Surgical Endoscopy

, Volume 32, Issue 8, pp 3576–3581 | Cite as

A model for predicting the GEARS score from virtual reality surgical simulator metrics

  • Ariel Kate DubinEmail author
  • Danielle Julian
  • Alyssa Tanaka
  • Patricia Mattingly
  • Roger Smith



Surgical education relies heavily upon simulation. Assessment tools include robotic simulator assessments and Global Evaluative Assessment of Robotic Skills (GEARS) metrics, which have been validated. Training programs use GEARS for proficiency testing; however, it requires a trained human evaluator. Due to limited time, learners are reliant on surgical simulator feedback to improve their skills. GEARS and simulator scores have been shown to be correlated but in what capacity is unknown. Our goal is to develop a model for predicting GEARS score using simulator metrics.


Linear and multivariate logistic regressions were used on previously reported data by this group. Subjects performed simple (Ring and Rail 1) and complex (Suture Sponge 1) tasks on simulators, the dV-Trainer (dVT) and the da Vinci Skills Simulator (dVSS). They were scored via simulator metrics and GEARS.


A linear model for each simulator and exercise showed a positive linear correlation. Equations were developed for predicting GEARS Total Score from simulator Overall Score. Next, the effects of each individual simulator metric on the GEARS Total Score for each simulator and exercise were examined. On the dVSS, Excessive Instrument Force was significant for Ring and Rail 1 and Instrument Collision was significant for Suture Sponge 1. On the dVT, Time to Complete was significant for both exercises. Once the significant variables were identified, multivariate models were generated. Comparing the predicted GEARS Total Score from the linear model (using only simulator Overall Score) to that using the multivariate model (using the significant variables for each simulator and exercise), the results were similar.


Our results suggest that trainees can use simulator Overall Score to predict GEARS Total Score using our linear regression equations. This can improve the training process for those preparing for high-stakes assessments.


Surgical education Simulation Robotic simulator Assessment Predictive model 



The authors would like to thank Julie Pepe, Ph.D. of Florida Hospital for her help with statistics.


This study received financial support through a grant from the US Army Telemedicine and Advanced Technology Research Center (TATRC), Grant Number W81XWH-11-2-0158.

Compliance with ethical standards


Drs. Dubin, Mattingly, Tanaka, and Smith and Ms. Julian have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ariel Kate Dubin
    • 1
    Email author
  • Danielle Julian
    • 2
  • Alyssa Tanaka
    • 3
  • Patricia Mattingly
    • 1
  • Roger Smith
    • 2
  1. 1.Department of Obstetrics and GynecologyColumbia University Medical CenterNew YorkUSA
  2. 2.Florida Hospital Nicholson CenterOrlandoUSA
  3. 3.SoarTech Inc.OrlandoUSA

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