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and vessel energy dissection. Six of the psychomotor skill tasks are described in
Figs. 5.14, 5.15, 5.16, 5.17, 5.18, and 5.19 below. Each task had to be completed
two consecutive times to the proficiency benchmark level. Proficiency was set to
benchmark performances by expert surgeons, which were determined indepen-
dently for each task of each simulator (i.e., the number of errors that were the
benchmark score on VR simulators and the physical dome varied for each exercise,
as per the expert performances). Visual representations of the same six exercises
are seen in Fig. 5.20.
The validation trial of the psychomotor skills included pre- and post-tests with
avian tissue models, evaluated with both a numeric metric checklist by the proctor
and a video analysis of both the checklist and a GEARS scoring. In the future, an
advanced fundamentals of specialty-specific basic skills have been (and others will
be) developed by the 12 participating specialties.
Fig. 5.14 FRS Task 1: Ring tower transfer. The trainee removes a ring from the top right middle
tower and places it on the lower left side tower. Then the ring from the top left middle tower is
removed and placed on the lower right side tower. Primary skills: eye-hand instrument coordina-
tion, camera navigation, use of camera pedal, and wristed instrument maneuvering. Secondary
skills: wrist articulation and ambidexterity
Fig. 5.15 FRS Task 2:
Knot tying. The trainee ties
a surgeon’s knot to
approximate the two
eyelets such that they touch
each other and then back
up the knot with two more
throws. Primary skills:
appropriate handling of
suture material and tying
secure knots. Secondary
Skills: Wrist articulation,
hand-eye instrument
coordination, and
ambidexterity
E.I. George et al.