Simulation Boot Camp Research Articles

An observer tool to enhance learning of incoming anesthesia residents’ skills during simulation training of central venous catheter insertion: a randomized controlled trial

BackgroundCentral venous catheter (CVC) insertion using simulation is an essential skill for anesthesiologists. Simulation training is an effective mean to master this skill. Given the large number of residents and the limited duration of training sessions, the active practice time is limited and residents remain observers of their colleagues for much of the session. To improve learning during observation periods, the use of an observer tool (OT) has been advocated but its educational effectiveness is not well defined.MethodsIncoming anesthesia residents were randomized to use an OT (i.e. procedural skill-based checklist) (OT+) or not (OT-) when observing other residents during a simulation bootcamp. The primary outcome was a composite score (total 60 points) evaluating CVC procedural skills rated immediately after the training. This score covers theoretical knowledge explored by multiple choice questions (MCQs) (/20), perceived improvement in knowledge and skills (/20), perceived impact on future professional life (/10) and satisfaction (/10). Measurements were repeated 1 month later. Residents in each group recorded the number of CVCs placed and their clinical outcomes (attempts, complications) during the first month of their clinical rotation using a logbook.ResultsImmediately after training, the composite score was similar between the two groups: 45.3 ± 4.2 (OT+, n = 49) and 44.4 ± 4.8 (OT-, n = 42) (p = 0.323). Analysis of sub-items also showed no difference. Results at 1 month were not different between groups.Analysis of the logbook showed no difference between groups. No serious complications were reported.ConclusionsThe use of a procedural task-based OT by incoming anesthesia residents and used during CVC insertion simulation training was not associated with better learning outcomes, neither immediately after the session nor when re-evaluated 1 month later. The training at least once on simulator of all residents could limit the impact of OT. Further studies are necessary to define the place of OT in simulation training.

Design, implementation and assessment of a novel, introductory curriculum into female, neurological and urodynamic urology: a 7-year experience of urology simulation bootcamp course.

To present the seven-year experience of a multi-component and interactive module on female, neurological and urodynamic urology (FNUU) training at the UK National Urology Simulation Bootcamp Course (USBC) and demonstrate trainee satisfaction and competency progression. During the week-long USBC, a four-hour module on FNUU was designed which consisted of short interactive presentations with an emphasis on practical stations in urodynamics, intravesical botulinum toxin injection, urethral bulking injection, female pelvic examination and, initially, mid-urethral tapes (subsequently replaced with percutaneous sacral nerve evaluation). The trainee's level of knowledge, operative experience and confidence were assessed pre- and post-course. The practical assessment consisted of preparation and intravesical administration of botulinum toxin, female pelvic examination, urodynamic trace interpretation or mid-urethral tape simulation. Trainee feedback was also collected. Two-hundred sixty-one newly appointed urology trainees participated in the USBC during this period. A high level of satisfaction was constantly reported. The highest rated session was urethral bulking with 72% being very satisfied, followed by Botox and urodynamics. The final assessment showed 70% had achieved level 4 competency in cystoscopy and Botox. Qualitative feedback was also obtained. To our knowledge, this is the first module of its kind, and it shows that it is feasible to develop, implement and evaluate an introductory curriculum into FNUU that is reproducible over a 7-year period with very positive feedback.

The need for a course to complete urological education for consultant practice using a simulated ‘boot camp’ structure at the end of specialist training: A survey-based study

To obtain opinions from urology trainees and consultants regarding the need for, and structure of, a post-specialty training Urology Simulation Boot Camp (USBC) for consultant practice. A survey-based study was conducted, and 'Google Forms' were distributed electronically via social media. Urology specialist trainees (ST) in years 5-7 (ST5-ST7), post-certification of completion of training (CCT) fellows and ST3 boot camp faculty consultants in practice for ≤5 years and >5 years were included. One hundred and seven responses were received. 97.2% of responders thought a pre-consultant USBC was worthwhile; 55.1% selected the course duration to be 2 days. 47.7% felt that the USBC should be delivered post-exam in ST7. 91.6%, 43.9%, 73.8%, 87.9% and 74.8% considered that modules in emergency operative procedures, novel uro-technologies, delivering multidisciplinary team (MDT) meetings, non-clinical consultant roles and responsibilities, stress and burnout to be important, respectively. 62.6% and 31.8% felt that the course should be wholly or part-funded by Health Education England (HEE). A post-specialty training, pre-consultant, USBC delivered post-exam in ST7, is worthwhile and should include modules on emergency operative procedures, leading MDTs, non-clinical roles and responsibilities and managing stress and burnout in consultant careers. Ideally, it should be fully/part-funded by HEE.

