Cost- effectiveness
Bowling
2010 1
Freshfrozen
cadavers
Proper assembly of the cystoscope, proper
setup of additional cystoscopy equipment
(distension medium, tubing, camera and light
source), performing a series of predetermined
bladder and urethra survey tasks, including
identification of abnormalities.
29
obstetrician–
gynecologists
2-hour
didactic
session
OSATS,
GRS
1B
-
-
Y
-
-
-
Y
Schout
2010 2
Uro
Mentor
Real-time cystourethroscopy
30 experts, 50
novices
GRS
3B
-
-
-
-
-
Y
-
Dolmans
2009 3
Uro
Mentor
56 urologists
33 residents
-
Y
-
Y
-
Y
-
Uro
Mentor
Evaluation
questionnair
e about the
tasks
OSATS
3B
Gettman
2009 4
4
-
Y
-
-
Y
-
Schout
2009 5
Uro
Mentor
Urethrocystoscopy task (bladder inspection,
biopsy, and coagulation) or a
ureterorenoscopy task (manipulation of a
distal ureter stone)
Task 1 involved a rigid cystoscope, and
placement of a guide wire through the ureteral
orifice and into the ureter.
Task 2 involved a flexible cystoscope for
performing diagnostic cystoscopy.
Task 3 involved a rigid cystoscope to identify
a bladder lesion.
Training, handling of scope
Training, systematic bladder inspection and
15-min
instruction
video
15-min
introduction
session
-
GRS
1B
-
Y
-
-
Y
-
10 novice
45 min per
sessions
50 trained 50
untrained
15-min
instruction
Reliability
Evaluation
scoring
Content validity
Training
duration
Construct validity
Level of
participants
Face validity
Training tasks
Oxford level of
evidence
Feasibility
Trade
name of
the model
Educational impact
Table 3: An overview of studies using various types of simulation models for cystoscopy training and assessment
forward planning
Training, speed and flow of procedure
residents
Task 1 involved a rigid cystoscope, and
placement of a guide wire through the ureteral
orifice and into the ureter.
Task2 involved a flexible cystoscope for
performing diagnostic cystoscopy.
Task 3 involved a rigid cystoscope to identify
a bladder lesion.
Cystoscopy, guide wire insertion, semirigid
ureteroscopy and basket extraction of a distal
ureteric stone
30 novice, 27
experts
All subjects
performed 5
trials of 3
basic
cystoscopic
tasks.
OSATS
3B
8 senior
residents, 8
junior
residents
10 novice, 21
expert
3 days
GRS
3B
-
OSATS
3B
2 supervised
training
sessions of 60
minutes each
with an
interval of 1
week
Exercise
performed 3
times before
assessment
6.5 hours
Total
procedure
time &
relative
blood loss
3B
Gettman
2008 6
Uro
Mentor
Matsumot
o 2006 7
Uro
Mentor
Dolmans
2006 8
Uro
Mentor
Cystoscopy task with biopsy taking and
coagulation of the biopsy site
Reich
2006 9
Uro
Trainer
Cystoscopy and resection of bladder tumors
24 medical
students, 12
residents
Manyak
2002 10
-
Endoscopy of the lower urinary tract
traversing the male urethra across the
prostate and into the urinary bladder
8 urology
residents
Shah 2002
Uro
Mentor
course
Flexible cystoscopy
14 urology
nurse
practitioners
11
17 question
written
evaluation
-
Y
Y
-
-
-
Y
Y
-
Y
-
Y
-
-
-
-
-
-
Y
-
-
-
-
-
Y
-
-
-
Y
-
-
Y
Y
-
-
4
Y
Shah,
2002 12
Uro
Mentor
Flexible cystoscopy
10 novices, 7
experts
-
Total time,
number of
flags
visualised
Wilhelm
2002 13
Uro
Mentor
Rigid cystoscopy, flexible ureteroscopy with
laser lithotripsy, and basket retrieval of a
proximal
ureteral stone
21 medical
students
Five 30
minute
supervised
training
sessions
GRS
2B
-
-
Y
-
-
-
-
-
-
Y
-
-
-
-
Table 4: An overview of studies using various types of simulation models for ureteroscopy training and assessment
URETERORENOSCOPY
-
GRS and time to
task completion.
Chou 2006
Uro Mentor
Cystoscopy: access the ureter with
a guide wire, insert the flexible
ureteroscope, identify the ureteral
stone, perform laser lithotripsy,
basket extract the stone, and
remove the ureteroscope.
Urethrocystoscopic task
(bladder inspection, biopsy and
coagulation) or a
ureterorenoscopic task (stone
manipulation of a distal ureter
stone).
