PD6-07 AUGMENTED REALITY VIDEO SIMULATION FOR ROBOTIC PARTIAL NEPHRECTOMY SURGERY TRAINING – THE NEXT GENERATION

Abstract

INTRODUCTION AND OBJECTIVES: By creating a low-stakes learning environment that permits deliberate practice and timely feedback, simulation-based training (SBT) modalities have grown in popularity over recent years. The educational value of surgical simulators, however, is only as good as the curriculum in which they are utilized. We designed a simulation-based flexible ureteroscopy (fURS) training course utilizing a novel inanimate training model (Cook URS model). We set out to evaluate the new curriculum and validate the Cook URS model. METHODS: A SBT curriculum was designed for Jr level (PGY1-3) urology residents at the University of Toronto and included a didactic lecture, focusing on fundamental urolithiasis management principles and basic fURS techniques, a hands-on demonstration of the various instrumentation and skills required for fURS, and 3 independent practice sessions using the Cook URS model. Both baseline pre-test and post-course assessment of fURS skill was conducted for a standardized task; fURS with basket manipulation of lower pole stone into the upper pole. Performances were video recorded and later reviewed by 2 blinded experts using a validated assessment device. RESULTS: A total of 10 residents participated in the fURS course. There was a significant difference in mean preand post-course task completion times (15.8 vs 9.4 mins, p<0.01) and performance scores (19.20 vs 25.25, p<0.01). Eighty percent of participants rated the Cook URS model as realistic ( 4/5, mean1⁄44.20) and 5 independent endourology experts rated the model as useful as a training device ( 4/5, mean1⁄44.90), providing both face and content validity. There was also significant correlation (p<0.05) between prior fURS experience and mean overall performance scores, task completion times, passing ratings, movement efficiency, instrument handling, and flow of procedure scores (Figure 1), demonstrating construct validity for the Cook URS model. The fURS global rating scale demonstrated good reliability, (Cronbach’s alpha 1⁄4 0.848). CONCLUSIONS: Our study demonstrated that a SBT curriculum for fURS can lead to improved short-term technical skills amongst Jr level urology residents. The Cook URS model demonstrated face, content and construct validity. Further study is required. Source of Funding: none