Current Status of Simulation and Training Models in Urological Surgery: A Systematic Review

PURPOSE - Increased awareness of patient safety, advances in surgical technology and reduced working times have led to the adoption of simulation-enhanced training. However, simulators available need to be scientifically evaluated before integration into curricula.

The aim of this study is to identify the currently available training models for urological surgery, their status of validation and evidence behind each model.

MATERIALS AND METHODS - Medline, EMBASE and Cochrane library databases were searched for English language articles published between 1990 and 2015, describing urological simulators and/or validation studies of these models. All studies were assessed for level of evidence and each model was subsequently awarded a level of recommendation, using a modified Oxford Centre for Evidence-Based Medicine classification, adapted for education by the European Association of Endoscopic Surgeons.

RESULTS - A total of 91 validation studies were identified pertaining to training models in endourology (n=63), laparoscopic surgery (n=17), robot-assisted surgery (n=8) and open urological surgery (n=6), with a total of 55 models. Of the included studies, six were classified Level 1b, nine Level 2a, 39 Level 2b and 19 Level 2c. Amongst all the training models, the URO-Mentor was the only model to receive a Level of Recommendation of 1.

CONCLUSIONS - UroSimulation is a growing field and increasing numbers of models are being produced. However, there are still too few validation studies with high level of evidence demonstrating the transferability of skills. Nevertheless, efforts should be made to utilise the currently available models in curriculum-based training programmes.

The Journal of urology. 2016 Mar 22 [Epub ahead of print]

Abdullatif Aydin, Ahmed M A Shafi, Muhammad Shamim Khan, Prokar Dasgupta, Kamran Ahmed

MRC Centre for Transplantation, King's College London., MRC Centre for Transplantation, King's College London., Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom., Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom., Department of Urology, Guy's and St. Thomas' NHS Foundation Trust King's Health Partners, London, United Kingdom. 

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