Aloosh Mehdi, Noureldin Yasser A, Andonian Sero
1 Division of Urology, McGill University Health Centre , Montréal, Québec, Canada .
2 Department of Urology, Benha University Hospital, Benha University , Benha, Egypt .
J Endourol. 2016 Oct;30(10):1120-1125. doi: 10.1089/end.2016.0365. Epub 2016 Sep 15.
To assess the learning curve of flexible ureteroscopic stone extraction using the UroMentor™ simulator and transfer of flexible ureteroscopic stone extraction skills to the operating theatre.
After obtaining ethics approval, urology Post-Graduate Trainees (PGTs) from Post-Graduate Years (PGYs) 1 to 4 were recruited. During phase I, participants completed 3 weekly 1-hour training sessions on the UroMentor simulator practicing task 10, where two stones from the left proximal ureter and renal pelvis were extracted using a basket. Objective assessments by the simulator and subjective assessments using the validated Ureteroscopy-Global Rating Scale (URS-GRS) were used to establish the learning curve. During phase II, the URS-GRS tool was used to assess performance of participants in the operating theatre. URS-GRS scores obtained on the simulator and in the operating theatre were correlated.
In phase I, eight urology PGTs (PGY1-4) with mean age of 27.8 ± 2 (25-31) years participated in the study. PGTs practiced a total of 52 times, with a mean operative time of 14.6 ± 4.3 minutes and a mean fluoroscopy time of 10.4 ± 12 seconds. Competency in task 10 was achieved after seven trials on the UroMentor simulator. In phase II, 5 PGTs were assessed during 55 consecutive flexible ureteroscopic stone extraction in the operating theatre. The mean operative time was 51.4 ± 15.2 minutes and the mean fluoroscopy time was 29 ± 6 seconds. There was a significant positive correlation between URS-GRS scores obtained on the simulator and in the operating theatre (r = 0.9, p = 0.03), thus establishing predictive validity of performance on the UroMentor simulator.
Competency in task 10 on the UroMentor simulator (flexible ureteroscopic stone extraction) was achieved after seven trials. Since there was a strong positive correlation between URS-GRS scores on the simulator and in the operating theatre, the skills obtained on the simulator could be transferred to the operating theatre.
评估使用UroMentor™模拟器进行输尿管软镜取石术的学习曲线，以及将输尿管软镜取石术技能应用于手术室的情况。
获得伦理批准后，招募了1至4年级的泌尿外科研究生学员（PGT）。在第一阶段，参与者在UroMentor模拟器上完成了3次每周1小时的培训课程，练习任务10，即使用篮子从左侧近端输尿管和肾盂中取出两块结石。通过模拟器进行客观评估，并使用经过验证的输尿管镜检查全球评分量表（URS-GRS）进行主观评估，以建立学习曲线。在第二阶段，使用URS-GRS工具评估参与者在手术室的表现。将在模拟器上和手术室中获得的URS-GRS分数进行相关性分析。
在第一阶段，8名泌尿外科PGT（PGY1-4）参与了研究，平均年龄为27.8±2（25-31）岁。PGT总共练习了52次，平均手术时间为14.6±4.3分钟，平均透视时间为10.4±12秒。在UroMentor模拟器上进行7次试验后，达到了任务10的能力要求。在第二阶段，在手术室连续进行55例输尿管软镜取石术期间对5名PGT进行了评估。平均手术时间为51.4±15.2分钟，平均透视时间为29±6秒。在模拟器上和手术室中获得的URS-GRS分数之间存在显著的正相关（r = 0.9，p = 0.03），从而确立了UroMentor模拟器上表现的预测效度。
在UroMentor模拟器上进行7次试验后，达到了任务10（输尿管软镜取石术）的能力要求。由于模拟器上和手术室中的URS-GRS分数之间存在很强的正相关，因此在模拟器上获得的技能可以应用于手术室。
Zotero 插件