Check patient identity, position the
patient, enter the bladder with
cystoscope, check the bladder, find
the orifices, place guide wire, enter
the bladder with ureteroscope,
enter the orifice, advance the
46 attending
urologists,
urology residents,
medical students
and industry
representatives
16 medical
students
2 months
70 urologists
26 urology
residents
15
Schout
2006 16
Uro Mentor
Brehmer
2005 17
Mediskills
Cost- effectiveness
Flexible ureteroscopy, renoscopy
and intrarenal basket extraction of
a lower pole calculus
Educational impact
Adult
ureteroscopy
trainer (Ideal
Anatomic
Modelling)
Reliability
White
2010 14
Content validity
Evaluation
scoring
Construct validity
Training
duration
Face validity
Level of
participants
Feasibility
Training tasks
Oxford level of
evidence
Trade name
of the model
3B
-
Y
Y
Y
-
-
-
OSATS
4
-
-
-
Y
-
-
-
-
Total procedure
time
4
-
Y
-
-
-
-
-
First two day 8
hrs
Next two days
2x8 hrs
OSATS
4
-
-
Y
Y
Y
Y
-
ureteroscope in the ureter and
empty the bladder.
Knoll 2005
Uro Mentor
Rigid and flexible
ureterorenoscopy treating a lower
calyceal stone,
20 experts, 5
novice
20 min session
Johnson
2004 19
Uro Mentor
Ureteroscopy and laser lithotripsy
18 medical
students, 13
medical students
10 days for 30
minutes daily
prior to
evaluation.
Ogan 2004
Uro Mentor
Rigid cystoscopy, passage of a
guide wire and flexible
ureteroscope (URS) inspection of
all calices and removal of the
ureteroscope.
Rigid cystoscopy, ureteral orifice
cannulation with a Bentson wire,
flexible ureteroscopy and
systematic inspection of the
collecting system
16 medical
students 16
residents
5 hours of
supervised
training on the
simulator
16 medical
students 16
residents
5 hours during a
2-week period
18
20
Jacomides
2004 21
Uro Mentor
Total operation
time, X-ray
exposure,
Guide wire
insertion time
,time of
progression from
the orifice to the
stone, stone
contact time,
number of
perforations,
bleeding
Scored by 2
independent
expert reviewers
using a modified
Global Rating
Operative
Performance
Scale (GROPS)
GRS
3B
-
Y
Y
Y
-
Y
Y
3B
-
-
-
-
-
Y
-
3B
-
-
Y
-
-
Y
-
OSATS
3B
-
-
Y
-
-
-
-
Matsumot2
002 22
Bench
model
Cystoscopy phase with guide wire
insertion and the ureteroscopy
phase with stone basket extraction.
40 medical
students
1 hour
GRS
4
Watterson
2002 23
Uro Mentor
Ureteroscopy
20 novice trainees
-
GRS
4
Brehmer
2002 24
Mediskills
bench model
Check patient identity, position the
patient, enter the bladder with
cystoscope, check the bladder, find
the orifices, place guide wire, enter
the bladder with ureteroscope,
enter the orifice, advance the
ureteroscope in the ureter and
empty the bladder.
9 consultants
5 trainees
-
OSATS
3B
Matsumot
2001 25
Limbs and
Things
Cystoscopy and guide wire
insertion, and ureteroscopy and
basket extraction of a stone.
17 urology
residents
1 hour
Ureteroscopic
global scale
4
-
-
-
-
Y
Y
-
Y
Y
Y
-
-
-
-
-
Y
Y
-
-
-
-
Y
-
Y
-
-
Training
duration
Evaluation scoring
Feasibility
Face validity
Educational impact
Cost- effectiveness
Kallstrom
2010 26
TURP
simulator
(PelvicVision)
Transurethral resection of
prostate
11 medical
students, 9
experienced
urologists
Procedure checklist
3B
-
-
Y
-
-
-
-
Schout 2009 27
Uro
Trainer
Transurethral bladder tumor
resection and/or
transurethral prostate
resection
104 urologists and
urology residents
Students
received a short
lecture on
benign prostatic
enlargement
and the
procedure of
TURP
-
4
-
Y
-
Y
-
-
-
Rashid 2007 28
TURP
(Transure
thral
resection
of the
prostate)
simulator
Transurethral resection of
prostate
72 urologists, 45
residents and 19
novices
-
Rated simulator
usefulness and
realism on a 10point scale (1—not
at all
useful/realistic/poor,
10—very
useful/realistic/excel
lent)
Grams resected,
blood loss, irrigant
volume used, foot
pedal use and
differential time
spent with
orientation, cutting
or coagulation.
