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The SIMULATE ureteroscopy training curriculum: educational value and transfer of skills

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SIMULATE Trial Contributors, Abdullatif Aydın, Kamran Ahmed, Umair Baig, Nicholas Raison, Andrea G Lantz Powers, Nicola Macchione, Ahmed Al-Jabir, Takashige Abe, Muhammad Shamim Khan, Prokar Dasgupta

Original languageEnglish
Pages (from-to)3615-3621
Number of pages7
JournalWorld Journal of Urology
Issue number9
Early online date3 Feb 2021
E-pub ahead of print3 Feb 2021
PublishedSep 2021

Bibliographical note

Funding Information: The authors are grateful to all contributors (listed below) and The Urology Foundation for generously funding this study. Equipment and instruments for executing the training courses were kindly provided by Olympus, Karl Storz, Boston Scientific, Coloplast, Simbionix, Limbs and Things and Mediskills. KA and PDG acknowledge support from the NIHR Biomedical Research Centre, MRC Centre for Transplantation, King’s Health Partners, Guy’s and St. Thomas’ Charity, School of Surgery, Health Education England, Royal College of Surgeons of England, Olympus, The Pelican Group, Technology Strategy Board and The Vattikuti Foundation. Publisher Copyright: © 2021, The Author(s).

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OBJECTIVE: Different simulation modalities may be utilised in a curricular fashion to benefit from the strengths of each training model. The aim of this study is to evaluate a novel multi-modality ureterorenoscopy (URS) simulation curriculum in terms of educational value, content validity, transfer of skills and inter-rater reliability.

METHODS: This international prospective study recruited urology residents (n = 46) with ≤ 10 URS experience and no prior simulation training. Participants were guided through each phase of the expert-developed SIMULATE URS curriculum by trainers and followed-up in the operating room (OR). Video recordings were obtained during training. A post-training evaluation survey was distributed to evaluate content validity and educational value, using descriptive statistics. Performance was evaluated using the objective structured assessment of technical skills (OSATS) scale to measure improvement in scores throughout the curriculum. Pearson's correlation coefficient and Cohen's kappa tests were utilised to investigate correlation and agreement between raters.

RESULTS: Participants reported gaining OR-transferrable skills (Mean: 4.33 ± 0.67) and demonstrated marked improvement in throughout the curriculum, transferred to the OR for both semi-rigid URS (p = 0.004) and flexible URS (p = 0.007). 70% of participants were successfully followed-up in the OR (n = 32). No differences were identified with the additional use of fresh frozen cadavers (p = 0.85, p = 0.90) and the URO Mentor VR simulator (p = 0.13, p = 0.22). A moderate level of correlation was noted on the video OSATS assessments, between two expert assessors (r = 0.70), but a poor agreement with the live rating.

CONCLUSION: The SIMULATE URS training curriculum received high educational value from participants, who demonstrated statistically significant improvement with consecutive cases throughout the curriculum and transferability of skills to the OR in both semi-rigid and flexible URS.

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