Elsevier

Urology

Volume 80, Issue 2, August 2012, Pages 330-336
Urology

Laparoscopy and Robotics
da Vinci Skills Simulator Construct Validation Study: Correlation of Prior Robotic Experience With Overall Score and Time Score Simulator Performance

https://doi.org/10.1016/j.urology.2012.02.059Get rights and content

Objective

To assess the construct validity of the da Vinci Skills Simulator (Intuitive Surgical, Sunnyvale, CA). Ideally, a well-designed simulator should demonstrate construct validity, which is defined in this study as the correlation between robotic surgical experience and performance on the simulator.

Patients and Methods

Thirty-nine surgeons (18 [46%] group I [0-20 robotic cases]; 8 [21%] group II [21-150 robotic cases]; and 13 [33%] group III [>150 robotic cases]) were enrolled from September 2010 to December 2010. Participants completed 24 virtual-reality exercises on the da Vinci Skills Simulator. Data on 12 performance metrics were collected by the software. Overall means for score and time across exercises were analyzed.

Results

Overall scores (64.7%/79.1%/87.4%) and time scores (39.1%/58.6%/87.3%) were significantly different among surgeons in groups I-III (P <.001) and demonstrated significant linear relationships (P <.001) for all 24 exercises. Comparisons between the 3 groups using a univariate general linear model (GLM) was used to compare groups I and II and II and III. Groups I and II differed using overall score for 15 exercises and time score for 11 exercises. Groups II and III differed using overall score for 6 exercises and time score for 15 exercises. Mean overall score for 1 exercise displayed significance between both groups I and II and II and III; while using time score, 5 exercises displayed significance between surgeons in groups I and II and II and III.

Conclusion

Initial construct validity analysis revealed that both overall scores and time scores showed a significant linear relationship when comparing the surgeons in groups I, II, and III. Overall score seems to be a stronger indicator for differences between surgeons in groups I and II. Time score seems to be a stronger indicator for differences between surgeons in groups II and III.

Section snippets

Material and Methods

Thirty-nine robotic surgeons completed 24 consecutive exercises on the robotic simulator; each exercise was completed only once and no surgeon had prior experience on the da Vinci Skills Simulator. Participants included general surgeons (11), gynecologists (16), and urologists (12). Twenty-seven were practicing surgeons, 3 were fellows, and 9 were residents (2-PGY II, 4-PGY III, 3-PGY IV). This study was completed at one academic institution and the participants came from both academic and

Results

The overall scores were 64.7% (standard error [SE] 13.4) for group I, 79.1% (SE 5.5) for group II, and 87.4% (SE 3.9) for group III. Between the 3 groups, the overall scores were both statistically significant (P <.001) and demonstrated a significant linear relationship (P <.001). Total time scores were 39.1% (SE 17.7) for group I, 58.6% (SE 21.2) for group II, and 87.3% (SE 8.6) for group III and were also both statistically significant (P <.001) and demonstrated a significant linear

Comment

Compared with prior published studies, this study had a high number of participants of varying prior experience and each participant performed all the simulator exercises,24 providing a comprehensive picture of robotic simulator performance. The complete 24-exercise set took surgeons between 1.5 and 4 hours to complete and used 12 performance metrics. There was a significant linear relationship between the 3 groups of robotic surgeons: group I, group II, and group III, in the analysis of both

Conclusions

Initial construct validity analysis of the da Vinci Skills Simulator revealed that increased simulator performance, as measured by overall scores and time scores correlated with surgeons who reported a greater number of prior robotic procedures. Simulation training has the potential to increase psychomotor skills and platform familiarity before there is patient contact. Future studies are needed to determine whether the use of simulation technology increases robotic proficiency of both

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    In 2010, Mimic collaborated with Intuitive Surgical (Sunnyvale, CA) (developers of the da Vinci surgical robot) to adapt its software suite to the da Vinci console, creating the DVSS. The most obvious advantage of the DVSS is that the simulator and console are one and the same, but it is also the most well-validated: By virtue of using the same software, the validation studies for the dV-Trainer can be extrapolated to the DVSS, and additional studies have further supported the face, content, construct, concurrent, and predictive validity of the DVSS specifically.27–31 The DVSS is officially supported by Intuitive in its Da Vinci Residency and Fellowship Training Program Implementation Guide.32

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Financial Disclosure: The authors declare that they have no relevant financial interests.

Funding Support: Intuitive Surgical, Sunnyvale, CA (Hartford Hospital Department of Research conducted the study; collected, managed, analyzed, and interpreted the data; prepared and edited the manuscript).

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