Face, content, and construct validity of four, inanimate training exercises using the da Vinci A® Si surgical system configured with Single-Site ™ instrumentation

Validated training exercises are essential tools for surgeons as they develop technical skills to use robot-assisted minimally invasive surgical systems. The purpose of this study was to show face, content, and construct validity of four, inanimate training exercises using the da Vinci (A (R)) Si surgical system configured with Single-Site ((TM)) instrumentation. New (N = 21) and experienced (N = 6) surgeons participated in the study. New surgeons (11 Gynecology [GYN] and 10 General Surgery [GEN]) had not completed any da Vinci Single-Site cases but may have completed multiport cases using the da Vinci system. They participated in this study prior to attending a certification course focused on da Vinci Single-Site instrumentation. Experienced surgeons (5 GYN and 1 GEN) had completed at least 25 da Vinci Single-Site cases. The surgeons completed four inanimate training exercises and then rated them with a questionnaire. Raw metrics and overall normalized scores were computed using both video recordings and kinematic data collected from the surgical system. The experienced surgeons significantly outperformed new surgeons for many raw metrics and the overall normalized scores derived from video review (p < 0.05). Only one exercise did not achieve a significant difference between new and experienced surgeons (p = 0.08) when calculating an overall normalized score using both video and advanced metrics derived from kinematic data. Both new and experienced surgeons rated the training exercises as appearing, to train and measure technical skills used during da Vinci Single-Site surgery and actually testing the technical skills used during da Vinci Single-Site surgery. In summary, the four training exercises showed face, content, and construct validity. Improved overall scores could be developed using additional metrics not included in this study. The results suggest that the training exercises could be used in an overall training curriculum aimed at developing proficiency in technical skills for surgeons new to da Vinci Single-Site instrumentation.