Use of a Low-Cost Portable 3D Virtual Reality Gesture-Mediated Simulator for Training and Learning Basic Psychomotor Skills in Minimally Invasive Surgery: Development and Content Validity Study (Preprint)

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 This study aims first to describe the development of a new gesture-based simulator for learning skills in 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 MIS using virtual reality (SIMISGEST-VR), a design-based research (DBR) paradigm was adopted. For the second objective, 30 participants completed a questionnaire, with responses scored on a 5-point Likert scale. A literature review on the validity of the MIS training-VR (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 <i>good enough</i> prototype of a gesture-based simulator was developed with metrics and feedback for learning psychomotor skills in MIS. As per the survey conducted to assess the 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 this study’s 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 SIMISGEST-VR was also obtained.

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Use of a Low-Cost Portable 3D Virtual Reality Gesture-Mediated Simulator for Training and Learning Basic Psychomotor Skills in Minimally Invasive Surgery: Development and Content Validity Study

Journal of Medical Internet Research ◽

10.2196/17491 ◽

2020 ◽

Vol 22 (7) ◽

pp. e17491 ◽

Cited By ~ 1

Author(s):

Fernando Alvarez-Lopez ◽

Marcelo Fabián Maina ◽

Francesc Saigí-Rubió

Keyword(s):

Virtual Reality ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Virtual Environments ◽

Invasive Surgery ◽

Low Cost ◽

Simulator Training ◽

Validity Evidence ◽

Psychomotor Skills ◽

Likert Score

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 This study aims first to describe the development of a new gesture-based simulator for learning skills in 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 MIS using virtual reality (SIMISGEST-VR), a design-based research (DBR) paradigm was adopted. For the second objective, 30 participants completed a questionnaire, with responses scored on a 5-point Likert scale. A literature review on the validity of the MIS training-VR (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. As per the survey conducted to assess the 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 this study’s 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 SIMISGEST-VR was also obtained.

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Use of a Low-Cost Portable 3D Virtual Reality Simulator for Psychomotor Skill Training in Minimally Invasive Surgery: Task Metrics and Score Validity (Preprint)

10.2196/preprints.19723 ◽

2020 ◽

Author(s):

Fernando Alvarez-Lopez ◽

Marcelo Fabián Maina ◽

Fernando Arango ◽

Francesc Saigí-Rubió

Keyword(s):

Virtual Reality ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Undergraduate Students ◽

Invasive Surgery ◽

Reference Group ◽

Low Cost ◽

Psychomotor Skills ◽

Multiple Sources ◽

Test Retest Reliability

BACKGROUND The high cost and low availability of virtual reality simulators in surgical specialty training programs in low- and middle-income countries make it necessary to develop and obtain sources of validity for new models of low-cost portable simulators that enable ubiquitous learning of psychomotor skills in minimally invasive surgery. OBJECTIVE The aim of this study was to obtain validity evidence for relationships to other variables, internal structure, and consequences of testing for the task scores of a new low-cost portable simulator mediated by gestures for learning basic psychomotor skills in minimally invasive surgery. This new simulator is called SIMISGEST-VR (Simulator of Minimally Invasive Surgery mediated by Gestures - Virtual Reality). METHODS In this prospective observational validity study, the authors looked for multiple sources of evidence (known group construct validity, prior videogaming experience, internal structure, test-retest reliability, and consequences of testing) for the proposed SIMISGEST-VR tasks. Undergraduate students (n=100, reference group), surgical residents (n=20), and experts in minimally invasive surgery (n=28) took part in the study. After answering a demographic questionnaire and watching a video of the tasks to be performed, they individually repeated each task 10 times with each hand. The simulator provided concurrent, immediate, and terminal feedback and obtained the task metrics (time and score). From the reference group, 29 undergraduate students were randomly selected to perform the tasks 6 months later in order to determine test-retest reliability. RESULTS Evidence from multiple sources, including strong intrarater reliability and internal consistency, considerable evidence for the hypothesized consequences of testing, and partial confirmation for relations to other variables, supports the validity of the scores and the metrics used to train and teach basic psychomotor skills for minimally invasive surgery via a new low-cost portable simulator that utilizes interaction technology mediated by gestures. CONCLUSIONS The results obtained provided multiple sources of evidence to validate SIMISGEST-VR tasks aimed at training novices with no prior experience and enabling them to learn basic psychomotor skills for minimally invasive surgery.

