Impact of Virtual Reality-Simulated Training on Urology Residents' Performance of Transurethral Resection of the Prostate

Abstract

Practice in a simulator-based environment improves the skills and dexterity of urology residents when performing the procedure on patients, without increased risks for the patients.

Systematic review of skills transfer after surgical simulation-based training

“…Thirteen studies 31 -43 investigated endoscopic procedures, including colonoscopy 36,40,43 , oesophogastroduodenoscopy 32,38,39,41 , cystourethroscopy 37 , flexible transnasal laryngoscopy 31,35 , endoscopic sinus surgery 33,42 and transurethral resection of prostate (TURP) 34 ( Table 2). Seven studies 44 -50 investigated other procedures, namely knee arthroscopy 46 , abdominal fascial closure 49 , cardiac catheterization 44 , superficial femoral artery angioplasty 47 and cataract surgery 45,48,50 (Table 3).…”

“…Medical students were the novices for three studies involving camera navigation 28 and transnasal flexible endoscopy 31,35 . Six 20,31,33,34,36,38 of the 27 RCTs did not report the method of randomization, and only three 21,23,27 reported clearly how the randomization process, including sequence generation, allocation concealment and implementation, occurred. Power calculation was reported by 15 RCTs 21,25,27 -32,34,36,37,41,43,44,49 .…”

“…Three studies 34,41,43 reported no overall score difference between a simulation-trained group and a control group for endoscopic procedures, although in two of these 41,43 the control group was made up of participants who had patientbased training, suggesting that simulation had provided an equivalent skills transfer. One of the above 41 , which compared skills scores for oesophagogastroduodenoscopy, found no difference between participants who received simulation-based training (either alone or in addition to patient-based training) and those who had patient-based training alone.…”

“…One study 34 reported a significant difference in transurethral prostate resection performance time for the first procedure after baseline assessment, in favour of those without simulation training ( Table 2). …”

Development and incorporation of hybrid simulation OSCE into in-training examinations to assess multiple CanMEDS competencies in urologic trainees

“…Simulation has often been used successfully in residency programs for training purposes. [2][3][4][5][6] Simulation can refer to relatively simple scenarios, such as using a low fidelity task trainer to teach suturing or a clinical interview involving a standardized patient. Hybrid simulations involve combining 2 or more forms of simulation (e.g., a high-fidelity computerized simulator with a standardized patient) to recreate real-world complex scenarios that require the trainee to use multiple skills concurrently.…”