Construct validity and educational role for motion analysis in a laparoscopic trainer.

Abstract

Laparoscopic models for ex vivo up-skilling are becoming increasingly important components of surgical education. This study aims to establish the construct validity and possible educational role of a new laparoscopic box trainer equipped with a motion-tracking device. A structured questionnaire was used to assign participants into novice, intermediate, or expert categories according to level of experience in minimal access surgery (MAS). Participants carried out a well-defined intracorporeal suturing task. Three specific motion analysis parameters (MAPs)-velocity, acceleration, and range-were measured and analyzed as movements in the four degrees of freedom available in traditional MAS using tracking sensors at the trocar insertion sites. The number of extreme velocity and acceleration events in all four degrees of freedom proved capable of differentiating between participants in the three categories of surgical experience using an ANOVA test (p<0.001). Post hoc analysis confirmed these differences in the number of extreme velocity and acceleration events between all groups tested except for the velocity of the roll between the intermediates and experts. These findings confirm construct validity for this new laparoscopic box trainer system, which employs a novel analysis based on motion parameters. Motion parameters provide information regarding the overall smoothness of the operator's instrument handling, an important aspect of a surgeon's technique. This preliminary data will be used to design a simulator with real-time motion feedback to enhance its educational value.