Urology Boot Camp: A Pilot Medical Student Curriculum for Common Bedside Urologic Procedures

ObjectivesTo develop a novel “bootcamp” simulation-based curriculum to introduce common urologic procedures and to improve readiness for performing them at bedside. MethodsThree hundred twenty-five third-year medical students at our single institution participated in a hands-on simulation “boot camp” over a 2-year accrual period. This curriculum was designed to teach basic urologic bedside procedures (ie, Foley catheter placement, Bladder irrigation) to third year medical students prior to the start of their surgical clerkships in a live instructional setting with direct feedback from instructors. The objective aspects of the study consisted of a survey administered to study participants following participation in the simulation boot camp, as well as pre- and post-module assessments. ResultsMedical students self-reported knowledge gains following the simulation session (P < .001), with 45.8% increase in procedural confidence. Additionally, students reported that the educational intervention was beneficial to their understanding of the subject matter (P < .001), were “very likely” to recommend the session to another medical student (P < .001), and felt that educational intervention better prepared them for an upcoming national exam (P < .001). Finally, the greatest gains were seen for those students who self-reported lower precurriculum knowledge (P < .001). ConclusionsFindings from our M3 "boot camp" led to self-reported gains in subject matter knowledge following the hands-on simulation curriculum, indicating that this type of educational intervention can be beneficial in preparing medical students for common bedside procedures.

Tangible effects of the COVID-19 pandemic: A fall in dexterity amongst surgical trainees?

BackgroundThe coronavirus pandemic has had an indisputable impact on surgical training. The qualitative effect on the perceived confidence and capability of trainees has been widely reported. In order to fully delineate the scope of the problem, quantitative data is also required.MethodsThis cross-sectional study collected compared data on the laparoscopic skills (pre- and post-pandemic) of first-year urology residents in the United Kingdom, who attended the annual Urology Simulation Boot Camp (USBC) in 2018 and 2019 (pre-pandemic), and 2021 (post-pandemic).ResultsPre-pandemic group performance was significantly better in 2 out of 4 tasks (Task 3 p < 0.001) (Task 4 p = 0.003) during the practice session. During the assessment, pre-pandemic group performance was better (p = 0.017) for Task 2 and significantly faster (p = 003) for Task 4.ConclusionsOur results provide evidence to support the notion that the coronavirus pandemic has had a tangible and detrimental effect on the technical skills of surgical trainees.

Simulation training in transurethral resection/laser vaporization of the prostate; evidence from a systematic review by the European Section of Uro-Technology.

Transurethral resection (TURP) and photoselective vaporization of the prostate (PVP) constitute established surgical options to treat benign prostate hyperplasia. We investigated the current literature for simulators that could be used as a tool for teaching urologists alone or within the boundaries of a course or a curriculum. A literature search was performed using PubMed, Scopus, EMBASE, and Cochrane Central Register of Controlled Trials-CENTRAL. Search terms included: Simulat*, train*, curricull*, transurethral, TUR*, vaporesect*, laser. The efficacy of different simulators and the impact of different devices, curricula and courses in training and trainee learning curves were the primary endpoints. Thirty-onestudies are selected and presented. Validated virtual reality TURP simulators are the UW VR, PelvicVision, Uro-Trainer, and TURPsim™. Validated synthetic TURP models are Dr. K. Forke's TURP trainer, Bristol TURP trainer, different tissue prostate models, and 3D-printed phantoms. The Myo Sim PVP and the GreenLightTM are sufficiently validated PVP simulators. Several TURP and PVP training curricula have been developed and judged as applicable. Finally, the TURP modules of the European Urology Residents Education Programme (EUREP) Hands-on Training course and the Urology Simulation Bootcamp Course (USBC) are the most basic annual TURP courses identified in the international literature. Simulators and courses or curricula are valuable learning and training TURP/PVP tools. The existent models seem efficient, are not always adequately evaluated and accepted. As part of training curricula and training courses, the use of training simulators can significantly improve quality for young urologists' education and clinical practice.

