Consensus guidelines for validation of virtual reality surgical simulators

Abstract

The Work Group for Evaluation and Implementation of Simulators and Skills Training Programmes is a newly formed subgroup of the European Association of Endoscopic Surgeons (EAES). This work group undertook a review of validation evidence for surgical simulators and the resulting consensus is presented in this article. Using clinical guidelines criteria, the evidence for validation for 6 different simulators was rated and subsequently translated to a level of recommendation for each system. The simulators could be divided into 2 basic types; systems for laparoscopic general surgery and flexible gastrointestinal endoscopy. Selection of simulators for inclusion in this consensus was based on their availability and relatively widespread usage as of July 2004. While level 2 recommendations were achieved for a few systems, it was clear that there was an overall lack of published validation studies with rigorous experimental methodology. Since the consensus meeting, there have been a number of new articles, system upgrades and new devices available. The work group intends to update these consensus guidelines on a regular basis, with the resulting article available on the EAES website (http://www.eaes-eur.org).

Acquiring basic endoscopy skills by training on the GI Mentor II

“…Currently, VR simulators are obtaining an increasingly prominent position in medical education, and they have enhanced training programs for endoscopic skills [1,14]. They still are being thoroughly evaluated because their application must be proven valid before their widespread integration into education and training programs [12,15,16].…”

“…Several VR simulator systems are currently available for lower gastrointestinal flexible endoscopy [12,15,16]. The validity of the different systems for lower gastrointestinal endoscopy skills has been studied previously [7,8,12,15,[17][18][19][20][21][22][23][24][25].…”

“…However, most of these studies did not focus on the basic tasks first, but included multiple (complex) tasks or used a relative small numbers of participants. On the basis of our experience with validation of simulators for assessment and training in laparoscopic skills [16,26], we evaluated the GI Mentor II (Simbionix Ltd., Lod, Israel) in terms of basic navigation skills for colonoscopy and proved its construct validity and didactic value [20].…”

Mapping the Maze of Minimally Invasive Surgery Simulators

“…Validity indicates whether a simulator measures the skill it is intended to measure. According to the European Association of Endoscopic Surgeons consensus guidelines drawn from Carter et al, 17 there is a need for a validation of the MIS simulators and their assessment methods, before their inclusion into training curricula.…”

“…These include construct, face, predictive, content, concurrent, and discriminate validity. 17,19 Construct validity is defined as correctly simulating or measuring the skills the device intends to train or assess. 20 Face validity illustrates adequate simulation and adequate resemblance to a task and whether a simulator is considered useful for training.…”