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Título

VALIDATION OF A PROGRESSIVE TRAINING PROGRAM USING ROBOTIC SURGERY VIRTUAL REALITY SIMULATOR

Resumo

Introduction: The Mimic’s dV Trainer (dVT) is the most validated virtual reality robotic surgery simulator in the literature. Despite this, these validation studies used outdated validity frameworks as face, content and construct validity types. Validity evidence is not for the simulator itself, but for the application or interpretation of the results of the training program that uses it. Most robotic centers have simulators, but lack elements to build a validated training program.
Objective: To validate a progressive training program in dVT.
Methods: This validation study was carried out using the Messick’s contemporary validity framework which considers 5 sources of evidence: content, responses, internal structure, relationship to other variables and consequences. Participants were divided into 3 training groups according to their levels of experience in robotic surgery, in addition to a control group. A progressive training for the acquisition of technical skills in robotic surgery was performed using the dVT and the scores were compared between the training groups. After performing the required dVT’s exercises, all experts filled out a post-study questionnaire. Then, a suture training task similar to the Sponge Suture 1 from the dVT was proposed in dry lab. Each training was recorded and a blinded rater would then evaluate the performances using an assessment tool. The results of this dry lab’s training were correlated with the automated performance assessments in the exercise from dVT. The performances of the training groups (participants who did the progressive training) were compared with control group (participants who trained in the dVT freely without any specific order).
Results: All experts assessed dVT as easy to use and useful as a training tool for the console functionalities of da Vinci robot. The training groups’ performances in dVT's exercises showed clear discrimination between experts and novices (p<0,05), with the exception of Ring Walk 1 exercise (p=0.11). Cronbach’s Alpha Coefficient was 0.96. There was a positive Pearson’s correlation between the scores in the Sponge Suture 1 and dry lab suture training task (r= 0,93; 95% CI between 0.72 and 0.98, with p = 0.0001). The training groups had better performances in dry lab suture simulation training than the control group (p=0.02).
Conclusions: This progressive training program in dVT established the five sources of validity evidence for the Messick’s contemporary validation process.

Palavras Chave ( separado por ; )

Robotic surgery; Validation study; Simulation training; Education; Virtual reality.