Examining validity evidence for a simulation-based assessment tool for basic robotic surgical skills

7 Citations (Scopus)


Increasing focus on patient safety makes it important to ensure surgical competency among surgeons before operating on patients. The objective was to gather validity evidence for a virtual-reality simulator test for robotic surgical skills and evaluate its potential as a training tool. Surgeons with varying experience in robotic surgery were recruited: novices (zero procedures), intermediates (1–50), experienced (> 50). Five experienced surgeons rated five exercises on the da Vinci Skills Simulator. Participants were tested using the five exercises. Participants were invited back 3 times and completed a total of 10 attempts per exercise. The outcome was the average simulator performance score for the 5 exercises. 32 participants from 5 surgical specialties were included. 38 participants completed all 4 sessions. A moderate correlation between the average total score and robotic experience was identified for the first attempt (Spearman r = 0.58; p = 0.0004). A difference in average total score was observed between novices and intermediates [median score 61% (IQR 52–66) vs. 83% (IQR 75–91), adjusted p < 0.0001], as well as novices and experienced [median score 61% (IQR 52–66) vs. 80 (IQR 69–85), adjusted p = 0.002]. All three groups improved their performance between the 1st and 10th attempts (p < 0.00). This study describes validity evidence for a virtual-reality simulator for basic robotic surgical skills, which can be used for assessment of basic competency and as a training tool. However, more validity evidence is needed before it can be used for certification or high-stakes assessment.

Original languageEnglish
JournalJournal of Robotic Surgery
Issue number1
Pages (from-to)99-106
Number of pages8
Publication statusPublished - 2019


  • Assessment
  • Robotic surgery
  • Simulation
  • Validity
  • Virtual reality
  • Clinical Competence
  • Simulation Training
  • Humans
  • Male
  • Surgeons/education
  • Educational Measurement/methods
  • Education, Medical/methods
  • Patient Safety
  • Female
  • Virtual Reality
  • Robotic Surgical Procedures/education


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