Peer-reviewed research


The McDougal principles of validation (construct, face and content) have been conducted by 4 research groups. Each of the groups belonged to a different procedures, surgical specialties and institutions. The first paper was from an orthopaedic team in London (UK), followed by a Plastic surgical team at Stanford Hospital in Stanford (USA) an oro-maxillofacial team at Mount Sinai in New York (USA) and a General Surgery team in Heidelberg (Germany).

Construct validation tests the ability of the simulator to differentiate between different experience groups. Content validation is the expert opinion of content within the simulations with focus on the accuracy of the anatomy, steps and use of instruments. Face validation is the subjective assessment of the platform as a training tool (face value).

Statistical significance was demonstrated in all studies proving repeatability of validation irrespective of procedure, specialty and location.

Learning curves and knowledge

This research was conducted by the orthopedic team in London (UK) and published in Injury. The learning curve is the progressive improvement in scores with repeated attempts. Knowledge transfer assesses the impact of learning, tested on another medium.

Participants naive to Intramedullary femoral nailing and Touch Surgery were assessed on an exam paper created to assess their understanding of the surgical procedure. The participants then used the app for learning and regularly tested themselves on the app. Finally they retook the exam-paper to see how much they had learned.

Mastery on the app took 6 consecutive repetitions. A significant rise in score was noted and scores rivaled that of the surgeons that validated the exam paper.

Training efficiency

This RCT paper was authored by the cardiothoracic team at Stanford and published in the Seminars in Thoracic and Cardiovascular Surgery journal. The team discuss the creation of the cardiopulmonary bypass (CPB) procedure on Touch Surgery then compare its efficacy as a learning tool to the recommended reading and textbook segments.

The team assessed medical students on their understanding of CPB on a 25 question exam. The exam had been validated by five cardiac surgeons. The medical students were then randomly allocated to use either the text based resources or the Touch Surgery app. The students were allowed to use the resource for 45 minutes and then retook the exam on CPB.

Baseline test showed that there was no difference between the two groups before intervention; however there was a statistically significant difference in the two groups after the 45 minute preparation session. This study demonstrated that Touch Surgery could outperform traditional text-based learning tools.