WCE 2017: Quality in Minimally Invasive Surgery: Standardization of Training

Vancouver, Canada (UroToday.com) Dr. Lee Richstone, professor of urology and system Vice Chairman at Northwell Health, presented on the need for standardization of training in minimally invasive surgery. Dr. Richstone began the presentation by emphasizing that current MIS surgeons have an obligation to train the next generation of surgeons, and an obligation to assess and certify their skill.

Currently, the field of MIS does not implement standardized training due to technical, non-technical, and affective domains. One particular reason Dr. Richstone noted that MIS is lacking in standardization is because the approach is outdated. Traditional methods are time or repetition based rather than proficiency (communication, teamwork, affective domains) based.

Dr. Richstone called for an embrace of simulation for validated procedure specific models, such as: cystoscopy, ureteroscopy and PCNL, Lap radical/partial, ureteral reimplantation, robotic partial and radical nephrectomies. In terms of evaluation of proficiency, Dr. Richstone recommended several validated assessment tools, including: simulator performance metrics, Global Evaluative Assessment of Robotic Skills (GEARS) and Crowdsourced Assessment of Technical Skill (CSATS).

Because standardization of training would be costly, time consuming, and resource and expertise dependent, Dr. Richstone proposed centralized curricula that are feasible and validated. Dr. Richstone concluded with a call to action: create a centralized approach to the standardization of training highlighting several key features: technical/nontechnical domains, incorporate simulation, validated assessment tools, and consider the cost/feasibility.

Presented by: Lee Richstone, MD


Affiliation: Northwell Health, Smith Institute for Urology, North Shore University Hospital
 New Hyde Park, New York

Written by: Taylor Capretz, Department of Urology, University of California-Irvine at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.