Title: Validation of the UW Virtual Reality TURP Simulator
1Validation of the UW Virtual Reality TURP
Simulator
Version 1.0
Presented By Timothy Kowalewski Robert Sweet,
MD Peter Oppenheimer Suzanne Weghorst Jeff
Berkley, Ph.D
2What is TURP?
- Transuretheral Resection of the Prostate
- Gold-standard for treating obstructive urinary
symptoms - Challenging to teach and learn
3Goals of the Project
- Overall Project Goal
- To help streamline urological procedure education
with the aid of simulation technology
- Specific Goals of This Study
- Establish validation status of Version 1.0, UW
- TURP Simulator as a training and assessment
tool.
4TURP a good model for Simulation
- Objective assessment
- High risk to patients
- Apparent training gap
- Common problem
Sweet, et al. Journal of Endourology. October,
2002.
5TURP a good model for Simulation
- Mainstay operation
- Apparent demand
- Amenable to current technology
98 TURP is the Gold Standard of
care
YES
75 Validated Simulator Useful after
Residency
6Methods
- Simulator Construction
- ? Virtual anatomy and visual elements
- ? Real-time force / tactile feedback
- ? O.R. instrumentation
- ? External physical model
- ? Auditory cues
7Methods
- Simulator Construction
- Training Video
- ? Definition of task and errors
- ? Statement of goal
Efficiently resect as much tissue as possible
while avoiding errors and
minimizing blood loss, amount of irrigant used,
coagulation current and number of
cuts
Special Thanks to Anthony Gallager, Ph.D
8Methods
- Simulator Construction
- Training Video
- Pre-Task Questionnaire
- ? Demographics, gender, professional
experience, education, video - game experience, TURP-related
questions, etc - ? Stratification of database
9Methods
- Simulator Construction
- Training Video
- Pre-Task Questionnaire
- Pre-Compiled, 5-minute Task
- ? Three trained, non-medical technicians
- ? Consistent, pre-determined responses
- ? Privacy and Anonymity
10Methods
- Simulator Construction
- Training Video
- Pre-Task Questionnaire
- Pre-Compiled, 5-minute Task
- Post-Task Questionnaire
- ? Critique of simulator according to its
elements - ? Open feedback
11Methods
- Simulator Construction
- Training Video
- Pre-Task Questionnaire
- Pre-Compiled, 5-minute Task
- Post-Task Questionnaire
- AUA Annual Conference
- ? 72 Experts
- ? 19 Trainees
- ? 19 Novices
12Metrics
- Grams of tissue resected
- Amount of irrigant used
- Quantity of ambient blood
- Number and severity of bleeding vessels
- Instrument position and interaction
- Number of cuts at tissue
- 12 Hz resolution
- Combinations thereof
13Results Face Validity
- Do you feel the UW TURP Simulator would be useful
as a training tool?
14Results Face Validity
- Would you like to see it implemented into the
curriculum of residency programs?
15Results Face Validity
- Do you feel it would be useful as a tool for
accreditation?
16Results Content Validity
- Categorical Standardized Likert scale of global
acceptability
17Results Novices vs. Experts
Result of Levene-conditioned two-tailed T-test
quantifies resolving potential of selected
metrics to determine differences between novices
and experts.
18Results Construct Validity
Performance of Errors
19Construct/Concurrent Validity (Cross-sectional)
- Metrics correlations mimicked the operating
room. - Experts and trainees were more efficient at
cutting than novices. (Plt.01) - Experts were more efficient at coagulating
bleeders than trainees who were more efficient
than novices. (Plt.05, Plt.01) - Performance among experts did not exhibit
decay - Video game experience influenced performance in
novices and experts only.
20Conclusions
- Established Face and Content Validity
- Established Construct Validity (X-sectional)
- Addressed Concurrent Validity (incomplete)
- NO assessment predictive validity or longitudinal
studies
- - - For Version 1.0 - - -
21Version 2.0Predictive and Construct Validation