Face, content and construct validation of the first virtual reality laparoscopic nephrectomy simulator

OBJECTIVE To evaluate the face, content and construct validity, and to identify whether participants improved with practice, for the Procedicus MIST Nephrectomy (TM) simulator (Mentice, Gothenburg, Sweden), which incorporates force feedback and can record numerous performance measures (metrics) during the simulation, and which is the first virtual reality simulator for laparoscopic nephrectomy. SUBJECTS AND METHODS Eight expert urological laparoscopic surgeons, 10 novices and 10 trainee urologists completed at least one simulated retroperitoneal radical nephrectomy. They completed a structured questionnaire to assess face and content validity; the performance of experts and novices were then compared to evaluate construct validity. RESULTS Face validity was established by the experts who all felt the simulator was a good training tool. Content validity was established by the experts who rated all aspects of the simulator as above average for realism. When performance metrics were analysed, experts completed the simulated nephrectomy significantly faster than novices, with fewer errors, less simulated haemorrhage and less tool travel, which established construct validity. After practice, both novices and trainees were able to perform the simulation faster, with fewer errors, less blood loss and less tool travel. CONCLUSIONS This study has established the face, content and construct validity for the Procedicus MIST Nephrectomy. The simulator can distinguish experts from novices and it has potential as a laparoscopic training tool for urology.