背景:良好的技术技能对外科医生至关重要。然而,尽管外科培训计划在选择外科住院医师时努力评估技术能力,对这种能力的有效评估仍然缺乏。已经提出手术模拟器作为用于此目的的潜在有效工具。当前的研究旨在开发使用虚拟现实手术模拟器的技术能力测试,并验证其在选择手术住院医师方面的用途。
方法:本研究分为三个阶段。在第1阶段,我们使用Lap-X-VR腹腔镜模拟器开发了技术能力测试的初始版本。在第2阶段和第3阶段,我们完善了测试并收集了经验数据,以评估有效性证据的四个主要来源(内容,响应过程,内部结构,以及与其他变量的关系),并评价试验的可行性和可接受性。具体来说,第二阶段包括30名高级外科医生对测试的审查,在第3阶段,对152名实习生进行了修订版的测试,以确定其心理测量特性。
结果:外科医生和实习生都认为该测试与选择手术住院医师高度相关。通过对试验管理所得数据的分析,支持分数计算过程的恰当性,表现出良好的心理测量特性,包括可靠性(α=0.83)和任务判别(平均判别=0.5,SD=0.1)。考试成绩和背景变量之间的相关性显示出与性别的显著相关性,手术模拟器经验,和视频游戏体验(ps<0.001)。这些变量,然而,总共只解释了10%的考试成绩差异。
结论:我们描述了创新的虚拟现实测试的系统开发,用于评估外科培训候选人的技术能力,并提供其有效性的证据,可行性和可接受性。需要进一步验证以支持选择测试的应用,以及辨别性别的影响,手术模拟器经验,和视频游戏体验对测试结果的公平性。然而,该测试似乎是一个有前景的工具,可以帮助培训项目评估候选人是否适合接受外科培训.
BACKGROUND: Good technical skills are crucial for surgeons. Yet although surgical training programs strive to assess technical aptitude when selecting surgical residents, valid assessments of such aptitude are still lacking. Surgical simulators have been proposed as a potentially effective tool for this purpose. The current study aims to develop a technical aptitude test using a virtual reality surgical simulator, and to validate its use for the selection of surgical residents.
METHODS: The study had three phases. In Phase 1, we developed an initial version of the technical aptitude test using the Lap-X-VR laparoscopic simulator. In Phases 2 and 3 we refined the test and collected empirical data to evaluate four main sources of validity evidence (content, response process, internal structure, and relationships with other variables), and to evaluate the feasibility and acceptability of the test. Specifically, Phase 2 comprised a review of the test by 30 senior surgeons, and in Phase 3 a revised version of the test was administered to 152 interns to determine its psychometric properties.
RESULTS: Both the surgeons and interns rated the test as highly relevant for selecting surgical residents. Analyses of the data obtained from the trial administration of the test supported the appropriateness of the score calculation process and showed good psychometric properties, including reliability (α = 0.83) and task discrimination (mean discrimination = 0.5, SD = 0.1). The correlations between test scores and background variables revealed significant correlations with gender, surgical simulator experience, and video game experience (ps < 0.001). These variables, however, explained together only 10% of the variance in test scores.
CONCLUSIONS: We describe the systematic development of an innovative virtual reality test for assessing technical aptitude in candidates for surgical training, and present evidence for its validity, feasibility and acceptability. Further validation is required to support the application of the test for selection, as well as to discern the impact of gender, surgical simulator experience, and video game experience on the fairness of test results. However, the test appears to be a promising tool that may help training programs assess the suitability of candidates for surgical training.