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Int J Surg. 2012;10(3):163-6. doi: 10.1016/j.ijsu.2012.02.012. Epub 2012 Feb 23.

Face validity, construct validity and training benefits of a virtual reality TURP simulator.

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Exeter Surgical Health Services Research Unit, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, Devon EX2 5DW, UK.



To assess face validity, construct validity and the training benefits of a virtual reality TURP simulator.


11 novices (no TURP experience) and 7 experts (>200 TURP's) completed a virtual reality median lobe prostate resection task on the TURPsim™ (Simbionix USA Corp., Cleveland, OH). Performance indicators (percentage of prostate resected (PR), percentage of capsular resection (CR) and time diathermy loop active without tissue contact (TAWC) were recorded via the TURPsim™ and compared between novices and experts to assess construct validity. Verbal comments provided by experts following task completion were used to assess face validity. Repeated attempts of the task by the novices were analysed to assess the training benefits of the TURPsim™.


Experts resected a significantly greater percentage of prostate per minute (p < 0.01) and had significantly less active diathermy time without tissue contact (p < 0.01) than novices. After practice, novices were able to perform the simulation more effectively, with significant improvement in all measured parameters. Improvement in performance was noted in novices following repetitive training, as evidenced by improved TAWC scores that were not significantly different from the expert group (p = 0.18).


This study has established face and construct validity for the TURPsim™. The potential benefit in using this tool to train novices has also been demonstrated.

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