Metrics for Laparoscopic Skills Trainers: The Weakest Link!

Metrics are widely employed in virtual environments and provide a yardstick for performance measurement. The current method of defining metrics for medical simulation remains more an art than a science. Herein, we report a practical scientific approach to defining metrics, specifically aimed at computer-assisted laparoscopic skills training. We also propose a standardized global scoring system usable across different laparoscopic trainers and tasks. The metrics were defined in an explicit way based on the relevant skills that a laparoscopic surgeon should master. We used a five degree of freedom device and a software platform capable of 1) tracking the motion of two laparoscopic instruments 2) real time information processing and feedback provision. A validation study was performed. The results show that our metrics and scoring system represent a technically sound approach that can be easily incorporated in a computerized trainer for any task, enabling a standardized performance assessment method.