1. Int J Med Robot. 2020 Aug;16(4):e2105. doi: 10.1002/rcs.2105. Epub 2020 Apr 4.

Systematic approach for content and construct validation: Case studies for 
arthroscopy and laparoscopy.

Farmer J(1), Demirel D(2), Erol R(1), Ahmadi D(3), Halic T(1), Kockara S(1), 
Arikatla VS(4), Sexton K(5), Ahmadi S(6).

Author information:
(1)Department of Computer Science, University of Central Arkansas, Conway, 
Arkansas, USA.
(2)Department of Computer Science, Florida Polytechnic University, Lakeland, 
Florida, USA.
(3)Pulaski Academy, Little Rock, Arkansas, USA.
(4)Kitware, Carrboro, North Carolina, USA.
(5)Department of Surgery, University of Arkansas for Medical Sciences, Little 
Rock, Arkansas, USA.
(6)Department of Orthopedic Surgery, University of Arkansas for Medical 
Sciences, Little Rock, Arkansas, USA.

BACKGROUND: In minimally invasive surgery, there are several challenges for 
training novice surgeons, such as limited field-of-view and unintuitive hand-eye 
coordination due to performing the operation according to video feedback. 
Virtual reality (VR) surgical simulators are a novel, risk-free, and 
cost-effective way to train and assess surgeons.
METHODS: We developed VR-based simulations to accurately assess and quantify 
performance of two VR simulations: gentleness simulation for laparoscopy and 
rotator cuff repair for arthroscopy. We performed content and construct validity 
studies for the simulators. In our analysis, we systematically rank surgeons 
using data mining classification techniques.
RESULTS: Using classification algorithms such as K-Nearest Neighbors, Support 
Vector Machines, and Logistic Regression we have achieved near 100% accuracy 
rate in identifying novices, and up to an 83% accuracy rate identifying experts. 
Sensitivity and specificity were up to 1.0 and 0.9, respectively.
CONCLUSION: Developed methodology to measure and differentiate the highly ranked 
surgeons and less-skilled surgeons.

© 2020 John Wiley & Sons, Ltd.

DOI: 10.1002/rcs.2105
PMCID: PMC7980497
PMID: 32207877 [Indexed for MEDLINE]

Conflict of interest statement: Competing interests The authors declare that 
they have no competing interests.