Comparative performance of high-fidelity training models for flexible ureteroscopy: Are all models effective?

Abstract

Objective:We performed a comparative study of high-fidelity training models for flexible ureteroscopy (URS). Our objective was to determine whether high-fidelity non-virtual reality (VR) models are as effective as the VR model in teaching flexible URS skills.Materials and Methods:Twenty-one trained urologists without clinical experience of flexible URS underwent dry lab simulation practice. After a warm-up period of 2 h, tasks were performed on a high-fidelity non-VR (Uro-scopic Trainer™; Endo-Urologie-Modell™) and a high-fidelity VR model (URO Mentor™). The participants were divided equally into three batches with rotation on each of the three stations for 30 min. Performance of the trainees was evaluated by an expert ureteroscopist using pass rating and global rating score (GRS). The participants rated a face validity questionnaire at the end of each session.Results:The GRS improved statistically at evaluation performed after second rotation (P<0.001 for batches 1, 2 and 3). Pass ratings also improved significantly for all training models when the third and first rotations were compared (P<0.05). The batch that was trained on the VR-based model had more improvement on pass ratings on second rotation but could not achieve statistical significance. Most of the realistic domains were higher for a VR model as compared with the non-VR model, except the realism of the flexible endoscope.Conclusions:All the models used for training flexible URS were effective in increasing the GRS and pass ratings irrespective of the VR status.

Evaluation of the Endo-Uro trainer for semi-rigid ureteroscopy training

“…5,6 The Uro-Scopic Trainer (Limbs & Things, Bristol, UK) is the most commonly used bench model, and allows rigid and flexible ureteroscopy training. 6 It has demonstrated face, construct, and concurrent validity, 4,7–9 as per the old framework of validity.…”

“…Mishra and colleagues analyzed the change in performance, among medical students, over three repetitions of a procedure. 9 Rate of skills acquisition was identified as a cause for the change in performance between the trials. Early stages were associated with rapid skill acquisition, displayed as a steep gradient in performance.…”

Validation of laparoscopy and flexible ureteroscopy tasks in inanimate simulation training models at a large-scale conference setting

“…Our findings suggest that these tasks could also be validated in another FURS trainer. Other FURS specific bench models that have been validated include the Uro-Scopic trainer (Limbs and things, UK) [ 14 ], Adult Ureteroscopy Trainer (Ideal Anatomic Modeling, USA) [ 15 ], K-Box (Porgés-Coloplast, France) [ 16 , 17 ], Cook URS model (Cook Medical, USA) [ 18 ] and Endo-Urologie-Modell (Karl Storz, Germany) [ 19 ]. Chou et al.…”

Simulation-based flexible ureteroscopy training using a novel ureteroscopy part-task trainer

“…But an expensive simulation model does not always equate to an effective teaching tool. 6 The Cook URS model is not overly expensive to manufacture (about $650 US) and is easy to assemble and care for. Our results indicate that models like this one are sufficient for trainee use and can allow trainees to improve their fURS skills in a Blankstein et al…”

“…5 Increasingly realistic surgical training models and virtualreality simulators have been developed. 6 Regardless of the complexity or fidelity of these simulators, their usefulness as educational tools are only as good as the curriculum in which they are utilized. Moreover, they must have the validity evidence to support their use.…”