3B
-
-
Y
-
-
-
-
Kallstrom
TURP
Transurethral resection of
17 experienced
-
3B
-
Y
Y
Y
-
-
-
Reliability
Level of
participants
Content validity
Training tasks
Construct validity
Trade
name of
the
model
Oxford level of
evidence
Table 5: An overview of studies using various types of simulation models for TURP/TURBT training and assessment
TURP/TURBT
29
VR
simulator
prostate
Sweet 2004 30
TURP
(Transure
thral
resection
of the
prostate)
simulator
Transurethral resection of
prostate
Kumar 2002 31
Latex
polymer
prostate
model in
a perspex
box
TURP
simulator
Transurethral resection of
prostate
1 urological
trainee, 1
consultant
urologist
Transurethral resection of
prostate
3 urologists
2005
Ballaro 1999
32
urologists for face
validity and 9
experienced
urologists for
content validit, 7
students for
construct validity
72 urologists &19
novice
5-minute
resection task
3B
-
Y
Y
Y
-
-
-
-
Capsular perforation,
external sphincter
resection, rectal
perforation, dorsal
venous complex
resection, ureteral
orifice resection and
undermining of the
bladder neck
-
3B
-
-
-
-
-
-
-
-
-
3B
-
-
-
Y
-
-
TURP/TURBT: Transurethral resection of prostate/Transurethral resection of bladder tumour
Percutaneous renal access
novices (15)
and experts
(9)
2x 30-minute
sessions
Stern 2007
Percutaneous nephrolithotomy
Review
Knudsen
2006 35
Porcine
kidney &
bladder
PERC
Mentor
Total time (seconds)
X-ray exposure time
(seconds
Total time spent
introducing needle to
collecting
system (seconds)
Number of attempts
to puncture the
collecting system
Perforations (number
of occurrences)
Total amount of
retrograde contrast
injected (mL)
GRS
Consisting of percutaneous renal
puncture followed by the
introduction of a guide wire into
the collecting system
Hammond
2004 36
Porcine
kidneys
Needle access, tract dilation and
renal access sheath insertion
using fluoroscopy.
63 trainees: 31 2x 30-minute
medical
sessions
students, 31
residents and 1
fellow
Not stated
-
34
Cost- effectiveness
PERC
Mentor
Modified
endourological GRS
3B
-
Y
Y
Y
-
-
-
-
4
-
Y
-
-
-
-
-
2B
Y
3A
Reliability
Mishra
2010 33
Content validity
Evaluation scoring
Construct validity
Training
duration
Face validity
Level of
participants
Feasibility
Training tasks
Oxford level of
evidence
Trade
name of
the model
Educational impact
Table 6: An overview of studies using various types of simulation models for percutaneous renal access
PERCUTANEOUS RENAL ACCESS
Y
Y
Y
Y
Y
Mishra
2002 37
Uro
Mentor
Ureterorenoscopy and
percutaneous nephrolitholapaxy
None,
evaluation of
Uro Mentor
-
-
5
-
-
-
-
-
Y
Y
Table 7: An overview of studies using various types of simulation models for laparoscopic nephrectomy training and assessment
39
Traxer
2001 40
8 expert
urological
laparoscopic
surgeons
10 residents
and 10
novices
2 sessions
Time
Haemorrhage
Tool travel
Total errors
4
-
Y
Y
Dissecting the renal hilum via the
retroperitoneal
21 medical
students
-
Time, blood
loss, path
length, and
total score
2B
-
Y
Y
Y
-
-
Laparoscopic nephrectomy
12 urology
residents
30 minutes
daily for 10
days.
OSATS
4
-
-
-
Y
Y
Y
-
Cost- effectiveness
Dissection and division of the
ureter; Dissection of hilum and
division of hilar vessels;
Dissection of kidney from
peritoneum
Educational impact
Procedicus
MIST
(Minimally
invasive
surgical
trainer)
Nephrectomy
simulator
LN
(Laparoscopi
c
nephrectomy
)-VR (Virtual
reality)
simulator
(Guy’sMentice)
Porcine
laparoscopic
nephrectomy
Reliability
Evaluation
scoring
Content validity
Training
duration
Construct validity
Level of
participants
Face validity
Wijn 2010
Training tasks
Feasibility
Brewin
2010 38
Trade name
of the model
Oxford level of
evidence
LAPAROSCOPIC NEPHRECTOMY
-
-
-
Table 8: An overview of studies using various types of simulation models for vasovasotomy training and assessment
50 junior
residents
1 day
OSATS
2B
-
-
-
-
Y
Y
Cost- effectiveness
Vasovasostomy
Educational impact
Silicone
tubing or
live rat
vas
deferens
Reliability
Evaluation
scoring
Content validity
Training
duration
Construct validity
Level of
participants
Face validity
Training tasks
Feasibility
Grober
2004 41
Trade
name of
the model
Oxford level of
evidence
VASOVASOTOMY
-
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