You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment/Ureteroscopy II1 Apr 20121516 EXAMINING THE VISUAL CONTROL STRATEGIES OF EXPERTS AND NOVICES TO ESTABLISH THE VALIDITY OF A NOVEL TURP SIMULATOR Thomas Dutton, Samuel Vine, John McGrath, Elizabeth Bright, and Mark Wilson Thomas DuttonThomas Dutton Exeter, United Kingdom More articles by this author , Samuel VineSamuel Vine Exeter, United Kingdom More articles by this author , John McGrathJohn McGrath Exeter, United Kingdom More articles by this author , Elizabeth BrightElizabeth Bright Exeter, United Kingdom More articles by this author , and Mark WilsonMark Wilson Exeter, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1283AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES With increasing resource constraints and patient concern, there has been a recent interest in the use of simulators to help surgeons acquire technical skills. Surgical simulators facilitate repetitive practice and performance feedback in a risk-free environment. Previous validation of simulators has focussed on motor proficiency measures. However, studies have shown that expertise in laparoscopic skills is underpinned by an efficient visual control strategy (fixations that are long in duration and low in frequency). Using infrared eye-tracking devices, experts are seen to ‘lock' their gaze on a target earlier and for longer, improving the accuracy of the subsequent motor skill. The aim of this study was to examine visual control measures and their utility as a novel method to assess the construct validity of a transurethral resection of prostate (TURP) virtual reality simulator (VR; Simbionix, USA Corp). METHODS 11 novices (no TURP experience) and 7 experts (>200 TURPS) completed the median lobe resection task on the simulator. All participants wore a gaze registration system that assessed their visual control strategy (recorded as the number of fixations per second and mean duration of fixations). The VR simulator also provided objective measures of performance (% prostate resected per minute) and safety/error (% prostatic capsule perforation and time diathermy active without tissue contact). RESULTS When compared to novices, experts employed a visual control strategy of fewer fixations per second (mean 1.49 vs 1.12, p < 0.05), but a longer mean fixation duration (0.43 vs 0.76, p < .005). Differences were also found in performance related measures; experts resected 59.05% of the prostate per minute whereas novices resected only 30.86% (p < .001) and experts were more precise with the diathermy than novices (0.32 vs 2.35, p < .005). However, both groups had an equal rate of prostatic capsular perforation (13.71 vs 16.91, p = 0.31). CONCLUSIONS Significant differences have been shown in the performance of experts versus novices (proficiency and safety parameters) whilst performing a VR TURP training task. Furthermore, experts and novices displayed the expected differences in visual control strategies. This suggests that the TURP simulator is a valid tool in the replication of this common urological procedure. The study of visual control strategies may be a useful adjunct, alongside assessment of motor performance, in assessing surgeons undergoing simulation training. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e614 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Thomas Dutton Exeter, United Kingdom More articles by this author Samuel Vine Exeter, United Kingdom More articles by this author John McGrath Exeter, United Kingdom More articles by this author Elizabeth Bright Exeter, United Kingdom More articles by this author Mark Wilson Exeter, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...