2005 SAGES Abstracts

POSTER ABSTRACTS
sure of a gastric perforation (using two suture ligatures), and
3) laparoscopic cholecystectomy. The students alternately
worked as operators or cameramen, and endoscopic surgeons
with more than 10 years of experience were their assistants.
Their performance was assessed from the time required for
each procedure and the error score. There were no significant
differences between the three groups in the total operating
time for the three procedures, the operating time for LC, and
the error score. However, there was a significant difference in
the time required for suturing the gastric perforation between
the VR group and the control group (p=0.0002), as well as
between the TB group and the control group (p=0.0012). The
time for the second suture comparing for the first suture was
significantly reduced in the VR group compared with the TB
group (p=0.0181). In the TB group, the time required for suture
ligatures by three students who were given instructions by the
trainers watching the procedure was shorter than that required
by students who received instructions from the trainers not
watching the procedure (p=0.0495). Based on these findings,
both the virtual simulator and the training box were useful in
training for placement of suture ligatures, but were not useful
in training for overall operation. The virtual simulator was also
useful for shortening the learning curve, while the training box
became more useful if instructions were given by a trainer
who was viewing the surgical procedures.
P160–Education/Outcomes
VALIDITY AND RELIABILITY OF A VIDEOTRAINER LAPARO-
SCOPIC CAMERA NAVIGATION SIMULATOR, J R Korndorffer
Jr. MD, D Stefanidis MD,R Sierra MD,J L Clayton PhD,C L
Touchard BS,J B Dunne PhD,D J Scott MD, Tulane University
Health Sciences Center, Department of Surgery
The videotrainer laparoscopic camera navigation (LCN) simulator
has previously been shown to develop skills which translate
to the OR. The purpose of this study was to determine the
construct and face validity and the reliability of the LCN simulator.
Subjects (n=31) including novices (R1, n=20), intermediates
(R2-5, n=7), and experts (>200 lap cases, n=4) were enrolled in
an IRB-approved protocol. Each subject performed 3 repetitions
on the 0° and 30° simulators and was scored (accuracy
and time) by direct observation. To evaluate construct validity,
scores were compared between groups using ANOVA and
with LCN experience using Pearson Correlation. To evaluate
face validity, intermediate and expert subjects rated the simulators
using a 10-point Likert scale. To evaluate reliability,
scores were analyzed by Pearson Correlation (test-retest) and
Cronbach alpha (internal consistency).
For the 0° simulator, no significant difference was
detected between groups and LCN experience did not correlate
with performance (r=0.26, p<0.16). For the 30°
simulator, a significant difference was detected between all
groups and LCN experience correlated significantly with performance
(r= 0.72, p<0.001). Face validity ratings were; 8.7
for "simulates movements required for LCN," 8.2
for "relevance to actual LCN," and 8.2 for
"usefulness for training." Test-retest reliability was
0.8 (p<0.001) for both the 0° and 30° simulators
and Cronbach alpha was 0.6 (0°) and 0.9
(30°).Although a trend was noted in the 0° simulator
scores, statistical significance was not reached due to the
easy level of difficulty and limited group sizes (further accrual
is underway). However, the more difficult 30° simulator
was able to discriminate between groups and clearly demonstrated
construct validity. Both simulators showed excellent
face validity and moderate to high reliability. These data further
support the use of the LCN simulator for training and possibly
assessment purposes.
P161–Education/Outcomes
PROFICIENCY-BASED TRAINING FOR LAPAROSCOPIC SUTUR-
ING: VR, VT, OR BOTH?, J R Korndorffer, Jr MD, J B Dunne
PhD,D Stefanidis MD,R Sierra MD,C L Touchard BS,D J Scott
MD, Tulane University Health Sciences Center
The purpose of this study was to compare the effectiveness of
laparoscopic suturing curricula using videotrainer (VT) and virtual
reality (VR) simulators, and to examine the role of VR
training as a cost effective adjunct to VT training.
Medical students (MS4, n=8) with no laparoscopic suturing
experience were enrolled in an IRB-approved, randomized,
controlled protocol. Subjects were pre-tested on a live porcine
laparoscopic Nissen fundoplication model, stratified according
to pre-test scores and randomized into three groups. The VT
group (n=3) practiced on a VT suturing model and the VR
group (n=3) practiced on the MIST-VR suturing module (stitch
and square-knot tasks) until predetermined proficiency scores
were achieved. The control group (n=2) received no training.
All groups were post-tested. The VR group then crossed over
to train on VT. Analysis was by ANOVA and paired t-test (mean
± sd, p