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

Surg Endosc. 2002 Dec;16(12):1746-52. doi: 10.1007/s00464-001-8215-6. Epub 2002 Jul 29.


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 a = 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.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Clinical Competence* / statistics & numerical data
  • Equipment and Supplies
  • Humans
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Learning*
  • Middle Aged
  • Minimally Invasive Surgical Procedures / education*
  • Minimally Invasive Surgical Procedures / statistics & numerical data
  • Psychomotor Performance*
  • Reference Standards
  • Statistics, Nonparametric
  • User-Computer Interface*