JMIR Publications

ABSTRACT

Background:

Simulation in virtual environments has become a new paradigm for surgeon training in Minimally Invasive Surgery (MIS). However, this technology is expensive and difficult to access.

Objective:

The objectives of this manuscript are, first, to describe the development of a new gesture-based simulator for learning skills in minimally invasive surgery (MIS); and second, to establish its fidelity to the criterion and sources of content-related validity evidence.

Methods:

For the development of the Gesture-Mediated Simulator for Minimally Invasive Surgery – Virtual Reality (SIMISGEST-VR), a design-based research (DBR) paradigm was adopted. For the second objective, 30 participants completed a questionnaire, with responses scored along a 5-point Likert scale. A literature review on the validity of the MIST-VR was conducted; the study of fidelity to the criterion was rated using a 10-item questionnaire, while the sources of content-related validity evidence were assessed using 10 questions about the simulator training capacity and 6 questions about MIS tasks; and an iterative process of instrument pilot testing was performed.

Results:

A “good enough” prototype of a gesture-based simulator was developed, with metrics and feedback for learning psychomotor skills in MIS. With respect to the survey to assess fidelity to the criterion, all 30 participants felt that most aspects of the simulator were adequately realistic and that it could be used as a tool for teaching basic psychomotor skills in laparoscopic surgery (Likert score: 4.07-4.73).The sources of content-related validity evidence showed that our simulator is a reliable training tool and that the exercises enable learning of the basic psychomotor skills required in MIS (Likert score: 4.28-4.67).

Conclusions:

The development of gesture-based 3D virtual environments for training and learning basic psychomotor skills in MIS opens up a new approach to low-cost, portable simulation that allows ubiquitous learning and preoperative warm-up. Fidelity to the criterion was duly evaluated, which allowed a “good enough” prototype to be achieved. Content-related validity evidence for the SIMISGEST-VR was also obtained.