Refinement in the analysis of motion within low-cost laparoscopic simulators of differing size: Implications on assessing technical skills

Background: Simulation is becoming more important in the teaching and assessment of technical skills. The purpose of this study was to refine the use of motion analysis parameters (MAPs) to assess performance of a defined task in low-cost pediatric laparoscopic simulators of differing size. Methods: 105 participants performed a defined intracorporeal suturing task in large and small pediatric laparoscopic simulators. Outcomes included MAPs — path length, extreme velocity events, and extreme acceleration events in all available degrees of freedom for novices, intermediates, and experts. ANOVA p < 0.05 was judged significant. Results: In the smaller simulator, all MAPs discriminated between expertise groups in all degrees of freedom. In the larger simulator, all but one MAP discriminated between expertise groups. Experts demonstrated the greatest variability in performance between the larger and smaller simulators. Conclusion: Analysis of motion in the performance of a defined intracorporeal suturing task allowed discrimination between novices, intermediates, and experts in large and small low-cost pediatric laparoscopic simulators. Further refinement in MAPs will determine their role in surgical education. Level of evidence: Not applicable.