World journal of Minimal Access Surgery Volume No 9

Original Article Open Access

Predictive Validity of the ProMIS Hybrid Simulator in a Urology Residency Training Program

Amjad Alwaal, Talal Al-Qaoud, Richard Haddad, Tarek Alzahrani, Josee Delisle and Maurice Anidjar
World journal of Minimal Access Surgery 2015, 4:1



We assessed the predictive validity of ProMIS hybrid laparoscopic simulator in a urology residency program.


Between June 2008 and December 2011, we trained 14 urology residents on ProMIS, measuring 5 basic laparoscopic tasks (peg transfer, pattern cutting, EndoLoop placement, extracorporeal suturing, and intracorporeal suturing). Then, we compared their last performance on ProMIS to their first performance on a porcine laparoscopic nephrectomy model. Two independent urologic surgeons with laparoscopic experience rated the resident performance on the porcine models, and kappa test with standardized weight function was used to assess for inter-observer bias. Non-parametric spearman correlation test was used to compare each rater’s cumulative score with the cumulative score obtained on the porcine models in order to test the predictive validity of the ProMIS simulator.


The kappa results showed acceptable agreement between the two observers amongst all domains of the rating scale of performance except for confidence of movement and efficiency. In addition, poor predictive validity of the ProMIS simulator was demonstrated.


We could not demonstrate the predictive validity for the ProMIS hybrid simulator in our urology residency program.

Key words

ProMIS, MISTELS, Laparoscopic simulator, MIS training

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