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Costs in Surgical Training, Does It Outweigh the Benefits?

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Practical Simulation in Urology

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Abstract

Over the last decades, the traditional surgical training model, which has been the basis of most residency programs in urology for more than a century, has faced several ethical and regulatory issues, leading to a major paradigm shift in surgical training worldwide. Simulation-based surgical training has been considered of paramount importance to overcome these challenges. This chapter addresses the current status of surgical training in urology, namely concerning simulation-based technical skills training (including dry-lab, wet-lab, virtual reality, and cadaveric simulation training), simulation-based non-technical skills training, and a comprehensive approach to simulation-based surgical training, in order to discuss not only the benefits of each modality but also its costs.

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References

  1. Sealy WC. Halsted is dead: Time for change in graduate surgical education. Curr Surg. 1999;56(1–2):34–9. https://doi.org/10.1016/S0149-7944(99)00005-7.

    Article  Google Scholar 

  2. Slama E. William Stewart Halsted: father of the model for our current surgical training programs. Bull Am Coll Surg. 2016.

    Google Scholar 

  3. Gallagher AG, O’Sullivan GC. Fundamentals of surgical simulation: principles and practices. New York: Springer; 2011.

    Google Scholar 

  4. Ahmed N, Devitt KS, Keshet I, Spicer J, Imrie K, Feldman L, Cools-Lartigue J, Kayssi A, Lipsman N, Elmi M, Kulkarni AV, Parshuram C, Mainprize T, Warren RJ, Fata P, Gorman MS, Feinberg S, Rutka J. A systematic review of the effects of resident duty hour restrictions in surgery: impact on resident wellness, training, and patient outcomes. Ann Surg. 2014 Jun;259(6):1041–53. https://doi.org/10.1097/SLA.0000000000000595.

    Article  PubMed  Google Scholar 

  5. D’Angelo J, Snyder M, Bleedorn J, Hardie R, Foley E, Greenberg JA. An interdisciplinary approach to surgical skills training decreases programmatic costs. J Surg Res. 2019 Mar;235:600–6. https://doi.org/10.1016/j.jss.2018.10.026.

    Article  PubMed  Google Scholar 

  6. Damewood RB, Blair PG, Park YS, Lupi LK, Newman RW, Sachdeva AK. “Taking training to the next level”: the American College of Surgeons Committee on residency training survey. J Surg Educ. 2017 Nov–Dec;74(6):e95–e105. https://doi.org/10.1016/j.jsurg.2017.07.008.

    Article  PubMed  Google Scholar 

  7. Bucholz EM, Sue GR, Yeo H, Roman SA, Bell RH Jr, Sosa JA. Our trainees’ confidence: results from a national survey of 4136 US general surgery residents. Arch Surg. 2011 Aug;146(8):907–14. https://doi.org/10.1001/archsurg.2011.178.

    Article  PubMed  Google Scholar 

  8. George BC, Bohnen JD, Williams RG, Meyerson SL, Schuller MC, Clark MJ, Meier AH, Torbeck L, Mandell SP, Mullen JT, Smink DS, Scully RE, Chipman JG, Auyang ED, Terhune KP, Wise PE, Choi JN, Foley EF, Dimick JB, Choti MA, Soper NJ, Lillemoe KD, Zwischenberger JB, Dunnington GL, DaRosa DA, Fryer JP. Procedural learning and safety collaborative (PLSC). Readiness of US general surgery residents for independent practice. Ann Surg. 2017 Oct;266(4):582–94. https://doi.org/10.1097/SLA.0000000000002414.

    Article  PubMed  Google Scholar 

  9. Jabbour N, Snyderman CH. The economics of surgical simulation. Otolaryngol Clin N Am. 2017 Oct;50(5):1029–36. https://doi.org/10.1016/j.otc.2017.05.012.

    Article  Google Scholar 

  10. McGaghie WC, Issenberg SB, Petrusa ER, Scalese RJ. A critical review of simulation-based medical education research: 2003-2009. Med Educ. 2010 Jan;44(1):50–63. https://doi.org/10.1111/j.1365-2923.2009.03547.x.

