Evaluation of a new virtual-reality training simulator for hysteroscopy

AuthorPD Dr. med. Michael Bajka, Dr. Stefan Tuchschmid, Daniel Fink, Prof. Dr. Gabor Szekely, PD Dr. Matthias Harders


To determine realism and training capacity of HystSim, a new virtual-reality simulator for the training of hysteroscopic interventions.


Sixty-two gynaecological surgeons with various levels of expertise were interviewed at the 13th Practical Course in Gynaecologic Endoscopy in Davos, Switzerland. All participants received a 20-min hands-on training on the simulator and filled out a four-page questionnaire. Twentythree questions with respect to the realism of the simulation and the training capacity were answered on a seven-point Likert scale along with 11 agree–disagree statements concerning the HystSim training in general.


Twenty-six participants had performed more than 50 hysteroscopies (‘‘experts’’) and 36 equal to or fewer than 50 (‘‘novices’’). Four of 60 (6.6%) responding participants judged the overall impression as ‘‘7 – absolutely realistic’’, 40 (66.6%) as ‘‘6 – realistic’’, and 16 (26.6%) as ‘‘5 – somewhat realistic’’. Novices (6.48; 95% confidence interval [CI] 6.28–6.7) rated the overall training capacity significantly higher than experts (6.08; 95% CI 5.85–6.3), however, high-grade acceptance was found in both groups. In response to the statements, 95.2% believe that HystSim allows procedural training of diagnostic and therapeutic hysteroscopy, and 85.5% suggest that HystSim training should be offered to all novices before performing surgery on real patients.


Face validity has been established for a new hysteroscopic surgery simulator. Potential trainees and trainers assess it to be a realistic and useful tool for the training of hysteroscopy. Further systematic validation studies are needed to clarify how this system can be optimally integrated into the gynaecological curriculum.