Fiard G, Descotes J-L, Troccaz J
Service d'urologie, CHU Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, 38000 Grenoble, France.
Service d'urologie, CHU Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France; Université Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, 38000 Grenoble, France.
Prog Urol. 2019 May-Jun;29(6):295-311. doi: 10.1016/j.purol.2019.03.003. Epub 2019 Apr 29.
Simulation-based training is taking an increasingly important place in surgical training and is becoming mandatory with the latest reform of the French medical studies.
The objectives of this work were to report the various simulation tools available for the surgical training in urology, along with their validation level, through a systematic literature review.
A search was conducted using Medline with the terms "urology" and "simulator". Articles in English and French were selected.
Two hundred and ninety-one abstracts were read, allowing for the selection of 154 articles read to assess their eligibility. Studies whose main objective was not the validation of a simulator, studies describing animal models or studies whose full text was not available were excluded.
One hundred and six studies were analyzed in this review. The simulators described were classified in 7 categories: laparoscopic surgery, robotic surgery, ureteroscopy, percutaneous nephrolithotomy, endoscopic bladder and prostate surgery, basic skills in urology, and ultrasound-guided prostate interventions simulators. Apparent and content validity were demonstrated for most simulators, but construct and predictive validity were often lacking.
We did not consider the use of simulators as competency evaluation tools. Besides, the latest terminology proposed to define the various validation steps was not taken into account.
Many simulators are available in the field of urology and allow the reproduction of a large variety of urological procedures. However, their validation level is inconsistent, and has to be taken into account when choosing a simulator for surgical training, along with its cost, the eagerness of students to use the simulator and its availability.
基于模拟的培训在外科手术培训中占据着越来越重要的地位，并且随着法国医学教育的最新改革，它已成为强制性要求。
本研究的目的是通过系统的文献综述，报告可用于泌尿外科手术培训的各种模拟工具及其验证水平。
使用Medline数据库，以“泌尿外科”和“模拟器”为关键词进行检索。选取英文和法文的文章。
阅读了291篇摘要，从中筛选出154篇文章进行资格评估。排除主要目的不是验证模拟器的研究、描述动物模型的研究或全文不可获取的研究。
本综述分析了106项研究。所描述的模拟器分为7类：腹腔镜手术、机器人手术、输尿管镜检查、经皮肾镜取石术、内镜下膀胱和前列腺手术、泌尿外科基本技能以及超声引导下前列腺介入模拟器。大多数模拟器都证明了表面效度和内容效度，但常常缺乏结构效度和预测效度。
我们未将模拟器用作能力评估工具。此外，未考虑用于定义各种验证步骤的最新术语。
泌尿外科领域有许多模拟器，可用于再现各种泌尿外科手术。然而，它们的验证水平不一致，在为手术培训选择模拟器时，必须考虑其验证水平，以及成本、学生使用模拟器的积极性和其可用性。
