Assessing Quality of Operative Performance in Virtual Reality Laparoscopic Cholecystectomy by Trainees

There has been an increase number of virtual reality simulators available, aiming to improve the training of surgeons. However the type of technical skills assessment tool which can reliably assess trainees of varying experience has not been evaluated. In this study we compare computer and human assessment tools of specific technical skills.

Complete laparoscopic cholecystectomies were assessed. Two independent observers assessed each operation blindly using the human specific technical skills likert assessment tool. Computer based assessed tool used the following: Totals of movements, path length and average speed of instruments. Trainees evaluated were: inexperienced, novice and intermediate.

60 laparoscopic tasks were performed by 30 trainees (10 in each group). Mean intraclass correlation coefficient for the assessments between the two independent observers was 0.97, p < 0.05. Construct validity was demonstrated using ANOVA for the total scores for each operation using the human based specific technical skills assessment tool, p values = 0.00. Construct validity was not as conclusive for the computer assessment tool for the operations, total number of instrument movements, p = 0.04; total path length of instruments, p = 0.01; total average speed of instruments, p = 0.55.

This study demonstrates a stronger construct validity of different grades of trainees using a human based assessment tool of specific technical skills compared to the computer parameters. It is important to use a reliable and valid specific technical skills assessment tool in surgery, as it will allow feedback and appraisal for trainees.

Session: Poster

Program Number: P163

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