Do Hybrid Simulator-generated Metrics Correlate with Content Valid Outcome Measures?

Objective: Hybrid simulators provide objective metrics for laparoscopic task performance. The aim of this study was to evaluate the correlation between hybrid simulator-generated metrics and content valid outcome measures.
Methods and Procedures: Residents underwent training with a previously validated 5-task simulation model (5-TSM). Tasks included: clip/divide vessel, excise lesion, loop appendectomy, mesh placement with tacks, and suture perforation with intracorporeal knot tying. After training residents were tested using a hybrid simulator (ProMISTM) with previously validated passing scores. Content validity was defined as the extent to which outcome measures departed from clinical reality. Content valid outcome measures (accuracy error [mm], knot slippage, leak, operating time [sec], tissue damage [mm]) were evaluated by two blinded raters. Interrater reliability (IRR) was assessed using kappa (k) coefficient. Hybrid simulator-generated metrics were path length (mm) and smoothness (jerk cm/sec3) of movements. Correlations between metrics and outcome measures were analyzed with Spearman rho coefficient. Values are given as means (standard deviation not shown). Results: Over 23 months, 20 residents underwent training with 5-TSM. For tasks 1-5, path length (mm) was 3895, 3472, 4620, 2408, 9089, respectively; smoothness (jerk cm/sec3) was 346, 455, 549, 264, 910; accuracy error (mm) was 0.45, 2.20, 0.55, 0.87, 0.20; knot slippage was 5%; there were 0 leaks; operating time (sec) was 54, 61, 135, 43, 130; tissue damage (mm) was 0, 0.28, 0, 0.8, 0. IRR was >.80 for all outcome measures except tissue damage k=.52. There was correlation between path length and operating time (rho .537-.709; P

Session: Podium Presentation

Program Number: S029

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