Surgical Endoscopy

, Volume 29, Issue 11, pp 3392–3403

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons

  • Fernando Pérez Escamirosa
  • Ricardo Manuel Ordorica Flores
  • Ignacio Oropesa García
  • Cristian Rubén Zalles Vidal
  • Arturo Minor Martínez
New Technology



The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons’ psychomotor skills.


Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand–eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach’s α test.


Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels.


EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons.


Laparoscopic surgery Surgical training Objective assessment Motion metrics Validation Endoscopic orthogonal video system (EndoViS


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Fernando Pérez Escamirosa
    • 1
  • Ricardo Manuel Ordorica Flores
    • 2
  • Ignacio Oropesa García
    • 3
  • Cristian Rubén Zalles Vidal
    • 2
  • Arturo Minor Martínez
    • 1
  1. 1.Bioelectronics Section, Department of Electrical EngineeringCenter for Research and Advanced Studies of the National Polytechnic Institute of Mexico (CINVESTAV - IPN)Mexico CityMexico
  2. 2.Department of Pediatric SurgeryHospital Infantil de Mexico Federico GómezMexico CityMexico
  3. 3.Bioengineering and Telemedicine Centre (GBT), ETSI TelecommunicationUniversidad Politécnica de Madrid (UPM)MadridSpain

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