 28 participants (8 experts, 7 intermediates, and 13 novices) were recruited. Content validity results were comparable or more favorable for the eoSim. Construct validity for motion analysis parameters was established for instrument path length (objects transfer, P = .025; suturing, P = .012), speed (suturing, P = .034), acceleration (suturing, P = .048), and smoothness (suturing, P < .001). For all tasks, there were significant differences between level of experience groups for eoSim task completion times and PLS scores (P = .038 to < .001). Significant relationships were found between eoSim and PLS task completion times for the precision cutting and suturing tasks (ρ = 0.298 and ρ = 0.435, respectively).
This study demonstrates validity of the adapted eoSim simulator for training in pediatric laparoscopy. Future work should focus on implementing and evaluating the proficiency-based training curriculum that is proposed using construct validity-derived metrics.
验证eoSim（®）模拟器（eoSurgical有限公司，爱丁堡，苏格兰，英国）用于小儿腹腔镜检查的有效性。
参与者根据其小儿腹腔镜检查专业知识进行分层。在小儿腹腔镜手术（PLS）和改良的eoSim模拟器上测试了三项任务。使用针对eoSim任务的运动分析软件和针对PLS任务的现有有效评分系统进行技能评估。使用李克特量表分级反馈回答来确定内容效度。通过调查eoSim和PLS评估工具区分经验水平的各自能力来评估结构效度。通过评估PLS和eoSim任务完成时间之间的关系来研究同时效度。
总共招募了28名参与者（8名专家、7名中级人员和13名新手）。eoSim的内容效度结果相当或更有利。针对器械路径长度（物体转移，P = 0.025；缝合，P = 0.012）、速度（缝合，P = 0.034）、加速度（缝合，P = 0.048）和平滑度（缝合，P < 0.001）建立了运动分析参数的结构效度。对于所有任务，eoSim任务完成时间和PLS评分在经验水平组之间存在显著差异（P = 0.038至<0.001）。在精确切割和缝合任务中，eoSim和PLS任务完成时间之间存在显著关系（分别为ρ = 0.298和ρ = 0.435）。
本研究证明了改良的eoSim模拟器用于小儿腹腔镜检查培训的有效性。未来的工作应集中在实施和评估使用基于结构效度得出的指标提出的基于熟练程度的培训课程。
