203 - Validation Design of a Computer-Based Simulation for Scrub Role Competency

Description: Study Question and

Background: Training for the surgical scrub role, which is essential in civilian and military perioperative care, has historically relied on apprenticeship-style education. However, apprentice models present standardization, skill sustainment, and readiness challenges, particularly for military surgical teams operating in low-volume, distributed, or austere environments. Computer-based simulation (CBS) offers a scalable, accessible alternative but often lacks rigorous psychometric validation and dedicated assessment tools. For example, PeriopSim (Conquer Experience Inc., 2024) is the only commercially available, off-the-shelf CBS platform designed specifically for scrub role training. However, it has not yet undergone psychometric evaluation. Without validated CBS training, perioperative nurses and surgical technologists may lack critical skills required for both hospital-based and austere surgical settings.
Research Question: To what extent does the PeriopSim Hemicolectomy module demonstrate content validity, reliability, and usability for scrub role training?

Design

Description: This cross-sectional validation study applies Messick's contemporary validity framework to assess the validity, reliability, and usability of the PeriopSim Hemicolectomy module for scrub role training. The study assesses multiple sources of validity evidence across four phases: content, response process, internal structure, relations to other variables, and generalizability. The laparotomy (hemicolectomy) module was chosen for its critical relevance to trauma surgery in civilian and military settings.

Methodology:

1. Instrument Development: The "Scrub Role Simulator: Content Validity and Usability" (SRS-CVU) instrument will be developed and validated through iterative feedback from perioperative educators and simulation experts using a modified Delphi method. Content validity ratios (CVR) and overall content validity index (CVI) will be calculated based on panelist responses to each item.
2. Content Validity: Module content validity will be evaluated using the SRS-CVU instrument with a second expert panel. CVIs and intraclass correlation coefficients (ICC) will be calculated for each item after module completion.
3. Reliability and Performance Testing: Module reliability will be evaluated with military perioperative nurses and surgical technologists. ICCs will be calculated based on participant performance scores across three CBS module sessions. Independent t-tests and one-way ANOVA will be used to analyze relationships between professional role, performance, and self-reported competency.
4. Usability Testing: End-user perceptions will be assessed using the System Usability Scale (SUS) and qualitative feedback. ICCs will be calculated to assess agreement, and Spearman's rank correlation will be used to analyze relationships between prior CBS exposure and usability.

Perioperative Nursing Implications: Validated computer-based simulation offers a standardized, scalable training solution to sustain scrub role competency and enhance perioperative safety. Establishing robust validity, reliability, and usability evidence for the PeriopSim module addresses a critical educational gap and aligns with AORN Guidelines for competency verification, professional development, and quality improvement in civilian and military perioperative practice.