Virtual reality as a metric for the assessment of laparoscopic psychomotor skills - Learning curves and reliability measures

Background: The objective assessment of the psychomotor skills of surgeons is now a priority; however, this is a difficult task because of measurement difficulties associated with the assessment of surgery in vivo. In this study, virtual reality (VR) was used to overcome these problems. Methods: Twelve experienced (> 50 minimal-access procedures), 12 inexperienced laparoscopic surgeons ( < 10 minimal-access procedures), and 12 laparoscopic novices participated in the study. Each subject completed 10 trials on the Minimally Invasive Surgical Trainer; Virtual Reality (MIST VR). Results: Experienced laparoscopic surgeons performed the tasks significantly (p < 0.01) faster, with less error, more economy in the movement of instruments and the use of diathermy, and with greater consistency in performance. The standardized coefficient alpha for performance measures ranged from alpha = 0.89 to 0.98, showing high internal measurement consistency. Test-retest reliability ranged from r = 0.96 to r = 0.5. Conclusion: VR is a useful tool for evaluating the psychomotor skills needed to perform laparoscopic surgery.