    Article  PubMed  Google Scholar 

  11. Singh P, Aggarwal R, Pucher PH, Hashimoto DA, Beyer-Berjot L, Bharathan R, Middleton KE, Jones J, Darzi A. An immersive “simulation week” enhances clinical performance of incoming surgical interns improved performance persists at 6 months follow-up. Surgery. 2015 Mar;157(3):432–43. https://doi.org/10.1016/j.surg.2014.09.024.

    Article  PubMed  Google Scholar 

  12. Dawe SR, Pena GN, Windsor JA, Broeders JA, Cregan PC, Hewett PJ, Maddern GJ. Systematic review of skills transfer after surgical simulation-based training. Br J Surg. 2014 Aug;101(9):1063–76. https://doi.org/10.1002/bjs.9482.

    Article  CAS  PubMed  Google Scholar 

  13. Naik R, Mandal I, Hampson A, Casey R, Vasdev N. A comparison of urology training across five major English-speaking countries. Curr Urol. 2020 Mar;14(1):14–21. https://doi.org/10.1159/000499265.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ballario R, Rubilotta E. Training and general and financial conditions of European residents in urology: an international survey. Eur Urol. 2004 Oct;46(4):517–21. https://doi.org/10.1016/j.eururo.2004.07.003.

    Article  PubMed  Google Scholar 

  15. Cooper RA. It’s time to address the problem of physician shortages: graduate medical education is the key. Ann Surg. 2007 Oct;246(4):527–34. https://doi.org/10.1097/SLA.0b013e3181571bc1.

    Article  PubMed  Google Scholar 

  16. Carrion DM, Rodriguez-Socarrás ME, Mantica G, Esperto F, Cebulla A, Duijvesz D, Patruno G, Vásquez JL, Veneziano D, Díez-Sebastian J, Gozen AS, Palou J, Gómez RJ. Current status of urology surgical training in Europe: an ESRU-ESU-ESUT collaborative study. World J Urol. 2020 Jan;38(1):239–46. https://doi.org/10.1007/s00345-019-02763-1.

    Article  PubMed  Google Scholar 

  17. de Oliveira TR, Cleynenbreugel BV, Pereira S, Oliveira P, Gaspar S, Domingues N, Leitão T, Palmas A, Lopes T, Poppel HV. Laparoscopic training in urology residency programs: a systematic review. Curr Urol. 2019 May 10;12(3):121–6. https://doi.org/10.1159/000489437.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, Bower P, Campbell S, Haneef R, Avery AJ, Ashcroft DM. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ. 2019 Jul 17;366:l4185. https://doi.org/10.1136/bmj.l4185.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Zhan C, Miller MR. Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. JAMA. 2003 Oct 8;290(14):1868–74. https://doi.org/10.1001/jama.290.14.1868.

    Article  CAS  PubMed  Google Scholar 

  20. Maruthappu M, Duclos A, Lipsitz SR, Orgill D, Carty MJ. Surgical learning curves and operative efficiency: a cross-specialty observational study. BMJ Open. 2015 Mar 13;5(3):e006679. https://doi.org/10.1136/bmjopen-2014-006679.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kozan AA, Chan LH, Biyani CS. Current status of simulation training in urology: a non-systematic review. Res Rep Urol. 2020 Mar 17;12:111–28. https://doi.org/10.2147/RRU.S237808.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Childs BS, Manganiello MD, Korets R. Novel education and simulation tools in urologic training. Curr Urol Rep. 2019 Nov 28;20(12):81. https://doi.org/10.1007/s11934-019-0947-8.

    Article  PubMed  Google Scholar 

  23. Preece R. The current role of simulation in urological training. Cent European J Urol. 2015;68:207–11. https://doi.org/10.5173/ceju.2015.522.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Pelly T, Shanmugathas N, Bowyer H, Wali A, Pankhania R. Low-cost simulation models in urology: a systematic review of the literature. Cent European J Urol. 2020;73:373–80. https://doi.org/10.5173/ceju.2020.0122.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Rowley K, Pruthi D, Al-Bayati O, Basler J, Liss MA. Novel use of household items in open and robotic surgical skills resident education. Adv Urol. 2019 Mar 7;2019:5794957. https://doi.org/10.1155/2019/5794957.