Design and assessment of a penile fracture simulation model

ObjectiveTo design and assess a novel penile fracture simulation model for teaching penile fracture repair. MethodsWe used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tunica”) and was applied over the penile model. A red jelly tablet (“clot”) was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a “One-way random model”. ResultsTwenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n = 13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n = 14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra. ConclusionThis is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp.

How to Implement a Simulation-Based Education Programme: Lessons from the UK Urology Simulation Boot Camp.

The operative and non-technical skills exposure of urology trainees has reduced due to a number of factors, including the European Working Time Directive, and the COVID-19 pandemic. Simulation-based education (SBE) is an innovative addition to clinical experience which can begin to address the skills-based learning deficiency in order to help trainees meet their curriculum requirements and optimise the exposure required for a trainee to become a competent general urology consultant. Surgical simulation is an effective training tool but has a complex implementation process, requiring considerable planning tailored to specific educational targets, to ensure it is sustainable and reproducible. Methodology from the field of implementation science offers an invaluable approach to design an effective simulation-based training adjunct, as exemplified by the example of the UK Urology Simulation Boot Camp (USBC), a comprehensive training course which incorporates core technical and non-technical skills based on the current Joint Committee on Surgical Training (JCST) urological training curriculum to equip newly appointed urology trainees to work as competent junior registrars. Delivered annually in Leeds since 2015, the course has had excellent feedback and results in improving the urological knowledge of trainees, as well as increases in trainees’ confidence. This paper will provide a summary of how the course was designed, delivered, reproduced, sustained and evaluated. Its success is demonstrated by its incorporation into the UK urology training programme, and since 2018, it is now recommended to all new urology residents in the UK. The course implementation model would be applicable to other surgical specialties.

Diseño y evaluación de un modelo de simulación de fractura de pene

ObjectiveTo design and assess a novel penile fracture simulation model for teaching penile fracture repair. MethodsWe used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tunica”) and was applied over the penile model. A red jelly tablet (“clot”) was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a “One-way random model”. ResultsTwenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n=13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n=14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra. ConclusionThis is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp.

Endoscopic surgical simulation using low-fidelity and virtual reality transurethral resection simulators in urology simulation boot camp course: trainees feedback assessment study.

The objective of our study was to study trainees' feedback and rating of models for training transurethral resection of bladder lesions (TURBT) and prostate (TURP) during simulation. The study was performed during the ''Transurethral resection (TUR) module" at the boot camp held in 2019. Prior to the course, all trainees were required to evaluate their experience in performing TURBT and TURP procedures. Trainees simulated resection on two different models; low-fidelity tissue model (Samed, GmBH, Dresden, Germany) and virtual reality simulator (TURPMentor, 3D Systems, Littleton, US). Following the completion of the module, trainees completed a questionnaire using a 5-point Likert scale to evaluate their assessment of the models for surgical training. In total, 174 simulation assessments were performed by 56 trainees (Samed Bladder-40, Prostate-45, TURPMentor Bladder-51, Prostate-37). All trainees reported that they had performed < 50 TUR procedures. The Samed model median scores were for appearance (4/5), texture (5/5), feel (5/5) and conductibility (5/5). The TURPMentor median score was for appearance (4/5), texture and feel (4/5) and conductibility (4/5). The most common criticism of the Samed model was that it failed to mimic bleeding. In contrast, trainees felt that the TURPMentor haptic feedback was inadequate to allow for close resection and did not calibrate movements accurately. Our results demonstrate that both forms of simulators (low-fidelity and virtual reality) were rated highly by urology trainees and improve their confidence in performing transurethral resection and in fact complement each other in providing lower tract endoscopic resection simulation.

