This scoping review synthesizes contemporary evidence on the role of simulation, uro-technology and structured training curricula in shaping the next generation of endourologists, both inside and outside of the operating theatre.
A broad range of simulation platforms - spanning low-fidelity benchtop models, virtual reality systems and high-fidelity hybrid simulators - have demonstrated validity in endourological training across ureteroscopy, percutaneous nephrolithotomy, transurethral surgery and laparoscopy, with several also showing skill transfer to the clinical environment. Proficiency-based progression curricula such as the Endoscopic Stone Treatment Steps 1 and 2, and the ENTRY project for transurethral bladder tumour resection, represent the current standard of structured competency-based training. Artificial intelligence is rapidly evolving and shaping simulation training by facilitating automated performance assessment and personalized, adaptive feedback. Simulation in paediatric endourology unfortunately remains a considerable gap.
Endourological training is at a turning point in history where simulation and uro-technology are shifting the learning phase away from the operating theatre. Structured, PBP-based curricula with objective performance metrics offer the most robust framework for competency development and new technologies will help individualize the learning pathway, assuring proficiency is reached prior to clinical exposure. Several hurdles still need to be taken before this can be made widely available for all urological trainees.
Current opinion in urology. 2026 Jun 11 [Epub ahead of print]
Otas Durutovic, Jan Klein, Laurian Dragos, Leye Ajayi, Christopher Netsch, Marcos Cepeda, Guido Kamphuis, Anna Bujons, Daron Smith, Thomas Tailly
Clinic of Urology, University Clinical Centre of Serbia, Belgrade, Serbia., Department of Urology, Cantonal Hospital of Frauenfeld and Münsterlingen, Spital Thurgau AG, Frauenfeld, Switzerland., Department of Urology, Cambridge University Hospitals NHS Foundation Trust, Cambridge., Department of Urology, Royal Free London NHS Foundation Trust, London, UK., Department of Urology, Asklepios Klinik Barmbek, Hamburg, Germany., Department of Urology, Hospital Universitario Río Hortega, Valladolid, Spain., Department of Urology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands., Division of Pediatric Urology, Urology Department, Fundació Puigvert Universitat Autonòma Barcelona, Barcelona, Spain., Department of Urology, Westmoreland Street Hospital, UCLH NHS Foundation Trust, London, UK., Department of Urology, AZ Maria Middelares Hospital.