Face-, expert, and referent validity of the Xitact LS500 - Laparoscopy Simulator

Background: This study was undertaken to establish face-, expert, and referent validity of the Xitact LS500; a virtual reality laparoscopic cholecystectomy simulator. Methods: A four-page, 20-item structured questionnaire was presented to 120 surgeons attending a surgical convention. Participants received an instructed hands-on tour on the Xitact simulator. Data were analyzed according to the level of experience of the surgeon, resulting in an expert group opinion of 87 surgeons and a referent group opinion of 33 surgeons. Results: The majority of respondents believe Xitact has the potential to become a useful tool in teaching (93.1 %) and measuring performance assessment (79.3%) in laparoscopic cholecystectomy. Expert- and referent-group opinion does not differ significantly on any of the presented statements. The opinion regarding the realism of the virtual laparoscopic cholecystectomy environment is favorable among both groups, although it is considered not yet perfect. The haptic feedback sensation of the Xitact is a parameter that needs further development. Conclusions: Both expert- and referent surgeons value Xitact to be an important and useful tool in the laparoscopic teaching setting. Further studies need to be performed to establish the construct validity of the simulator (e.g., to what extent is the simulator logically encompassed into a theoretical framework of acquiring skills, needed for the laparoscopic cholecystectomy) to measure shortening of learning curves on the laparoscopic cholecystectomy procedure, and ultimately to justify its use in the surgical curriculum.