Methodologies for establishing validity in surgical simulation studies

Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity...

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Published in	Surgery Vol. 147; no. 5; pp. 622 - 630
Main Authors	Van Nortwick, Sara S., Lendvay, Thomas S., Jensen, Aaron R., Wright, Andrew S., Horvath, Karen D., Kim, Sara
Format	Journal Article
Language	English
Published	New York, NY Mosby, Inc 01.05.2010 Elsevier
Subjects	Biological and medical sciences Competency-Based Education - methods Competency-Based Education - standards Computer-Assisted Instruction - methods Computer-Assisted Instruction - standards Education, Medical, Graduate - methods Education, Medical, Graduate - standards Educational Measurement - standards General aspects General Surgery - education Humans Medical sciences Reproducibility of Results Surgery Medicine Validity Treatment Methodology Simulation Surgery
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ISSN	0039-6060 1532-7361 1532-7361
DOI	10.1016/j.surg.2009.10.068

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Abstract	Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity in surgical simulation studies. We conducted a systematic review of studies establishing validity. A PubMed search was performed with the following keywords: “validity/validation,” “simulation,” “surgery,” and “technical skills.” Descriptors were tabulated for 29 methodological variables by 2 reviewers. A total of 83 studies were included in the review. Of these studies, 60% targeted construct, 24% targeted concurrent, and 5% looked at predictive validity. Less than half (45%) of all the studies reported reliability data. Most studies (82%) were conducted in a single institution with a mean of 37 subjects recruited. Only half of the studies provided rationale for task selection. Data sources included simulator-generated measures (34%), performance assessment by human evaluators (33%), motion tracking (6%), and combined modes (28%). In studies using human evaluators, videotaping was a common (48%) blinding technique; however, 34% of the studies did not blind evaluators. Commonly reported outcomes included task time (86%), economy of motion (51%), technical errors (48%), and number of movements (25%). The typical validation study comes from a single institution with a small sample size, lacks clear justification for task selection, omits reliability reporting, and poses potential bias in study design. The lack of standardized validation methodologies creates challenges for training centers that survey the literature to determine the appropriate method for their local settings.
AbstractList	Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity in surgical simulation studies. We conducted a systematic review of studies establishing validity. A PubMed search was performed with the following keywords: “validity/validation,” “simulation,” “surgery,” and “technical skills.” Descriptors were tabulated for 29 methodological variables by 2 reviewers. A total of 83 studies were included in the review. Of these studies, 60% targeted construct, 24% targeted concurrent, and 5% looked at predictive validity. Less than half (45%) of all the studies reported reliability data. Most studies (82%) were conducted in a single institution with a mean of 37 subjects recruited. Only half of the studies provided rationale for task selection. Data sources included simulator-generated measures (34%), performance assessment by human evaluators (33%), motion tracking (6%), and combined modes (28%). In studies using human evaluators, videotaping was a common (48%) blinding technique; however, 34% of the studies did not blind evaluators. Commonly reported outcomes included task time (86%), economy of motion (51%), technical errors (48%), and number of movements (25%). The typical validation study comes from a single institution with a small sample size, lacks clear justification for task selection, omits reliability reporting, and poses potential bias in study design. The lack of standardized validation methodologies creates challenges for training centers that survey the literature to determine the appropriate method for their local settings. Background Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity in surgical simulation studies. Methods We conducted a systematic review of studies establishing validity. A PubMed search was performed with the following keywords: “validity/validation,” “simulation,” “surgery,” and “technical skills.” Descriptors were tabulated for 29 methodological variables by 2 reviewers. Results A total of 83 studies were included in the review. Of these studies, 60% targeted construct, 24% targeted concurrent, and 5% looked at predictive validity. Less than half (45%) of all the studies reported reliability data. Most studies (82%) were conducted in a single institution with a mean of 37 subjects recruited. Only half of the studies provided rationale for task selection. Data sources included simulator-generated measures (34%), performance assessment by human evaluators (33%), motion tracking (6%), and combined modes (28%). In studies using human evaluators, videotaping was a common (48%) blinding technique; however, 34% of the studies did not blind evaluators. Commonly reported outcomes included task time (86%), economy of motion (51%), technical errors (48%), and number of movements (25%). Conclusion The typical validation study comes from a single institution with a small sample size, lacks clear justification for task selection, omits reliability reporting, and poses potential bias in study design. The lack of standardized validation methodologies creates challenges for training centers that survey the literature to determine the appropriate method for their local settings. Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity in surgical simulation studies.BACKGROUNDValidating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for conducting rigorous validation studies. Our study reports current methodological approaches and proposes benchmark criteria for establishing validity in surgical simulation studies.We conducted a systematic review of studies establishing validity. A PubMed search was performed with the following keywords: "validity/validation," "simulation," "surgery," and "technical skills." Descriptors were tabulated for 29 methodological variables by 2 reviewers.METHODSWe conducted a systematic review of studies establishing validity. A PubMed search was performed with the following keywords: "validity/validation," "simulation," "surgery," and "technical skills." Descriptors were tabulated for 29 methodological variables by 2 reviewers.A total of 83 studies were included in the review. Of these studies, 60% targeted construct, 24% targeted concurrent, and 5% looked at predictive validity. Less than half (45%) of all the studies reported reliability data. Most studies (82%) were conducted in a single institution with a mean of 37 subjects recruited. Only half of the studies provided rationale for task selection. Data sources included simulator-generated measures (34%), performance assessment by human evaluators (33%), motion tracking (6%), and combined modes (28%). In studies using human evaluators, videotaping was a common (48%) blinding technique; however, 34% of the studies did not blind evaluators. Commonly reported outcomes included task time (86%), economy of motion (51%), technical errors (48%), and number of movements (25%).RESULTSA total of 83 studies were included in the review. Of these studies, 60% targeted construct, 24% targeted concurrent, and 5% looked at predictive validity. Less than half (45%) of all the studies reported reliability data. Most studies (82%) were conducted in a single institution with a mean of 37 subjects recruited. Only half of the studies provided rationale for task selection. Data sources included simulator-generated measures (34%), performance assessment by human evaluators (33%), motion tracking (6%), and combined modes (28%). In studies using human evaluators, videotaping was a common (48%) blinding technique; however, 34% of the studies did not blind evaluators. Commonly reported outcomes included task time (86%), economy of motion (51%), technical errors (48%), and number of movements (25%).The typical validation study comes from a single institution with a small sample size, lacks clear justification for task selection, omits reliability reporting, and poses potential bias in study design. The lack of standardized validation methodologies creates challenges for training centers that survey the literature to determine the appropriate method for their local settings.CONCLUSIONThe typical validation study comes from a single institution with a small sample size, lacks clear justification for task selection, omits reliability reporting, and poses potential bias in study design. The lack of standardized validation methodologies creates challenges for training centers that survey the literature to determine the appropriate method for their local settings.
Author	Wright, Andrew S. Jensen, Aaron R. Van Nortwick, Sara S. Horvath, Karen D. Lendvay, Thomas S. Kim, Sara
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Snippet	Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies for... Background Validating assessment tools in surgical simulation training is critical to objectively measuring skills. Most reviews do not elicit methodologies...
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SubjectTerms	Biological and medical sciences Competency-Based Education - methods Competency-Based Education - standards Computer-Assisted Instruction - methods Computer-Assisted Instruction - standards Education, Medical, Graduate - methods Education, Medical, Graduate - standards Educational Measurement - standards General aspects General Surgery - education Humans Medical sciences Reproducibility of Results Surgery
Title	Methodologies for establishing validity in surgical simulation studies
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