Endoscopic surgical simulation using low-fidelity and virtual reality transurethral resection simulators in Urology Simulation Bootcamp Course: trainee feedback assessment study

Endoscopic surgical simulation using low-fidelity and virtual reality transurethral resection simulators in Urology Simulation Bootcamp Course: trainee feedback assessment study

Urology simulation boot camp: A perspective from non-UK delegates

BackgroundMedical simulation has become an integral part of modern-day surgical training. Despite its benefits, it is still not widely incorporated in the curriculum of trainees. The Urology Boot Camp (USBC) is an innovative 5-day course aimed at trainees entering the UK training scheme. Since its implementation, there's been increasing interest by non-UK trainees. ObjectiveTo assess the experiences of non-UK trainees in the USBC, both quantitatively and qualitatively, including skills progression analysis. Design, setting and participantsThis double-group cohort retrospective study included 20 delegates from non-UK countries and 76 trainees from UK who attended the USBC in 2017 and 2018. Trainees undertook pre- and post-course MCQs, pre-course operative experience questionnaires and a 12-month post-course survey on the usefulness of the skills acquired. Outcome measurements and statistical analysisDifferences in mean MCQ scores between UK and non-UK delegates at baseline and after the course were assessed by the independent T-test. Each core urology procedural skill was evaluated by an expert and graded according to a Likert scale (1–5). The Kruskal–Wallis test was used to assess the differences in the scores between both groups on endourological techniques. A Likert scale (1–5) was used to grade the participants’ answers to the post-course 12-month survey. Results and limitationsTrainees from UK scored significantly higher in the pre-course MCQ assessment, however after completion of the boot camp, no significant difference was noted. There were no differences between the groups at e-BLUS completion times, and both groups significantly improved their results. A 12-month post-course survey on the utility of training during the boot camp and qualitative evaluation of the course by overseas delegates was very positive. ConclusionsThe USBC is a valuable learning experience that leads to improvement of technical and soft skills of UK and non-UK trainees alike.

Anesthesia Simulation Boot Camp-a Decade of Experience Enhancing Self-efficacy in First-year Residents.

Novice anesthesiology residents must acquire new technical, cognitive, and behavioral skills as they transition into the high-stakes perioperative environment. Simulation-based education improves procedural skill and behavior, and it permits deliberate practice with feedback; exposure to uncommon, high-consequence events; assessment; reproducibility; and zero risk to patients. We introduced a 5-day, high-fidelity Simulation Boot Camp (SBC) in 2006 for first-year clinical anesthesia residents (CA-1s) and report over a decade of experience assessing its impact on self-efficacy, value, feasibility, and sustainability. All CA-1s in our residency program participated in the SBC as part of orientation. Participants completed 2 individual high-fidelity simulations per day, each with a private debriefing session from an attending anesthesiologist in our simulation center. We measured their self-reported confidence, which we report as self-efficacy (SE), the belief in one's own ability to successfully execute a skill or behavior necessary for a desired outcome, for 25 basic anesthesia skills before and after course completion. Participants also completed a postcourse evaluation. Of the 281 CA-1s who participated in the course from 2006 to 2016, we collected data on 267 (95%). SE improved over the course of SBC for all 25 individual skills (P < .001) and remained stable over the decade-long period of study. Univariate analysis revealed a strong association between increased SE and male sex (P < .001), video gaming experience (P < .001), and completion of a prior residency (P = .018). Males were also more likely to report video gaming experience (P < .001). Multivariable analysis revealed that although women had lower SE than did men, they had a greater increase in SE attributed to participation in SBC (P = .041). Participants strongly agreed SBC was a realistic and nonjudgmental learning tool, built confidence, and should be mandatory. Most comments were positive, reflecting overall satisfaction with SBC. SBC increases SE, is feasible, valuable to participants, and sustainable with remarkably consistency over the study period.

