Construct validity of anterior segment anti-tremor and forceps surgical simulator training modules. Attending versus resident surgeon performance

Purpose: To compare the performance of the anterior segment forceps and anti-tremor training modules of the EYESi surgical simulator (VRmagic) by residents and experienced attending surgeons using the simulator for the first time. Setting: Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, USA. Methods: Twelve residents (4 per year) in the Mayo Clinic ophthalmology residency program and 3 experienced anterior segment surgeons participated. Each participant completed a total of 20 task trials on the EYESi forceps and anti-tremor level 4 training modules. Thus, the 15 participants completed a total of 300 task trials. Results: For the forceps module, experienced surgeons achieved significantly better total scores (P = .03), with lower total task time (P = .007) and instrument-in-eye time (P = .006) measurements. For the anti-tremor module, experienced surgeons achieved significantly better total scores (P = .02), with lower task time (P = .04) and instrument-in-eye time (P = .02) measurements. In addition, experienced surgeons performing the anti-tremor task had 76% more precise surgical outcomes as measured by the out-of-tolerance percentage (P = .03). All forceps and anti-tremor-measured parameters indicated significantly lower performance (P<.05) for the first 1 or 2 trials, with the exception of anti-tremor module incision stress, out-of-tolerance percentage, and average tremor values. Experienced surgeons had more consistent (lower variance) total scores on the forceps (P = .05) and anti-tremor (P = .03) training modules. Conclusion: The EYESi surgical simulator anterior segment forceps and anti-tremor modules showed significant (P<.05) construct validity.