    Article  PubMed  PubMed Central  Google Scholar 

  26. van der Poel H, Brinkman W, van Cleynenbreugel B, Kallidonis P, Stolzenburg JU, Liatsikos E, Ahmed K, Brunckhorst O, Khan MS, Do M, Ganzer R, Murphy DG, Van Rij S, Dundee PE, Dasgupta P. Training in minimally invasive surgery in urology: European Association of Urology/International Consultation of Urological Diseases consultation. BJU Int. 2016 Mar;117(3):515–30. https://doi.org/10.1111/bju.13320.

    Article  PubMed  Google Scholar 

  27. Canalichio KL, Berrondo C, Lendvay TS. Simulation training in urology: state of the art and future directions. Adv Med Educ Pract. 2020 Jun 2;11:391–6. https://doi.org/10.2147/AMEP.S198941.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Veneziano D, Ploumidis A, Proietti S, Tokas T, Kamphuis G, Tripepi G, Van Cleynenbreugel B, Gozen A, Breda A, Palou J, Sarica K, Liatsikos E, Ahmed K, Somani BK, ESU Training Group. Validation of the endoscopic stone treatment step 1 (EST-s1): a novel EAU training and assessment tool for basic endoscopic stone treatment skills-a collaborative work by ESU, ESUT and EULIS. World J Urol. 2020 Jan;38(1):193–205. https://doi.org/10.1007/s00345-019-02736-4.

    Article  PubMed  Google Scholar 

  29. Somani BK, Van Cleynenbreugel B, Gozen A, Palou J, Barmoshe S, Biyani S, Gaya JM, Hellawell G, Pini G, Oscar FR, Sanchez Salas R, Macek P, Skolarikos A, Wagner C, Eret V, Haensel S, Siena G, Schmidt M, Klitsch M, Vesely S, Ploumidis A, Proietti S, Kamphuis G, Tokas T, Geraghty R, Veneziano D. The European Urology Residents Education Programme hands-on training format: 4 years of hands-on training improvements from the European School of Urology. Eur Urol Focus. 2019 Nov;5(6):1152–6. https://doi.org/10.1016/j.euf.2018.03.002.

    Article  PubMed  Google Scholar 

  30. Villa L, Somani BK, Sener TE, Cloutier J, Cloutier J, Butticè S, Marson F, Ploumidis A, Proietti S, Traxer O. Comprehensive flexible ureteroscopy (FURS) simulator for training in endourology: the K-box model. Cent European J Urol. 2016;69(1):118–20. https://doi.org/10.5173/ceju.2016.710.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Chou DS, Abdelshehid C, Clayman RV, McDougall EM. Comparison of results of virtual-reality simulator and training model for basic ureteroscopy training. J Endourol. 2006 Apr;20(4):266–71. https://doi.org/10.1089/end.2006.20.266.

    Article  PubMed  Google Scholar 

  32. Shee K, Koo K, Wu X, Ghali FM, Halter RJ, Hyams ES. A novel ex vivo trainer for robotic vesicourethral anastomosis. J Robot Surg. 2020 Feb;14(1):21–7. https://doi.org/10.1007/s11701-019-00926-1.

    Article  PubMed  Google Scholar 

  33. Matsumoto ED, Hamstra SJ, Radomski SB, Cusimano MD. The effect of bench model fidelity on endourological skills: a randomized controlled study. J Urol. 2002 Mar;167(3):1243–7.

    Article  Google Scholar 

  34. Mantica G, Rivas JG, Carrion DM, Rodriguez-Socarrás ME, Esperto F, Cacciamani GE, Veneziano D. Simulator availability index: a novel easy indicator to track training trends. Is Europe currently at a urological training recession risk? Cent Eur J Urol. 2020;73(2):231–3. https://doi.org/10.5173/ceju.2020.0048.

    Article  Google Scholar 

  35. Reznick RK, MacRae H. Teaching surgical skills – changes in the wind. N Engl J Med. 2006 Dec 21;355(25):2664–9. https://doi.org/10.1056/NEJMra054785.

