Abstract
BACKGROUND: This study aimed to develop and validate a virtual reality (VR) simulation-based test for assessing laparoscopic camera navigation skills, using Messick's contemporary framework to gather validity evidence and establish an evidence-based pass/fail standard. METHODS: The test was developed through consensus among surgical experts and included eight clinically relevant metrics. A total of 24 participants, comprising 12 novice medical students and 12 experienced surgical residents, were recruited. RESULTS: The test demonstrated high internal consistency reliability (Cronbach's α = 0.88) and test-retest reliability (Pearson's r = 0.84). Significant differences in performance were observed between novices (51.8 ± 13.9) and experienced participants (81.7 ± 6.0, p < 0.001), indicating strong discriminative ability.A pass/fail score of 70% was established using the contrasting groups' method, with one novice passing and no experienced participants failing. Participants perceived the simulator as realistic and beneficial for skill improvement, though experienced participants were less inclined to use it for further practice. CONCLUSIONS: The study concludes that the VR laparoscopic camera navigation test provides a valid and reliable tool for training and assessing surgical assistants, supporting its integration into mastery learning programs to ensure proficiency before clinical practice.