Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, Macdonald Engineering Building, 815 Sherbrooke St W, Montreal, QC, H3A 2K7, Canada.
Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology & Neurosurgery, Montreal Neurological Institute, McGill University, 2200 Leo Pariseau, Suite 2210, Montreal, QC, H2X 4B3, Canada.
Med Biol Eng Comput. 2024 Jun;62(6):1887-1897. doi: 10.1007/s11517-024-03053-8. Epub 2024 Feb 26.
Mixed-reality surgical simulators are seen more objective than conventional training. The simulators' utility in training must be established through validation studies. Establish face-, content-, and construct-validity of a novel mixed-reality surgical simulator developed by McGill University, CAE-Healthcare, and DePuy Synthes. This study, approved by a Research Ethics Board, examined a simulated L4-L5 oblique lateral lumbar interbody fusion (OLLIF) scenario. A 5-point Likert scale questionnaire was used. Chi-square test verified validity consensus. Construct validity investigated 276 surgical performance metrics across three groups, using ANOVA, Welch-ANOVA, or Kruskal-Wallis tests. A post-hoc Dunn's test with a Bonferroni correction was used for further analysis on significant metrics. Musculoskeletal Biomechanics Research Lab, McGill University, Montreal, Canada. DePuy Synthes, Johnson & Johnson Family of Companies, research lab. Thirty-four participants were recruited: spine surgeons, fellows, neurosurgical, and orthopedic residents. Only seven surgeons out of the 34 were recruited in a side-by-side cadaver trial, where participants completed an OLLIF surgery first on a cadaver and then immediately on the simulator. Participants were separated a priori into three groups: post-, senior-, and junior-residents. Post-residents rated validity, median > 3, for 13/20 face-validity and 9/25 content-validity statements. Seven face-validity and 12 content-validity statements were rated neutral. Chi-square test indicated agreeability between group responses. Construct validity found eight metrics with significant differences (p < 0.05) between the three groups. Validity was established. Most face-validity statements were positively rated, with few neutrally rated pertaining to the simulation's graphics. Although fewer content-validity statements were validated, most were rated neutral (only four were negatively rated). The findings underscored the importance of using realistic physics-based forces in surgical simulations. Construct validity demonstrated the simulator's capacity to differentiate surgical expertise.
混合现实手术模拟器被认为比传统培训更客观。模拟器在培训中的效用必须通过验证研究来建立。本研究旨在通过验证研究来确定由麦吉尔大学、CAE-Healthcare 和 DePuy Synthes 开发的新型混合现实手术模拟器的表面效度、内容效度和结构效度。这项研究得到了伦理委员会的批准，检验了一个模拟的 L4-L5 斜外侧腰椎椎间融合术（OLLIF）场景。使用 5 分李克特量表问卷调查。卡方检验验证了有效性共识。结构效度研究了三组共 276 项手术绩效指标，使用方差分析、Welch-ANOVA 或 Kruskal-Wallis 检验。对于具有统计学意义的指标，使用事后 Dunn 检验和 Bonferroni 校正进行进一步分析。加拿大蒙特利尔麦吉尔大学肌肉骨骼生物力学研究实验室。DePuy Synthes，Johnson & Johnson 公司的研究实验室。共招募了 34 名参与者：脊柱外科医生、研究员、神经外科医生和骨科住院医师。只有 7 名外科医生参加了尸体旁对比试验，他们首先在尸体上完成了 OLLIF 手术，然后立即在模拟器上完成。参与者事先被分为三组：住院医师后期、高级住院医师和初级住院医师。住院医师后期对 20 项表面有效性和 9 项内容有效性声明中的 13 项和 9 项进行了有效性评分，中位数>3。7 项表面有效性和 12 项内容有效性声明的评分是中立的。卡方检验表明，组间反应具有一致性。结构效度发现，三组间有 8 项指标存在显著差异（p<0.05）。该研究确立了有效性。大多数表面有效性声明得到了积极评价，只有少数与模拟的图形相关的声明评价为中立。尽管内容有效性声明中只有少数得到验证，但大多数评价为中立（只有四项为负面评价）。这些发现强调了在手术模拟中使用基于真实物理力的重要性。结构效度表明，模拟器具有区分手术专业知识的能力。
