Development and validation of a low-cost laparoscopic simulation box

Nerea Martín-Calvo; Beatriz Gómez; Nieves Díez; Marcos Llorente; Secundino Fernández; Ane Ferreiro Abal; Francisco Javier Pueyo

doi:10.1016/j.cireng.2022.07.033

Development and validation of a low-cost laparoscopic simulation box

Cir Esp (Engl Ed). 2022 Aug 17:S2173-5077(22)00293-9. doi: 10.1016/j.cireng.2022.07.033. Online ahead of print.

Authors

Nerea Martín-Calvo¹, Beatriz Gómez², Nieves Díez³, Marcos Llorente⁴, Secundino Fernández⁴, Ane Ferreiro Abal⁵, Francisco Javier Pueyo⁶

Affiliations

¹ University of Navarra, Faculty of Medicine, Department of Preventive Medicine and Public Health, 31008 Pamplona, Spain; CIBER-obn, Institute Salud Carlos III, 28029 Madrid, Spain; IdiSNA, Institute of Health Research of Navarra, 31008 Pamplona, Spain. Electronic address: nmartincalvo@unav.es.
² University of Navarra, Faculty of Medicine, 31008 Pamplona, Spain.
³ University of Navarra, Faculty of Medicine, Department of Pathology, Anatomy and Physiology, 31008 Pamplona, Spain.
⁴ Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain.
⁵ University of Navarra, School of Engineering, 20018, San Sebastián, Spain.
⁶ Department of Anesthesiology, Perioperative Medicine and Critical Care, University of Navarra Clinic, 31008 Pamplona, Spain.

PMID: 35985573
DOI: 10.1016/j.cireng.2022.07.033

Abstract

Introduction: The acquisition of laparoscopic technique skills in an operating room is conditioned by the expertise of the tutor and the number of training interventions by the trainee. For students and surgeons to use a laparoscopic simulator to train their skills, it must be validated beforehand.

Methods: A laparoscopic simulator box was designed, along with 6 interchangeable training games. The simulator was validated by a group of 19 experts, physicians with an experience from at least 100 laparoscopic surgeries, and 20 students of 4th to 6th grades of medical school (non-experts). To evaluate its construct validity, time-to-completion and the number of successfully completed games were assessed. We used 11 and 9-item questionnaires to gather information on content and face validity respectively. In both questionnaires, answers were collected through Likert-type scales, scored from 1 to 5.

Results: The group of experts required less time and successfully completed more games than the group of non-experts (p < 0.01). The group of non-experts gave a score ≥4 points on each of the questions regarding the content validity of the tool, however, the experts rated with a significant lower mean score the need for the simulator to learn the surgical technique (3.68 points; p < 0.01). Regarding the face validity, all items were graded with a score ≥4 points except for the question relating to the spatial realism (3.82 points).

Conclusion: The laparoscopy simulation box and the games were valid means for training surgeons and medical students to develop the skills required for the laparoscopic technique.

Keywords: Caja de simulación; Construct validity; Content validity; Estudio de validación; Face validity; Laparoscopia; Laparoscopy; Simulation box; Validation study; Validez aparente; Validez de constructo; Validez de contenido.