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Use of a Low-Cost Portable 3D Virtual Reality Simulator for Psychomotor Skill Training in Minimally Invasive Surgery: Task Metrics and Score Validity

JMIR Serious Games ◽

10.2196/19723 ◽

2020 ◽

Vol 8 (4) ◽

pp. e19723

Author(s):

Fernando Alvarez-Lopez ◽

Marcelo Fabián Maina ◽

Fernando Arango ◽

Francesc Saigí-Rubió

Keyword(s):

Virtual Reality ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Undergraduate Students ◽

Invasive Surgery ◽

Reference Group ◽

Low Cost ◽

Psychomotor Skills ◽

Multiple Sources ◽

Test Retest Reliability

Background The high cost and low availability of virtual reality simulators in surgical specialty training programs in low- and middle-income countries make it necessary to develop and obtain sources of validity for new models of low-cost portable simulators that enable ubiquitous learning of psychomotor skills in minimally invasive surgery. Objective The aim of this study was to obtain validity evidence for relationships to other variables, internal structure, and consequences of testing for the task scores of a new low-cost portable simulator mediated by gestures for learning basic psychomotor skills in minimally invasive surgery. This new simulator is called SIMISGEST-VR (Simulator of Minimally Invasive Surgery mediated by Gestures - Virtual Reality). Methods In this prospective observational validity study, the authors looked for multiple sources of evidence (known group construct validity, prior videogaming experience, internal structure, test-retest reliability, and consequences of testing) for the proposed SIMISGEST-VR tasks. Undergraduate students (n=100, reference group), surgical residents (n=20), and experts in minimally invasive surgery (n=28) took part in the study. After answering a demographic questionnaire and watching a video of the tasks to be performed, they individually repeated each task 10 times with each hand. The simulator provided concurrent, immediate, and terminal feedback and obtained the task metrics (time and score). From the reference group, 29 undergraduate students were randomly selected to perform the tasks 6 months later in order to determine test-retest reliability. Results Evidence from multiple sources, including strong intrarater reliability and internal consistency, considerable evidence for the hypothesized consequences of testing, and partial confirmation for relations to other variables, supports the validity of the scores and the metrics used to train and teach basic psychomotor skills for minimally invasive surgery via a new low-cost portable simulator that utilizes interaction technology mediated by gestures. Conclusions The results obtained provided multiple sources of evidence to validate SIMISGEST-VR tasks aimed at training novices with no prior experience and enabling them to learn basic psychomotor skills for minimally invasive surgery.

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Haptic interface for virtual reality based minimally invasive surgery simulation

Proceedings. 1998 IEEE International Conference on Robotics and Automation (Cat. No.98CH36146) ◽

10.1109/robot.1998.676435 ◽

2002 ◽

Cited By ~ 16

Author(s):

R. Baumann ◽

R. Clavel

Keyword(s):

Virtual Reality ◽

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Haptic Interface ◽

Surgery Simulation

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Conference Reports

Robotica ◽

10.1017/s0263574798210277 ◽

1998 ◽

Vol 16 (4) ◽

pp. 477-478

Author(s):

Susan J. Lederman ◽

Robert D. Howe

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Virtual Environments ◽

Invasive Surgery ◽

Architectural Design ◽

Space Exploration ◽

Haptic Interfaces ◽

Annual Symposium ◽

Human Machine Interaction ◽

Machine Interaction

SIXTH ANNUAL SYMPOSIUM ON HAPTIC INTERFACESThe Sixth Annual Symposium for Haptic Interfaces for Virtual Environment and Teleoperator Systems was held on Nov. 17–18, 1997 in Dallas, Texas. Haptic interfaces are devices that allow human–machine interaction through force and touch. Areas of application include, but are by no means limited, to telemanipulation (for work in hazardous or challenging environments such as space exploration, undersea operations, microsurgery and minimally-invasive surgery, and hazardous waste clean-up) and virtual environments (for realistic interactions with computer simulations in critical procedure training, architectural design, product prototyping, and data visualization).

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