Simulation-based training and assessment in urological surgery

Abstract

Simulation has become widely accepted as a supplementary method of training. Within urology, the greatest number of procedure-specific models and subsequent validation studies have been carried out in the field of endourology. Many generic-skills simulators have been created for laparoscopic and robot-assisted surgery, but only a limited number of procedure-specific models are available. By contrast, open urological simulation has only seen a handful of validated models. Of the available modalities, virtual reality (VR) simulators are most commonly used for endourology and robotic surgery training, the former also employing many high-fidelity bench models. Smaller dry-lab and ex vivo animal models have been used for laparoscopic and robotic training, whereas live animals and human cadavers are widely used for full procedural training. Newer concepts such as augmented-reality (AR) models and patient-specific simulators have also been introduced. Several curricula, including one recommended within, have been produced, incorporating various different training modalities and nontechnical skills training techniques. Such curricula and validated models should be used in a structured fashion to supplement operating room training.

Transurethral Resection of Bladder Tumors: Next-generation Virtual Reality Training for Surgeons

“…Transurethral surgery is an important part of urology and requires a lot of technical skills and know-how by the surgeon. A large part of the procedural learning curve, especially technical skills, can be acquired using simulators for training [10]. It is well known that many procedures must be performed until an acceptable plateau in outcome factors, such as operation time, complication rate, or blood loss, is reached [11,12].…”

Non-technical skills: a review of training and evaluation in urology

“…To create an NTS curriculum in urology, training should be specific to the level of seniority and subspecialty whilst remaining logistically viable [50]. To date, research has tended to focus on the validity and feasibility of specific aspects of NTS training, with high-quality studies evaluating transfer of NTS still lacking [35], which should be addressed in future studies.…”

Validation of the Advanced Scope Trainer for Flexible Ureterorenoscopy Training

“…Minimally invasive procedures, in the modern era, have a steep learning curve and many models are being utilised to provide simulation training to postgraduate surgical trainees [3,4]. The traditional method of 'see one, do one, teach one' is becoming more difficult to implement in an era of the 'Working-Time Directive' and increased time pressures on trainees therefore, simulators are being increasingly used.…”