Surgical Endoscopy

, Volume 21, Issue 7, pp 1158–1164 | Cite as

Construct and face validity and task workload for laparoscopic camera navigation: virtual reality versus videotrainer systems at the SAGES Learning Center

  • Dimitrios Stefanidis
  • Randy Haluck
  • Tai Pham
  • J. Bruce Dunne
  • Timothy Reinke
  • Sarah Markley
  • James R. KorndorfferJr.
  • Paul Arellano
  • Daniel B. Jones
  • Daniel J. Scott



Laparoscopic camera navigation (LCN) training on simulators has demonstrated transferability to actual operations, but no comparative data exist. The objective of this study was to compare the construct and face validity, as well as workload, of two previously validated virtual reality (VR) and videotrainer (VT) systems.


Attendees (n = 90) of the SAGES 2005 Learning Center performed two repetitions on both VR (EndoTower™) and VT (Tulane Trainer) LCN systems using 30° laparoscopes and completed a questionnaire regarding demographics, simulator characteristics, and task workload. Construct validity was determined by comparing the performance scores of subjects with various levels of experience according to five parameters and face validity according to eight. The validated NASA-TLX questionnaire that rates the mental, physical, and temporal demand of a task as well as the performance, effort, and frustration of the subject was used for workload measurement.


Construct validity was demonstrated for both simulators according to the number of basic laparoscopic cases (p = 0.005), number of advanced cases (p < 0.001), and frequency of angled scope use (p < 0.001), and only for VT according to training level (p < 0.001) and fellowship training (p = 0.008). Face validity ratings on a 1-20 scale averaged 15.4 ± 3 for VR vs. 16 ± 2.6 for VT (p = 0.04). Ninety-six percent of participants rated both simulators as valid educational tools. The NASA-TLX overall workload score was 69.5 ± 24 for VR vs. 68.8 ± 20.5 for VT (p = 0.31).


This is the largest study to date that compares two validated LCN simulators. While subtle differences exist, both VR and VT simulators demonstrated excellent construct validity, good face validity, and acceptable workload parameters. These systems thus represent useful training devices and should be widely used to improve surgical performance.


Simulation Skills assessment Virtual reality Laparoscopic camera navigation Construct validity Face validity Workload 



The authors gratefully acknowledge SAGES, Verefi Inc., and Karl Storz Endoscopy for equipment support.


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Copyright information

© Springer Science+Business Media, LLC 2006

Authors and Affiliations

  • Dimitrios Stefanidis
    • 1
  • Randy Haluck
    • 2
  • Tai Pham
    • 2
  • J. Bruce Dunne
    • 3
  • Timothy Reinke
    • 2
  • Sarah Markley
    • 3
  • James R. KorndorfferJr.
    • 3
  • Paul Arellano
    • 4
  • Daniel B. Jones
    • 5
  • Daniel J. Scott
    • 6
  1. 1.Department of General Surgery - Division of Gastrointestinal and Minimally Invasive SurgeryCarolinas Medical CenterCharlotteUSA
  2. 2.Department of SurgeryPennsylvania State UniversityPhiladelphiaUSA
  3. 3.Tulane Center for Minimally Invasive SurgeryTulane University Health Sciences CenterNew OrleansUSA
  4. 4.Texas Endosurgery InstituteSan AntonioUSA
  5. 5.Section of Minimally Invasive Surgery, Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonUSA
  6. 6.Southwestern Center for Minimally Invasive SurgeryUniversity of Texas Southwestern Medical CenterDallasUSA

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