Anesthesia Simulation Boot Camp—a Decade of Experience Enhancing Self-efficacy in First-year Residents

Anesthesia Simulation Boot Camp—a Decade of Experience Enhancing Self-efficacy in First-year Residents

Global Assessment of Urological Endoscopic Skills (GAUES): development and validation of a novel assessment tool to evaluate endourological skills

To develop and evaluate an assessment tool for endourological skills during simulation including cystoscopy, ureteroscopy (URS) and transurethral resection (TUR) procedures. We designed a Global Assessment of Urological Endoscopic Skills (GAUES) tool, comprised of nine endourology task-specific and two global-rating skills items. The tool was developed through two rounds of the Delphi process. The GAUES tool was used to assess acquisition of URS and TUR skills of novices (Year 2 core surgical trainees, CT2) and intermediate level trainees (residents at the start of the UK higher surgical training programme in Urology, Speciality Trainee Year 3, ST3) at the Urology Simulation Boot Camp (USBC) between 2016 and 2018. Validity was evaluated by comparing scores between trainees with different levels of urological experience. Inter-rater reliability was also assessed. We evaluated 130 residents, 52% of trainees were at an intermediate stage of training and 39% were novices. In all, 9% of the anonymous forms were missing demographics. The completion rate of the GAUES tool during the USBC for URS and TUR was 85% and 89%, respectively. Our analysis demonstrated a significant difference in all domains between intermediates and novices at assessment in URS, except for one domain more suited to clinical assessment (P=0.226). There was excellent intraclass correlation (ICC) overall between the two experts' judgements, ICC=0.841 (95% confidence interval 0.767-0.893; P<0.001, n=88). We have developed the novel GAUES tool for cystoscopic, URS and TUR skills. Overall, we demonstrated good face, content and construct validity and excellent reliability, suggesting that the GAUES tool can be useful for endourological skills assessment.

A simple novel training model for teaching suprapubic catheter (SPC) exchange

ObjectivesTo develop a suprapubic catheter (SPC) training model as no specific realistic training model exists to replicate SPC exchange where a catheter tract is present. Materials and methodsWe describe a novel, anatomically realistic, animal simulator model for use in SPC training, which was trialed at a national urology simulation boot camp by new urology trainees and validated by expert urologists. A scale reproduction of an abdominal wall was created using a porcine abdominal wall. A segment of small bowel was stitched around a size 16F Foley catheter to form a tract. Abdominal wall tissue was excised cylindrically to create an opening, and the small bowel tract was passed through the abdominal wall and sutured anteriorly, producing a realistic SPC tract: inferiorly, the tract was anastomosed to a porcine urinary bladder. This model was evaluated by 10 expert urologists for content validity with an 8-item 5-point rating scale used to evaluate domains relevant to the simulator. ResultsThe domains were scored between 1 and 5 by 10 expert urologists, 1 being «strongly disagree» and 5 being «strongly agree». The average expert ratings of the domains were then calculated and tabulated following the training course. There was an average global rating of 4.2/5 for the model, with an average usefulness for training score of 4.6/5. ConclusionThe feedback from experts and trainees (informal) was overwhelmingly positive. On average, our experts reported high satisfaction with their experience using this simulator as a training tool.

Evaluation of 3 Cognitive Load Measures During Repeated Simulation Exercises for Novice Anesthesiology Residents

Maintaining an appropriate level of cognitive load during simulations is crucial to optimize learning. We evaluated 3 subjective measures of cognitive load in a simulated operating room (OR) context across multiple scenarios of varying complexity. This observational study of 25 first-year anesthesiology residents took place during a 5-day simulation "Boot Camp." Each day, participants completed 2 different high-fidelity scenarios in a fully equipped simulated OR. After each simulation, participants completed 3 cognitive load measures: the Paas scale, NASA Task Load Index (TLX), and Cognitive Load Component (CLC) questionnaire. Two-way repeated-measures and mixed-design analyses of variance, with the cognitive load measures and scenarios as independent factors, were used to determine the effect of using different measures to report cognitive load. Cognitive load scores reported by all measures correlated significantly with one another (P < 0.01): TLX and Paas (r = 0.65); Paas and CLC (r = 0.63); and TLX and CLC (r = 0.61). The CLC subscale scores (intrinsic, extraneous, germane) also correlated significantly with composite TLX and Paas scores (P < 0.01). Scenarios and measures displayed significant interaction: F(10, 210) = 3.01, P = 0.001. Participants reported highest overall cognitive load using the Paas scale. All cognitive load measures were sensitive to scenario variability and showed similar fluctuation patterns across the 10 scenarios. The findings suggest that cognitive load measures can help create benchmarks based on learner perceptions of cognitive burden for different simulation scenarios.