    Article  CAS  PubMed  Google Scholar 

  36. Sidhu RS, Park J, Brydges R, MacRae HM, Dubrowski A. Laboratory-based vascular anastomosis training: a randomized controlled trial evaluating the effects of bench model fidelity and level of training on skill acquisition. J Vasc Surg. 2007 Feb;45(2):343–9. https://doi.org/10.1016/j.jvs.2006.09.040.

    Article  PubMed  Google Scholar 

  37. Palter VN, Grantcharov TP. Simulation in surgical education. CMAJ. 2010 Aug;182(11):1191–6. https://doi.org/10.1503/cmaj.091743.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Bedetti B, Schnorr P, Schmidt J, Scarci M. The role of wet lab in thoracic surgery. J Vis Surg. 2017 May;4(3):61. https://doi.org/10.21037/jovs.2017.03.23.

    Article  Google Scholar 

  39. Shetty S, Zevin B, Grantcharov TP, Roberts KE, Duffy AJ. Perceptions, training experiences, and preferences of surgical residents toward laparoscopic simulation training: a resident survey. J Surg Educ. 2014 Sep–Oct;71(5):727–33. https://doi.org/10.1016/j.jsurg.2014.01.006.

    Article  PubMed  Google Scholar 

  40. Teoh JY, Cho CL, Wei Y, Isotani S, Tiong HY, Ong TA, Kijvikai K, Chu PS, Chan ES, Ng CF, Asian Urological Surgery Training & Education Group. A newly developed porcine training model for transurethral piecemeal and en bloc resection of bladder tumour. World J Urol. 2019 Sep;37(9):1879–87. https://doi.org/10.1007/s00345-018-2602-2.

    Article  PubMed  Google Scholar 

  41. Hou S, Ross G, Tait I, Halliday P, Tang B. Development and validation of a novel and cost-effective animal tissue model for training transurethral resection of the prostate. J Surg Educ. 2017 Sep–Oct;74(5):898–905. https://doi.org/10.1016/j.jsurg.2017.03.004.

    Article  PubMed  Google Scholar 

  42. Brunckhorst O, Aydin A, Abboudi H, Sahai A, Khan MS, Dasgupta P, Ahmed K. Simulation-based ureteroscopy training: a systematic review. J Surg Educ. 2015a Jan-Feb;72(1):135–43. https://doi.org/10.1016/j.jsurg.2014.07.003.

    Article  PubMed  Google Scholar 

  43. Soria F, Morcillo E, Serrano A, Cansino R, Rioja J, Fernandez I, de la Cruz J, Van Cleynenbreugel B, Sanchez-Margallo FM. Development and validation of a novel skills training model for retrograde intrarenal surgery. J Endourol. 2015 Nov;29(11):1276–81. https://doi.org/10.1089/end.2015.0421.

    Article  PubMed  Google Scholar 

  44. Lovegrove CE, Abe T, Aydin A, Veneziano D, Sarica K, Khan MS, Dasgupta P, Ahmed K. Simulation training in upper tract endourology: myth or reality? Minerva Urol Nefrol. 2017;69(6):579–88. https://doi.org/10.23736/S0393-2249.17.02873-9.

    Article  PubMed  Google Scholar 

  45. Brunckhorst O, Shahid S, Aydin A, Khan S, McIlhenny C, Brewin J, Sahai A, Bello F, Kneebone R, Shamim Khan M, Dasgupta P, Ahmed K. The relationship between technical and nontechnical skills within a simulation-based ureteroscopy training environment. J Surg Educ. 2015b Sep–Oct;72(5):1039–44. https://doi.org/10.1016/j.jsurg.2015.04.002.

    Article  PubMed  Google Scholar 

  46. Laguna MP, Arce-Alcazar A, Mochtar CA, Van Velthoven R, Peltier A, de la Rosette JJ. Construct validity of the chicken model in the simulation of laparoscopic radical prostatectomy suture. J Endourol. 2006 Jan;20(1):69–73. https://doi.org/10.1089/end.2006.20.69.

    Article  CAS  PubMed  Google Scholar 

  47. Ramachandran A, Kurien A, Patil P, Symons S, Ganpule A, Muthu V, Desai M. A novel training model for laparoscopic pyeloplasty using chicken crop. J Endourol. 2008 Apr;22(4):725–8. https://doi.org/10.1089/end.2007.0380.

