Abstract
Widespread acceptance of laparoscopic urology techniques has posed many challenges to training urology residents and allowing postgraduate urologists to acquire often difficult new surgical skills. Several factors in surgical training programs are limiting the ability to train residents in the operating room, including limited-hours work weeks, increasing demand for operating room productivity, and general public awareness of medical errors. As such, surgical simulation may provide an opportunity to enhance residency experience and training, and optimize post-graduate acquisition of new skills and maintenance of competency. This review article explains and defines the various levels of validity as it pertains to surgical simulators. The most recently and comprehensively validity tested simulators are outlined and summarized. The potential role of surgical simulation in the formative and summative assessment of surgical trainees, as well as, the certification and recertification process of postgraduate surgeons will be delineated. Surgical simulation will be an important adjunct to the traditional methods of surgical skills training and will allow surgeons to maintain their proficiency in the technically challenging aspects of minimally invasive urologic surgery.
Highlights
Competency in surgery requires the acquisition of a certain degree of factual knowledge, clinical judgment, interpersonal communication capability, and technical skills
These issues become important in the training of laparoscopic surgery as these procedures are associated with unique challenges, such as a small working space, limited instrument movement, decreased tactile sensation, and counterintuitive manipulation of instruments in a two-dimensional field of view
Surgical simulation is increasingly becoming an adjunct to the traditional methods of surgical skills training in the operative room
Summary
Competency in surgery requires the acquisition of a certain degree of factual knowledge, clinical judgment, interpersonal communication capability, and technical skills. Increased awareness by the general public of medical errors has reduced the tolerance for training surgeons in the operating room. These issues become important in the training of laparoscopic surgery as these procedures are associated with unique challenges, such as a small working space, limited instrument movement, decreased tactile sensation, and counterintuitive manipulation of instruments in a two-dimensional field of view. In an effort to provide preliminary laparoscopic skills and procedures training, animal laboratories have been utilized. They are costly, require highly skilled personnel, lack the exact duplication of human anatomy, and offer only a one-time experience. Validity is determined by how well an evaluation measures what it sets out to measure
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