Face and construct validity of a computer-based virtual reality simulator for ERCP

Background: Currently, little evidence supports computer-based simulation for ERCP training. Objective: To determine face and construct validity of a computer-based Simulator for ERCP and assess its perceived utility as a training tool. Design: Novice and expert endoscopists completed 2 simulated ERCP cases by using the GI Mentor II. Setting: Virtual Education and Surgical Simulation Laboratory, Medical College of Georgia. Main Outcome Measurements: Outcomes included times to complete the procedure, reach the papilla, and use fluoroscopy; attempts to cannulate the papilla, pancreatic duct, and common bile duct; and number of contrast injections and complications. Subjects assessed simulator graphics, procedural accuracy, difficulty, haptics,overall realism, and training potential. Results: Only when performance data from cases A and B were combined did the GI Mentor II differentiate novices and experts based on times to complete the procedure, reach the papilla, and Use fluoroscopy Across skill levels, overall opinions were similar regarding graphics (moderately realistic), accuracy (similar to clinical ERCP), difficulty (similar to clinical ERCP), overall realism (moderately realistic), and haptics. Most participants (92%) claimed that the Simulator has definite training potential or should be required for training. Limitations: Small sample size, single institution. Conclusions: The GI Mentor II demonstrated construct validity for ERCP based on select metrics. Most Subjects thought that the simulated graphics, procedural accuracy, and overall realism exhibit face validity. Subjects deemed it a useful training tool. Study repetition involving more participants and cases may help confirm results and establish the simulator's ability to differentiate skill levels based on ERCP-specific metrics. (Gastrointest Endosc 2010;71:357-64.)