PD58-04 EFFECT OF SIMULATION-BASED TRAINING ON SURGICAL PROFICIENCY AND PATIENT OUTCOMES: THE SIMULATE RANDOMIZED CONTROLLED TRIAL

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment (PD58)1 Sep 2021PD58-04 EFFECT OF SIMULATION-BASED TRAINING ON SURGICAL PROFICIENCY AND PATIENT OUTCOMES: THE SIMULATE RANDOMIZED CONTROLLED TRIAL Abdullatif Aydin, Kamran Ahmed, Takashige Abe, Nicholas Raison, Mieke Van Hemelrijck, Hashim Ahmed, Furhan Mukhtar, Ahmed Al-Jabir, Oliver Brunckhorst, Nobuo Shinohara, Wei Zhu, Guohua Zeng, John Sfakianos, Mantu Gupta, Ashutosh Tewari, Ali Serdar Gözen, Jens Rassweiler, Andreas Skolarikos Athens, Greece, Thomas Kunit, Thomas Knoll, Andrea Lantz Powers, Ben Chew, Kemal Sarica, Muhammad Shamim Khan, and Prokar Dasgupta Abdullatif AydinAbdullatif Aydin More articles by this author , Kamran AhmedKamran Ahmed More articles by this author , Takashige AbeTakashige Abe More articles by this author , Nicholas RaisonNicholas Raison More articles by this author , Mieke Van HemelrijckMieke Van Hemelrijck More articles by this author , Hashim AhmedHashim Ahmed More articles by this author , Furhan MukhtarFurhan Mukhtar More articles by this author , Ahmed Al-JabirAhmed Al-Jabir More articles by this author , Oliver BrunckhorstOliver Brunckhorst More articles by this author , Nobuo ShinoharaNobuo Shinohara More articles by this author , Wei ZhuWei Zhu More articles by this author , Guohua ZengGuohua Zeng More articles by this author , John SfakianosJohn Sfakianos More articles by this author , Mantu GuptaMantu Gupta More articles by this author , Ashutosh TewariAshutosh Tewari More articles by this author , Ali Serdar GözenAli Serdar Gözen More articles by this author , Jens RassweilerJens Rassweiler More articles by this author , Andreas Skolarikos Athens, GreeceAndreas Skolarikos Athens, Greece More articles by this author , Thomas KunitThomas Kunit More articles by this author , Thomas KnollThomas Knoll More articles by this author , Andrea Lantz PowersAndrea Lantz Powers More articles by this author , Ben ChewBen Chew More articles by this author , Kemal SaricaKemal Sarica More articles by this author , Muhammad Shamim KhanMuhammad Shamim Khan More articles by this author , and Prokar DasguptaProkar Dasgupta More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002092.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Simulation-based surgical training is hypothesised to enhance progression along the initial phase of the learning curve. Residents can acquire skills outside of the operating room (OR), without endangering patient safety. However, to date, the transferability of simulation to the OR has been limited to small-scale studies conducted with medical students. The aim of this multicentre randomized controlled trial (ISCRTN 12260261) is to evaluate the effectiveness of simulation training, compared to conventional training in terms of proficiency and patient outcomes. METHODS: This international, multicentre randomised controlled superiority trial recruited urology residents(n=94) who had performed ≤10 ureterorenoscopy (URS) cases, as a selected index procedure, with no prior simulation experience. Recruits were randomised to simulation-based training (SBT) or non-simulation-based training (NSBT) groups, the latter of which is the current standard of training. Training sessions were conducted for the SBT arm, utilising an expert-developed multi-modality training curriculum. The primary outcome was the number of procedures required to achieve proficiency, defined as achieving a score of ≥28 on an Objective Structured Assessment of Technical Skill (OSATS) assessment scale, on 3 consecutive operations, without complications. Secondary outcomes included number of surgical complications and stone-free status in each arm. All participants were followed up for 25 procedures or over 18 months. RESULTS: A total of 1140 cases were performed by 65 participants where proficiency was achieved in 66% of SBT (n=21/32) and 55% of NSBT (n=18/33) participants (OR 1.59 [95% CI 0.59-4.33]) over a mean of 9.6 and 10.9 procedures (HR: 1.41 [95% CI 0.72-2.75]). More participants reached proficiency in the SBT arm in flexible ureterorenoscopy (OR 3.33 [95% CI 1.09-10.24]), requiring fewer number of procedures (HR 0.89 [95% CI 0.39-2.02]). Significant differences were observed in overall comparison of OSATS scores between groups (27.3 vs 25.9; p<0.0001), with fewer total (15 vs 37) and serious complications (3 vs 9 ureteric injuries) in the SBT group. CONCLUSIONS: Simulation-based training demonstrated higher overall proficiency scores than residents conventionally trained. Fewer procedures were required to achieve proficiency in flexible ureterorenoscopy, the complex form of the index procedure with fewer serious complications overall. Source of Funding: The Urology Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1017-e1018 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Abdullatif Aydin More articles by this author Kamran Ahmed More articles by this author Takashige Abe More articles by this author Nicholas Raison More articles by this author Mieke Van Hemelrijck More articles by this author Hashim Ahmed More articles by this author Furhan Mukhtar More articles by this author Ahmed Al-Jabir More articles by this author Oliver Brunckhorst More articles by this author Nobuo Shinohara More articles by this author Wei Zhu More articles by this author Guohua Zeng More articles by this author John Sfakianos More articles by this author Mantu Gupta More articles by this author Ashutosh Tewari More articles by this author Ali Serdar Gözen More articles by this author Jens Rassweiler More articles by this author Andreas Skolarikos Athens, Greece More articles by this author Thomas Kunit More articles by this author Thomas Knoll More articles by this author Andrea Lantz Powers More articles by this author Ben Chew More articles by this author Kemal Sarica More articles by this author Muhammad Shamim Khan More articles by this author Prokar Dasgupta More articles by this author Expand All Advertisement Loading ...

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