    Article  PubMed  Google Scholar 

  48. Jiang C, Liu M, Chen J, Wang P, Lin T, Xu K, Han J, Huang H, Huang J. Construct validity of the chicken crop model in the simulation of laparoscopic pyeloplasty. J Endourol. 2013 Aug;27(8):1032–6. https://doi.org/10.1089/end.2013.0085.

    Article  PubMed  Google Scholar 

  49. Higuchi M, Abe T, Hotta K, Morita K, Miyata H, Furumido J, Iwahara N, Kon M, Osawa T, Matsumoto R, Kikuchi H, Kurashima Y, Murai S, Aydin A, Raison N, Ahmed K, Khan MS, Dasgupta P, Shinohara N. Development and validation of a porcine organ model for training in essential laparoscopic surgical skills. Int J Urol. 2020 Oct;27(10):929–38. https://doi.org/10.1111/iju.14315.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Gutt CN, Kim ZG, Krähenbühl L. Training for advanced laparoscopic surgery. Eur J Surg. 2002;168(3):172–7. https://doi.org/10.1080/110241502320127793.

    Article  PubMed  Google Scholar 

  51. Molinas CR, Binda MM, Mailova K, Koninckx PR. The rabbit nephrectomy model for training in laparoscopic surgery. Hum Reprod. 2004 Jan;19(1):185–90. https://doi.org/10.1093/humrep/deh025.

    Article  PubMed  Google Scholar 

  52. Marchini GS, Fioravanti ID Jr, Horta LV, Torricelli FC, Mitre AI, Arap MA. Specific training for LESS surgery results from a prospective study in the animal model. Int Braz J Urol. 2016 Jan–Feb;42(1):90–5. https://doi.org/10.1590/S1677-5538.IBJU.2014.0658.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Hung AJ, Ng CK, Patil MB, Zehnder P, Huang E, Aron M, Gill IS, Desai MM. Validation of a novel robotic-assisted partial nephrectomy surgical training model. BJU Int. 2012 Sep;110(6):870–4. https://doi.org/10.1111/j.1464-410X.2012.10953.x.

    Article  PubMed  Google Scholar 

  54. Hamacher A, Whangbo TK, Kim SJ, Chung KJ. Virtual reality and simulation for progressive treatments in urology. Int Neurourol J. 2018;22(3):151–60. https://doi.org/10.5213/inj.1836210.105.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Seymour NE. VR to OR: a review of the evidence that virtual reality simulation improves operating room performance. World J Surg. 2008 Feb;32(2):182–8. https://doi.org/10.1007/s00268-007-9307-9.

    Article  PubMed  Google Scholar 

  56. MacCraith E, Forde JC, Davis NF. Robotic simulation training for urological trainees: a comprehensive review on cost, merits and challenges. J Robot Surg. 2019 Jun;13(3):371–7. https://doi.org/10.1007/s11701-019-00934-1.

    Article  PubMed  Google Scholar 

  57. Aydin A, Raison N, Khan MS, Dasgupta P, Ahmed K. Simulation-based training and assessment in urological surgery. Nat Rev Urol. 2016 Sep;13(9):503–19. https://doi.org/10.1038/nrurol.2016.147.

    Article  PubMed  Google Scholar 

  58. Moglia A, Ferrari V, Morelli L, Ferrari M, Mosca F, Cuschieri A. A systematic review of virtual reality simulators for robot-assisted surgery. Eur Urol. 2016 Jun;69(6):1065–80. https://doi.org/10.1016/j.eururo.2015.09.021.

    Article  PubMed  Google Scholar 

  59. Rheman S, Raza SJ, Stegemann AP, Zeeck K, Din R, Llewellyn A, Dio L, Trznadel M, Seo YW, Chowriappa AJ, Kesavadas T, Ahmed K, Guru KA. Simulation-based robot-assisted surgical training: a health economic evaluation. Int J Surg. 2013;11(9):841–6. https://doi.org/10.1016/j.ijsu.2013.08.006.

