Methodologies for establishing validity in surgical simulation studies

Nortwick, Sara S. Van; Lendvay, Thomas S.; Jensen, Aaron R.; Wright, Andrew S.; Horvath, Karen D.; Kim, Sara

doi:10.1016/j.surg.2009.10.068

Cited by 140 publications

(88 citation statements)

References 85 publications

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“…25 Indeed, it is interesting to note that while no studies reported presenting the simulator in a high-fidelity setting (for example, a fully simulated operating room), many studies reported that the participants found the simulation realistic. Definitions of validity and reliability used in the surgical literature are inconsistent, 53 and inconsistencies in validation study methodologies within this review limited our ability to draw strong conclusions comparing the effectiveness of simulation-based curricula 15,49 and evaluating the transfer of skills from the simulation setting to the operating room. 48 These are open questions yet to be addressed in future research.…”

Section: Discussionmentioning

confidence: 98%

The use of simulation in neurosurgical education and training

Kirkman

Ahmed²,

Albert³

et al. 2014

JNS

146

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Object There is increasing evidence that simulation provides high-quality, time-effective training in an era of resident duty-hour restrictions. Simulation may also permit trainees to acquire key skills in a safe environment, important in a specialty such as neurosurgery, where technical error can result in devastating consequences. The authors systematically reviewed the application of simulation within neurosurgical training and explored the state of the art in simulation within this specialty. To their knowledge this is the first systematic review published on this topic to date. Methods The authors searched the Ovid MEDLINE, Embase, and PsycINFO databases and identified 4101 articles; 195 abstracts were screened by 2 authors for inclusion. The authors reviewed data on study population, study design and setting, outcome measures, key findings, and limitations. Results Twenty-eight articles formed the basis of this systematic review. Several different simulators are at the neurosurgeon's disposal, including those for ventriculostomy, neuroendoscopic procedures, and spinal surgery, with evidence for improved performance in a range of procedures. Feedback from participants has generally been favorable. However, study quality was found to be poor overall, with many studies hampered by nonrandomized design, presenting normal rather than abnormal anatomy, lack of control groups and long-term follow-up, poor study reporting, lack of evidence of improved simulator performance translating into clinical benefit, and poor reliability and validity evidence. The mean Medical Education Research Study Quality Instrument score of included studies was 9.21 ± 1.95 (± SD) out of a possible score of 18. Conclusions The authors demonstrate qualitative and quantitative benefits of a range of neurosurgical simulators but find significant shortfalls in methodology and design. Future studies should seek to improve study design and reporting, and provide long-term follow-up data on simulated and ideally patient outcomes.

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Section: Discussionmentioning

confidence: 98%

The use of simulation in neurosurgical education and training

Kirkman

Ahmed²,

Albert³

et al. 2014

JNS

146

View full text Add to dashboard Cite

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“…Therefore, the predictive validity of this study is unknown and requires long-term follow-up. 19 Second, the training models used in this study may not represent conditions in the human model, although face and content validation ratings were overall high. For instance, the phantom in this study represented a nonobese patient, and we envision that there will be challenges in using this technology in individuals with increasing BMI.…”

Section: Resultsmentioning

confidence: 99%

Content and Face Validation of a Curriculum for Ultrasonic Propulsion of Calculi in a Human Renal Model

Hsi

Dunmire

Cunitz

et al. 2014

Journal of Endourology

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Purpose: Ultrasonic propulsion to reposition urinary tract calculi requires knowledge about ultrasound image capture, device manipulation, and interpretation. The purpose of this study was to validate a cognitive and technical skills curriculum to teach urologists ultrasonic propulsion to reposition kidney stones in tissue phantoms. Materials and Methods: Ten board-certified urologists recruited from a single institution underwent a didactic session on renal ultrasound imaging. Subjects completed technical skills modules in tissue phantoms, including kidney imaging, pushing a stone through a translucent maze, and repositioning a lower pole calyceal stone. Objective cognitive and technical performance metrics were recorded. Subjects completed a questionnaire to ascertain face and content validity on a five-point Likert scale. Results: Eight urologists (80%) had never attended a previous ultrasound course, and nine (90%) performed renal ultrasounds less frequently than every 6 months. Mean cognitive skills scores improved from 55% to 91% ( p < 0.0001) on pre-and post-didactic tests. In the kidney phantom, 10 subjects (100%) repositioned the lower pole calyceal stone to at least the lower pole infundibulum, while 9 (90%) successfully repositioned the stone to the renal pelvis. A mean -SD (15.7 -13.3) pushes were required to complete the task over an average of 4.6 -2.2 minutes. Urologists rated the curriculum's effectiveness and realism as a training tool at a mean score of 4.6/5.0 and 4.1/5.0, respectively. Conclusions: The curriculum for ultrasonic propulsion is effective and useful for training urologists with limited ultrasound proficiency in stone repositioning technique. Further studies in animate and human models will be required to assess predictive validity.

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“…Por último, queda pendiente evaluar la transferencia de estas habilidades a situaciones clínicas con pacientes (validez predictiva) 13 , aunque existe en la literatura reportes que muestran que es posible que estas destrezas se transfieran a modelos más complejos 6,24 . En conclusión, este programa de entrenamiento simulado de técnicas básicas de sutura es factible de realizar, siendo reproducible y válido en términos de apariencia y contenido.…”

Section: Discussionunclassified

“…Los participantes, al realizar un punto simple, obtuvieron una mediana de puntaje OSATS pre entrenamiento de 10 [5][6][7][8][9][10][11][12][13][14][15][16][17] …”

Section: Evaluación De Punto Simpleunclassified

Programa Pionero De Simulación en Sutura Para Estudiantes De Medicina De Pregrado

Alvarado

et al. 2015

Rev Chil Cir

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a pioneer simulation curriculum of suture technique training for medical students introduction: Simulation has demonstrated utility in suture skills training on surgical residents. Objective: Evaluate validity of a simulated training curriculum of basic suture skills for medical students. methods: Study conducted on 2013. Medical students were selected from the School of Medicine of Pontificia Universidad Católica de Chile (EMPUC). The program included four theoretical sessions and six practical sessions in order to training basic surgical tasks (five in total) on a simulated rubber model: one handed knot-tying, simple suture, vertical mattress suture, subcuticular interrupted suture and subcuticular running suture. A survey was applied to the participants to qualify each element of the program, on a scale of 1 to 7 (face-validity). One task (simple suture) was recorded on video, before and after training, to be evaluated by two experts on a blind fashion (content validity). Experts measure participant skills using an OSATS (Objective Structured Assessment of Technical Skills) and operative time. Statistical analysis for non-parametric variables, median and interquartile range, significant p-value < 0.05. results: Thirty-six medical students participated, with assistance percentage was over 80%. Students qualified the experience favorably: simulated bench-model 6.0 ; p < 0.001) after training in every participant. conclusion: This simulated curriculum delivers an alternative method for the development of technical competencies in medical students and could be incorporated on medical schools curricula.

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Methodologies for establishing validity in surgical simulation studies

Cited by 140 publications

References 85 publications

The use of simulation in neurosurgical education and training

The use of simulation in neurosurgical education and training

Content and Face Validation of a Curriculum for Ultrasonic Propulsion of Calculi in a Human Renal Model

Programa Pionero De Simulación en Sutura Para Estudiantes De Medicina De Pregrado

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