400+ Validation Studies
Evidence-based Simulation Training
Find here a selection of validation studies, the culmination of extensive research and rigorous validation processes providing evidence of the validity and reliability of our simulation technology, which helped pave the way for revolutionizing surgical education and training. Based on some of the studies we have established proficiency-based curricula which are integrated into our simulators.
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Objective
To assess whether real-time cystourethroscopy (CUS) performance improves by simulator-based training (criterion or predictive validity), addressing the research question ‘Does practical skills training on the URO Mentor (UM, Simbionix USA Corp., Cleveland, OH, USA) virtual-reality simulator improve the performance of flexible CUS in patients’.
Subjects and Methods
Participants (71 interns from Catharina Hospital Eindhoven, CHE, and 29 from University Medical Centre Groningen, UMCG) were randomized to carry out CUS in a patient after training on the UM (UM trained, 50) or without training on UM (control, 50). The assessment of real-time performance consisted of scoring on a Global Rating Scale (GRS) by supervisors unaware of training status. Data were analysed using stepwise multiple linear regression. The effect size (ES) indication for correlations was used to interpret the magnitude of a standard regression coefficient (β); an ES of 0.10, 0.30 and 0.50 were considered small, moderate and large, respectively. The study was approved by the Medical Review Ethics Committees of the participating hospitals.
Results
Overall, the group that received training performed significantly better than the controls (P ≤ 0.003, β range 0.30–0.47). There was no effect of training for participants with a specific preference for a surgical speciality in two of five GRS scores. Participants from CHE obtained higher GRS 3 scores than those from UMCG. Significantly more UMCG trainees indicated having had stress than those from CHE (P < 0.001).
Conclusions
The results showed that interns who had trained on UM outperformed controls for a CUS procedure in a patient. Training for CUS on the UM is to be recommended for learning to respect tissue, procedural knowledge, flow of procedure and forward planning. Use of the UM to train interns with a specific interest in a surgical speciality in handling instruments, and time and motion, seems to be of limited value.
Keywords
randomized controlled trial, simulation, training, transfer, cysto-urethroscopy, validation
Abstract:
Objective Diferent simulation modalities may be utilised in a curricular fashion to beneft from the strengths of each training model. The aim of this study is to evaluate a novel multi-modality ureterorenoscopy (URS) simulation curriculum in terms of educational value, content validity, transfer of skills and inter-rater reliability.
Methods:
This international prospective study recruited urology residents (n=46) with≤10 URS experience and no prior simulation training. Participants were guided through each phase of the expert-developed SIMULATE URS curriculum by trainers and followed-up in the operating room (OR). Video recordings were obtained during training. A post-training evaluation survey was distributed to evaluate content validity and educational value, using descriptive statistics. Performance was evaluated using the objective structured assessment of technical skills (OSATS) scale to measure improvement in scores throughout the curriculum. Pearson’s correlation coefcient and Cohen’s kappa tests were utilised to investigate correlation and agreement between raters.
Results:
Participants reported gaining OR-transferrable skills (Mean: 4.33±0.67) and demonstrated marked improvement in throughout the curriculum, transferred to the OR for both semi-rigid URS (p=0.004) and fexible URS (p=0.007). 70% of participants were successfully followed-up in the OR (n=32). No diferences were identifed with the additional use of fresh frozen cadavers (p=0.85, p=0.90) and the URO Mentor VR simulator (p=0.13, p=0.22). A moderate level of correlation was noted on the video OSATS assessments, between two expert assessors (r=0.70), but a poor agreement with the live rating.
Conclusion:
The SIMULATE URS training curriculum received high educational value from participants, who demonstrated statistically signifcant improvement with consecutive cases throughout the curriculum and transferability of skills to the OR in both semi-rigid and fexible URS.
Keywords Education · Simulation · Urology training · Ureterorenoscopy · Curriculum
Background: Virtual reality (VR) has been recognized as a useful modality in the training of surgical skills. With respect to basic endoscopic skill training of urology, we sought to investigate the effectiveness of the UroMentor(TM) virtual reality simulator (VRS) in the skill acquisition of flexible cystoscopy.
Methods: Urologists familiar with rigid cystoscopy procedures were selected to take part in a virtual training course of flexible cystoscopy. Changes in total operating time, frequency of injury, number of digital markers inside the bladder, and the global rating scale (GRS) scores were assessed following eight repeated training sessions on the UroMentor(TM).
Results: Eighteen urologists voluntarily took part in the study. Total operating time was significantly lower after eight sessions of training by comparison ((111 ± 10) seconds and (511 ± 67) seconds, respectively; P < 0.001). Additionally, the frequency of injury decreased with training from (12 ± 2) times to (5 ± 1) times (P < 0.001), while the number of digital markers observed increased from 9 ± 0 to 10 ± 1 (P = 0.005). Finally, training with the UroMentor(TM) resulted in a GRS increase from (1.3 ± 0.2) points to (3.9 ± 0.2) points (P < 0.001).
Conclusion: The VRS UroMentor(TM) can improve urologists’ ability to perform flexible cystoscopy and could be used as an effective training tool for trainees.