Skip to main content
SpringerLink
Log in

Validation of a new basic virtual reality simulator for training of basic endoscopic skills

The SIMENDO

  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to establish content, face, concurrent, and the first step of construct validity of a new simulator, the SIMENDO, in order to determine its usefulness for training basic endoscopic skills.

Methods

The validation started with an explanation of the goals, content, and features of the simulator (content validity). Then, participants from eight different medical centers consisting of experts (≥100 laparoscopic procedures performed) and surgical trainees (<100) were informed of the goals and received a “hands-on tour” of the virtual reality (VR) trainer. Subsequently, they were asked to answer 28 structured questions about the simulator (face validity). Ratings were scored on a scale from 1 (very bad/useless) to 5 (excellent/very useful). Additional comments could be given as well. Furthermore, two experiments were conducted. In experiment 1, aimed at establishing concurrent validity, the training effect of a single-handed hand–eye coordination task in the simulator was compared with a similar task in a conventional box trainer and with the performance of a control group that received no training. In experiment 2 (first step of construct validity), the total score of task time, collisions, and path length of three consecutive runs in the simulator was compared between experts (>100 endoscopic procedures) and novices (no experience).

Results

A total of 75 participants (36 expert surgeons and 39 surgical trainees) filled out the questionnaire. Usefulness of tasks, features, and movement realism were scored between a mean value of 3.3 for depth perception and 4.3 for appreciation of training with the instrument. There were no significant differences between the mean values of the scores given by the experts and surgical trainees. In response to statements, 81% considered this VR trainer generally useful for training endoscopic techniques to residents, and 83% agreed that the simulator was useful to train hand–eye coordination. In experiment 1, the training effect for the single-handed task showed no significant difference between the conventional trainer and the VR simulator (concurrent validity). In experiment 2, experts scored significantly better than novices on all parameters used (construct validity).

Conclusion

Content, face, and concurrent validity of the SIMENDO is established. The simulator is considered useful for training eye–hand coordination for endoscopic surgery. The evaluated task could discriminate between the skills of experienced surgeons and novices, giving the first indication of construct validity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Aggarwal R, Darzi A (2004) Surgical education and training in the new millennium. Surg Endosc 18: 1409–1410

    Article  CAS  PubMed  Google Scholar 

  2. Aggarwal R, Moorthy K, Darzi A (2004) Laparoscopic skills training and assessment. Br J Surg 91: 1549–1558

    CAS  PubMed  Google Scholar 

  3. Ali MR, et al. (2002) Training the novice in laparoscopy. More challenge is better. Surg Endosc 16: 1732–1736

    CAS  Google Scholar 

  4. Babineau TJ, et al. (2004) The “cost” of operative training for surgical residents. Arch Surg 139: 366–370

    PubMed  Google Scholar 

  5. Bridges M, Diamond DL (1999) The financial impact of teaching surgical residents in the operating room. Am J Surg 177: 28–32

    Article  CAS  PubMed  Google Scholar 

  6. Champion HR, Gallagher AG (2003) Surgical simulation—a “good idea whose time has come.” Br J Surg 90: 767–768

    Article  CAS  PubMed  Google Scholar 

  7. Duffy AJ, et al. (2005) Construct validity for the LAPSIM laparoscopic surgical simulator. Surg Endosc 19: 401– 405

    Article  CAS  PubMed  Google Scholar 

  8. Emken JL, McDougall EM, Clayman RV (2004) Training and assessment of laparoscopic skills. J Soc Laparoendosc Surg 8: 195–199

    Google Scholar 

  9. Feldman LS, Sherman V, Fried GM (2004) Using simulators to assess laparoscopic competence: ready for widespread use? Surgery 135: 28–42

    PubMed  Google Scholar 

  10. Gallagher AG, Ritter EM, Satava RM (2003) Fundamental principles of validation and reliability: rigorous science for the assessment of surgical education and training. Surg Endosc 17: 1525–1529

    CAS  PubMed  Google Scholar 

  11. Gallagher AG, et al. (1999) Virtual reality training in laparoscopic surgery: a preliminary assessment of Minimally Invasive Surgical Trainer Virtual Reality (MIST VR). Endoscopy 31: 310–313

    Article  CAS  PubMed  Google Scholar 

  12. Gallagher AG, et al. (2001) Objective psychomotor skills assessment of experienced, junior, and novice laparoscopists with virtual reality. World J Surg 25: 1478–1483

    CAS  PubMed  Google Scholar 

  13. Gallagher AG, et al. (2004) Discriminative validity of the Minimally Invasive Surgical Trainer in Virtual Reality (MIST-VR) using criteria levels based on expert performance. Surg Endosc 18: 660–665