A Simulation Boot Camp for Future Nurse Educators.

Palmer, Janice L. PhD, RN, CNE; McLaughlin, Dorcas E. PhD, RN; Hankamer, Beth A. MSN, RN Author Information

A Multidisciplinary Basic Airway Skills Boot Camp for Novice Trainees.

Introduction: Otolaryngology and anesthesiology residents may be the first responders to airway emergencies, even in the first weeks of training. These residents may be unfamiliar with the armamentarium of airway maneuvers, the most basic of which may be lifesaving. Boot camp education has been demonstrated to be effective in multiple disciplines. In this study, we examine whether an immersive, multidisciplinary boot camp style simulation course leads to an improvement in novice airway provider confidence.Methods: Novice otolaryngology and anesthesiology residents participated in an annual (2013-2018) multidisciplinary boot camp simulation course. Residents completed an anonymous pre- and post-test self-assessment tool reporting their confidence for airway skills and concepts from the curriculum. Responses were on a Likert scale from 1 to 5 (1=no familiarity, 5=extremely comfortable). We analyzed pre- and post-course participant self-reported comfort level with the airway management skills and concepts addressed in the course. Frequencies and percentages were reported. Fisher’s exact test was used to assess statistical significance at level 0.05.Results: A total of 62 residents, including 50 anesthesiology residents and 12 otolaryngology residents, completed a post-test self-assessment tool. For all topics covered in the course, there was a statistically significant change in the percentage of residents who reported familiarity with the topic (p<0.001). This corresponded to an increase in self-reported comfort level and a decrease in non-familiarity or discomfort with the airway topics covered in the course. The greatest increase in percentage of residents reporting feeling comfortable or extremely comfortable with the task after completion of the simulation boot camp were all moderately advanced airway maneuvers (laryngeal mask airway [LMA] placement, flexible fiberoptic intubation, glidescope intubation, endotracheal intubation, and two-person mask ventilation). The greatest decrease in non-familiarity or discomfort was seen in moderately complex to advanced airway topics (fiberoptic intubation, glidescope intubation, intubating LMA, rigid bronchoscopy, cricothyroidotomy, tracheostomy, and laryngectomy).Conclusions: Our data support the use of immersive surgical boot camp experiences to enhance resident familiarity and comfort and decrease unfamiliarity and discomfort with a wide variety of airway topics and maneuvers.

Modelo simple y novedoso para la formación del recambio de catéter suprapúbico (CSP)

ObjectivesTo develop a suprapubic catheter (SPC) training model as no specific realistic training model exists to replicate SPC exchange where a catheter tract is present. Materials and methodsWe describe a novel, anatomically realistic, animal simulator model for use in SPC training, which was trialed at a national urology simulation boot camp by new urology trainees and validated by expert urologists. A scale reproduction of an abdominal wall was created using a porcine abdominal wall. A segment of small bowel was stitched around a size 16F Foley catheter to form a tract. Abdominal wall tissue was excised cylindrically to create an opening, and the small bowel tract was passed through the abdominal wall and sutured anteriorly, producing a realistic SPC tract: inferiorly, the tract was anastomosed to a porcine urinary bladder. This model was evaluated by 10 expert urologists for content validity with an 8-item 5-point rating scale used to evaluate domains relevant to the simulator. ResultsThe domains were scored between 1 and 5 by 10 expert urologists, 1 being «strongly disagree» and 5 being «strongly agree». The average expert ratings of the domains were then calculated and tabulated following the training course. There was an average global rating of 4.2/5 for the model, with an average usefulness for training score of 4.6/5. ConclusionThe feedback from experts and trainees (informal) was overwhelmingly positive. On average, our experts reported high satisfaction with their experience using this simulator as a training tool.