Validation of a Simulator for Cranial Graft Lift Training: Face, Content, and Construct Validity
M. Hollensteiner, P. Augat, D. Fürst, B. Esterer, S. Gabauer, M. Malek, S. Hunger, F. Schrödl, A. Schrempf - Validation of a Simulator for Cranial Graft Lift Training: Face, Content, and Construct Validity - Journal of Cranio-Maxillo-Facial Surgery, Vol. 46, No. 8, 2018, pp. 1390-1394
Purpose: Surgical skills can be improved through practical
exercise. The use of specimens, human as well as animal, or live
animals for surgical training is limited due to ethical concerns.
Drawbacks of simulators are costs, fidelity and creditibility. Thus,
simulators must be evaluated objectively to determine their validity
before they can be used as teaching modalities. The aim of this study
was to verify the face content and construct validity of a novel
model-based simulator for lifting tabula externa transplants from the
Materials and Methods: Participants were invited to perform a
tabula externa graft lift during a training session on the simulator. Task
performance was analyzed with a standardized assessment tool evaluating
realism and appropriateness. Specialist ratings were used to evaluate the
performance of the participants. This was an exploratory study using
a questionnaire, a t Kepler University Hospital, Linz, Austria, a
university hospital. According to their expertise in
craniomaxillofacial surgery, 17 participants were subdivided into 3
groups: 8 novices, 7 experts and 2 raters.
Results: The face validity (realism) obtained an average score of 4.2 of a
maximum of 5 points. Likewise, the content validity (appropriateness
as a teaching modality) obtained an average score of 4.8 of maximum 5 points. No differences were found between experts and novices
concerning the recorded surgery completion times (p=0.418) or the
sizes of the lifted grafts (p=0.110). During the evaluation of task
performance, the expert surgeons (46.9 ± 3.7) were graded significantly
better than the novices (36.4 ± 8.5), which proved the construct validity
of the simulator (p=0.001).
Conclusion: All investigated validities were confirmed and approved
the simulator as a valid training tool for parietal graft lift.