    Article  CAS  PubMed  Google Scholar 

  14. Gallagher AG, et al. (2005) Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 241: 364–372

    Article  PubMed  Google Scholar 

  15. Grantcharov TP, et al. (2001) Virtual reality computer simulation. Surg Endosc 15: 242–244

    Article  CAS  PubMed  Google Scholar 

  16. Grantcharov TP, et al. (2004) Randomized clinical trial of virtual reality simulation for laparoscopic skills training. Br J Surg 91: 146–150

    Article  CAS  PubMed  Google Scholar 

  17. Haluck RS (2005) Computer-based surgical simulation is too expensive. Or is it? Surg Endosc 19: 159–160

    CAS  Google Scholar 

  18. Haluck RS, et al. (2001) Are surgery training programs ready for virtual reality? A survey of program directors in general surgery. J Am Coll Surg 193: 660–665

    Article  CAS  PubMed  Google Scholar 

  19. Heijnsdijk EA, et al. (2004) The influence of force feedback and visual feedback in grasping tissue laparoscopically. Surg Endosc 18: 980–985

    CAS  PubMed  Google Scholar 

  20. Krummel TM (1998) Surgical simulation and virtual reality: the coming revolution. Ann Surg 228: 635–637

    Article  CAS  PubMed  Google Scholar 

  21. Lehmann KS, et al. (2005) A prospective randomized study to test the transfer of basic psychomotor skills from virtual reality to physical reality in a comparable training setting. Ann Surg 241: 442–449

    Article  PubMed  Google Scholar 

  22. Mac Fadyen BV Jr (2004) Teaching, training, and clinical surgery. Are we making a difference. Surg Endosc 18: 361–362

    Google Scholar 

  23. Marshall RL, et al. (2000) Practical training for postgraduate year 1 surgery residents. Am J Surg 179: 194–196

    Article  CAS  PubMed  Google Scholar 

  24. Pearson AM, et al. (2002) Evaluation of structured and quantitative training methods for teaching intracorporeal knot tying. Surg Endosc 16: 130–137

    Article  CAS  PubMed  Google Scholar 

  25. Schijven M, Jakimowicz J (2002) Face-, expert, and referent validity of the Xitact LS500 laparoscopy simulator. Surg Endosc 16: 1764–1770

    CAS  PubMed  Google Scholar 

  26. Schijven M, Jakimowicz J (2003) Construct validity: experts and novices performing on the Xitact LS500 laparoscopy simulator. Surg Endosc 17: 803–810

    CAS  PubMed  Google Scholar 

  27. Schijven M, Jakimowicz J (2003) Virtual reality surgical laparoscopic simulators. Surg Endosc 17: 1943–1950

    CAS  PubMed  Google Scholar 

  28. Seymour NE, et al. (2002) Virtual reality training improves operating room performance: results of a randomized, double-blinded study. Ann Surg 236: 458–464

    Article  PubMed  Google Scholar 

  29. Taffinder N, et al. (1998) Validation of virtual reality to teach and assess psychomotor skills in laparoscopic surgery: results from randomised controlled studies using the MIST VR laparoscopic simulator. Stud Health Technol Inform 50: 124–130

    CAS  PubMed  Google Scholar 

  30. Torkington J, et al. (2000) The role of simulation in surgical training. Ann R Coll Surg Engl 82: 88–94

    CAS  PubMed  Google Scholar 

  31. Torkington J, et al. (2001) Skill transfer from virtual reality to a real laparoscopic task. Surg Endosc 15: 1076–1079

    CAS  PubMed  Google Scholar 

  32. Villegas L, et al. (2003) Laparoscopic skills training. Surg Endosc 17: 1879–1888

    CAS  PubMed  Google Scholar 

  33. Wentink M (2003) Hand–eye coordination in minimally invasive surgery. Theory, surgical practice & training. Faculty of Mechanical Engineering and Marine Technology, Delft University of Technology, Delft, The Netherlands

Download references

Author information

Authors and Affiliations

  1. Man Machine Systems Group, Faculty of Mechanical, Maritime & Materials Engineering, Delft University of Technology, Mekelweg 2, CD Delft, 2628, The Netherlands

    E. G. G. Verdaasdonk, L. P. S. Stassen, L. J. Monteny & J. Dankelman

  2. Department of Surgery, Reinier de Graaf Group, Reiniere de Graatweg 3-11, AD Delft, 2625, The Netherlands

    E. G. G. Verdaasdonk & L. P. S. Stassen

Authors
  1. E. G. G. Verdaasdonk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L. P. S. Stassen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. J. Monteny
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Dankelman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. G. G. Verdaasdonk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Verdaasdonk, E.G.G., Stassen, L.P.S., Monteny, L.J. et al. Validation of a new basic virtual reality simulator for training of basic endoscopic skills. Surg Endosc 20, 511–518 (2006). https://doi.org/10.1007/s00464-005-0230-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-005-0230-6

Keywords

Search

Navigation