Hybrid Augmented Reality Simulator: Preliminary Construct Validation of Laparoscopic Smoothness in a Urology Residency Program

PurposeWe examined the usefulness, reliability and applicability of the smoothness metric of the ProMIS hybrid simulator (Haptica, Dublin, Ireland) for a urology residency program.Materials and MethodsA total of 15 urology residents divided into junior and senior cohorts were followed prospectively for 6 training sessions. Validated McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS) laparoscopic tasks were used. The ProMIS hybrid simulator smoothness parameter, a unit-free metric of movement efficiency, was recorded using 3-dimensional visual tracking technology. Results were compared between cohorts at the midpoint and end of the defined training sessions. End of study junior means were also retrospectively compared to senior mid training means. Statistical significance was determined using the Mann-Whitney U test (α = 0.05).ResultsStatistically significant differences between 8 junior and 7 senior cohorts were measured in all MISTELS tasks. A statistically significant performance variation was also detected at the mid and end testing times. When juniors and seniors were compared between sessions 1 and 3, and 4 and 6, statistically significant performance improvements were noted. Lastly, statistical differences were also maintained when mid session senior means were compared to end of session junior means. A 38% improvement in task completion in the senior cohort as well as a 10-fold decrease in variance was observed compared to a 12% improvement in juniors, indicating greater efficiency of movement in seniors.ConclusionsThe laparoscopic smoothness metric in the hybrid simulator demonstrated construct validity by effectively differentiating between experienced and novice urology residents using validated MISTELS tasks. The outcome suggests that the hybrid simulator smoothness metric is a valuable asset in residency programs for preparatory training for live operative experience, allowing improved trainee assessment.