Training on Bench Models Improves Dexterity in Ureteroscopy

Abstract

Introduction: There is a need for alternative training in endourology. Computerised simulators have been introduced but have, so far, not been compared to real surgery. Bench models have proved to be comparable to real surgery when performing standard procedures in the upper urinary tract. Objective: To validate training on bench models as a tool to improve dexterity in semi-rigid ureteroscopy. Methods: Urology residents were tested when performing semi-rigid ureteroscopy on a bench model (Mediskills), before and after training. All standard equipment and instruments, including fluoroscopy, were available. For the test procedure we used a task-specific checklist and a global score (maximum score 10 + 9 = 19). After base line assessment, the participants practised under supervision. After training they were reassessed, using the same procedure as previously. Results: The performance was significantly better after the training. Results before/after were: 5.1/9.2, 2.6/7.8 and 7.7/17.2 for task-specific checklist, global score and total score respectively. All residents felt more familiar with the instruments and the procedure after the training. Conclusion: Training on bench models for ureteroscopy enhanced the manual dexterity as well as familiarity with the method and is recommendable before operating on patients.