Construct validation of a low-fidelity endoscopic sinus surgery simulator

Background: Before a simulator becomes widely accepted, it must be relevant, affordable, and accessible. We have developed a low-cost model emphasizing the basic skills required for endoscopic sinus surgery (ESS). It is noninvasive,free from risk of infection, and an excellent low-pressure learning opportunity. The current study was designed to assess the construct validity of our simulator. Methods: We conducted a stratified randomized crossover-control study. Otolaryngology residents, fellows, and faculty performed predetermined tasks oil the model or cadaver, and then switched. Evaluation included hand motion analysis, task time, and blinded expert review. Results: Sixteen subjects at various levels of training participated. Cadaver performance correlated well with level of training and previous experience with ESS. However, model performance did not demonstrate statistically significant correlation. Conclusion: Our model was unable to demonstrate clear construct validity at this time. Materials and structural modifications are in progress. Pending further validation, its low-cost construction possesses potential for integration into otolaryngology residency curricula. Assessment of the simulator's ability to improve surgical skill is also planned.