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Simulation-based training for prostate surgery.
BJU Int. 2015 Oct; 116(4):665-74.BI

Abstract

OBJECTIVES

To identify and review the currently available simulators for prostate surgery and to explore the evidence supporting their validity for training purposes.

MATERIALS AND METHODS

A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the American Urological Association, European Association of Urology, British Association of Urological Surgeons and World Congress of Endourology meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included; studies regarding other urological simulators were excluded.

RESULTS

A total of 22 studies that carried out a validation study were identified. Five validated models and/or simulators were identified for TURP, one for photoselective vaporisation of the prostate, two for holmium enucleation of the prostate, three for laparoscopic radical prostatectomy (LRP) and four for robot-assisted surgery. Of the TURP simulators, all five have demonstrated content validity, three face validity and four construct validity. The GreenLight laser simulator has demonstrated face, content and construct validities. The Kansai HoLEP Simulator has demonstrated face and content validity whilst the UroSim HoLEP Simulator has demonstrated face, content and construct validity. All three animal models for LRP have been shown to have construct validity whilst the chicken skin model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy, both of which demonstrated construct validity.

CONCLUSIONS

A wide range of different simulators are available for prostate surgery, including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators can be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, to determine which simulators have greater efficacy than others and to assess the cost-effectiveness of the simulators and the transferability of skills learnt. With surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers great scope for implementation alongside traditional methods of training.

Authors+Show Affiliations

MRC Centre for Transplantation, King's College London, Department of Urology, Guy's Hospital, King's Health Partners, London, UK.MRC Centre for Transplantation, King's College London, Department of Urology, Guy's Hospital, King's Health Partners, London, UK.MRC Centre for Transplantation, King's College London, Department of Urology, Guy's Hospital, King's Health Partners, London, UK.MRC Centre for Transplantation, King's College London, Department of Urology, Guy's Hospital, King's Health Partners, London, UK.MRC Centre for Transplantation, King's College London, Department of Urology, Guy's Hospital, King's Health Partners, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24588806

Citation

Khan, Raheej, et al. "Simulation-based Training for Prostate Surgery." BJU International, vol. 116, no. 4, 2015, pp. 665-74.
Khan R, Aydin A, Khan MS, et al. Simulation-based training for prostate surgery. BJU Int. 2015;116(4):665-74.
Khan, R., Aydin, A., Khan, M. S., Dasgupta, P., & Ahmed, K. (2015). Simulation-based training for prostate surgery. BJU International, 116(4), 665-74. https://doi.org/10.1111/bju.12721
Khan R, et al. Simulation-based Training for Prostate Surgery. BJU Int. 2015;116(4):665-74. PubMed PMID: 24588806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Simulation-based training for prostate surgery. AU - Khan,Raheej, AU - Aydin,Abdullatif, AU - Khan,Muhammad Shamim, AU - Dasgupta,Prokar, AU - Ahmed,Kamran, Y1 - 2015/04/16/ PY - 2014/3/5/entrez PY - 2014/3/5/pubmed PY - 2015/12/15/medline KW - assessment KW - prostate KW - simulation KW - training SP - 665 EP - 74 JF - BJU international JO - BJU Int. VL - 116 IS - 4 N2 - OBJECTIVES: To identify and review the currently available simulators for prostate surgery and to explore the evidence supporting their validity for training purposes. MATERIALS AND METHODS: A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves. Furthermore, relevant abstracts from the American Urological Association, European Association of Urology, British Association of Urological Surgeons and World Congress of Endourology meetings, between 1999 and 2013, were included. Only studies related to prostate surgery simulators were included; studies regarding other urological simulators were excluded. RESULTS: A total of 22 studies that carried out a validation study were identified. Five validated models and/or simulators were identified for TURP, one for photoselective vaporisation of the prostate, two for holmium enucleation of the prostate, three for laparoscopic radical prostatectomy (LRP) and four for robot-assisted surgery. Of the TURP simulators, all five have demonstrated content validity, three face validity and four construct validity. The GreenLight laser simulator has demonstrated face, content and construct validities. The Kansai HoLEP Simulator has demonstrated face and content validity whilst the UroSim HoLEP Simulator has demonstrated face, content and construct validity. All three animal models for LRP have been shown to have construct validity whilst the chicken skin model was also content valid. Only two robotic simulators were identified with relevance to robot-assisted laparoscopic prostatectomy, both of which demonstrated construct validity. CONCLUSIONS: A wide range of different simulators are available for prostate surgery, including synthetic bench models, virtual-reality platforms, animal models, human cadavers, distributed simulation and advanced training programmes and modules. The currently validated simulators can be used by healthcare organisations to provide supplementary training sessions for trainee surgeons. Further research should be conducted to validate simulated environments, to determine which simulators have greater efficacy than others and to assess the cost-effectiveness of the simulators and the transferability of skills learnt. With surgeons investigating new possibilities for easily reproducible and valid methods of training, simulation offers great scope for implementation alongside traditional methods of training. SN - 1464-410X UR - https://www.unboundmedicine.com/medline/citation/24588806/Simulation_based_training_for_prostate_surgery_ L2 - https://doi.org/10.1111/bju.12721 DB - PRIME DP - Unbound Medicine ER -