Shamim Khan M, Ahmed K, Gavazzi A, Gohil R, Thomas L, Poulsen J, Ahmed M, Jaye P, Dasgupta P. BJU Int. 2012 Aug 29. doi: 10.1111/j.1464-410X.2012.11204.x. [Epub ahead of print]

Development and implementation of centralized simulation training: evaluation of feasibility, acceptability and construct validity.

 ABSTRACT:

OBJECTIVES

• To establish the feasibility and acceptability of a centralized, simulation-based training-programme.
• Simulation is increasingly establishing its role in urological training, with two areas that are relevant to urologists: (i) technical skills and (ii) non-technical skills.

MATERIALS AND METHODS

• For this London Deanery supported pilot Simulation and Technology enhanced Learning Initiative (STeLI) project, we developed a structured multimodal simulation training programme.
• The programme incorporated: (i) technical skills training using virtual-reality simulators (Uro-mentor and Perc-mentor [Symbionix, Cleveland, OH, USA], Procedicus MIST-Nephrectomy [Mentice, Gothenburg, Sweden] and SEP Robotic simulator [Sim Surgery, Oslo, Norway]); bench-top models (synthetic models for cystocopy, transurethral resection of the prostate, transurethral resection of bladder tumour, ureteroscopy); and a European (Aalborg, Denmark) wet-lab training facility; as well as (ii) non-technical skills/crisis resource management (CRM), using SimMan (Laerdal Medical Ltd, Orpington, UK) to teach team-working, decision-making and communication skills.
• The feasibility, acceptability and construct validity of these training modules were assessed using validated questionnaires, as well as global and procedure/task-specific rating scales.

RESULTS

• In total 33, three specialist registrars of different grades and five urological nurses participated in the present study.
• Construct-validity between junior and senior trainees was significant. Of the participants, 90% rated the training models as being realistic and easy to use.
• In total 95% of the participants recommended the use of simulation during surgical training, 95% approved the format of the teaching by the faculty and 90% rated the sessions as well organized.
• A significant number of trainees (60%) would like to have easy access to a simulation facility to allow more practice and enhancement of their skills.

CONCLUSIONS

• A centralized simulation programme that provides training in both technical and non-technical skills is feasible.
• It is expected to improve the performance of future surgeons in a simulated environment and thus improve patient safety.