Evaluation of a new virtual-reality training simulator for hysteroscopy

To determine realism and training capacity of HystSim, a new virtual-reality simulator for the training of hysteroscopic interventions. Sixty-two gynaecological surgeons with various levels of expertise were interviewed at the 13(th) Practical Course in Gynaecologic Endoscopy in Davos, Switzerland. All participants received a 20-min hands-on training on the simulator and filled out a four-page questionnaire. Twenty-three questions with respect to the realism of the simulation and the training capacity were answered on a seven-point Likert scale along with 11 agree-disagree statements concerning the HystSim training in general. Twenty-six participants had performed more than 50 hysteroscopies (experts) and 36 equal to or fewer than 50 (novices). Four of 60 (6.6%) responding participants judged the overall impression as 7 - absolutely realistic, 40 (66.6%) as 6 - realistic, and 16 (26.6%) as 5 - somewhat realistic. Novices (6.48; 95% confidence interval [CI] 6.28-6.7) rated the overall training capacity significantly higher than experts (6.08; 95% CI 5.85-6.3), however, high-grade acceptance was found in both groups. In response to the statements, 95.2% believe that HystSim allows procedural training of diagnostic and therapeutic hysteroscopy, and 85.5% suggest that HystSim training should be offered to all novices before performing surgery on real patients. Face validity has been established for a new hysteroscopic surgery simulator. Potential trainees and trainers assess it to be a realistic and useful tool for the training of hysteroscopy. Further systematic validation studies are needed to clarify how this system can be optimally integrated into the gynaecological curriculum.