    Article  Google Scholar 

  60. Shamim Khan M, Ahmed K, Gavazzi A, Gohil R, Thomas L, Poulsen J, Ahmed M, Jaye P, Dasgupta P. Development and implementation of centralized simulation training: evaluation of feasibility, acceptability and construct validity. BJU Int. 2013 Mar;111(3):518–23. https://doi.org/10.1111/j.1464-410X.2012.11204.x.

    Article  PubMed  Google Scholar 

  61. Estai M, Bunt S. Best teaching practices in anatomy education: a critical review. Ann Anat. 2016 Nov;208:151–7. https://doi.org/10.1016/j.aanat.2016.02.010.

    Article  PubMed  Google Scholar 

  62. Healy SE, Rai BP, Biyani CS, Eisma R, Soames RW, Nabi G. Thiel embalming method for cadaver preservation: a review of new training model for urologic skills training. Urology. 2015 Mar;85(3):499–504. https://doi.org/10.1016/j.urology.2014.11.009.

    Article  PubMed  Google Scholar 

  63. Hayashi S, Naito M, Kawata S, Qu N, Hatayama N, Hirai S, Itoh M. History and future of human cadaver preservation for surgical training: from formalin to saturated salt solution method. Anat Sci Int. 2016 Jan;91(1):1–7. https://doi.org/10.1007/s12565-015-0299-5.

    Article  CAS  PubMed  Google Scholar 

  64. Yiasemidou M, Roberts D, Glassman D, Tomlinson J, Biyani S, Miskovic D. A multispecialty evaluation of Thiel cadavers for surgical training. World J Surg. 2017 May;41(5):1201–7. https://doi.org/10.1007/s00268-016-3868-4.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Goyri-O’Neill J, Pais D, Freire de Andrade F, Ribeiro P, Belo A, O’Neill A, Ramos S, Neves Marques C. Improvement of the embalming perfusion method: the innovation and the results by light and scanning electron microscopy. Acta Medica Port. 2013 May-Jun;26(3):188–94.

    Google Scholar 

  66. Cabello R, González C, Quicios C, Bueno G, García JV, Arribas AB, Clascá F. An experimental model for training in renal transplantation surgery with human cadavers preserved using W. Thiel’s embalming technique. J Surg Educ. 2015 Mar–Apr;72(2):192–7. https://doi.org/10.1016/j.jsurg.2014.10.002.

  67. Rai BP, Stolzenburg JU, Healy S, Tang B, Jones P, Sweeney C, Somani BK, Biyani CS, Nabi G. Preliminary validation of Thiel embalmed cadavers for laparoscopic radical nephrectomy. J Endourol. 2015 May;29(5):595–603. https://doi.org/10.1089/end.2014.0719.

    Article  PubMed  Google Scholar 

  68. Huri E, Ezer M, Chan E. The novel laparoscopic training 3D model in urology with surgical anatomic remarks: fresh-frozen cadaveric tissue. Turk J Urol. 2016 Dec;42(4):224–9. https://doi.org/10.5152/tud.2016.84770.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Bertolo R, Garisto J, Dagenais J, Sagalovich D, Kaouk JH. Single session of robotic human cadaver training: the immediate impact on urology residents in a teaching hospital. J Laparoendosc Adv Surg Tech A. 2018 Oct;28(10):1157–62. https://doi.org/10.1089/lap.2018.0109.

    Article  PubMed  Google Scholar 

  70. Blaschko SD, Brooks HM, Dhuy SM, Charest-Shell C, Clayman RV, McDougall EM. Coordinated multiple cadaver use for minimally invasive surgical training. JSLS. 2007 Oct–Dec;11(4):403–7.

    PubMed  PubMed Central  Google Scholar 

  71. Bele U, Kelc R. Upper and lower urinary tract endoscopy training on Thiel-embalmed cadavers. Urology. 2016 Jul;93:27–32. https://doi.org/10.1016/j.urology.2016.01.040.

    Article  PubMed  Google Scholar 

  72. Mains E, Tang B, Golabek T, Wiatr T, Ross G, Duncan A, Howie D, Tait I, Chłosta P, Kata SG. Ureterorenoscopy training on cadavers embalmed by Thiel’s method: simulation or a further step towards reality? Initial report. Cent European J Urol. 2017;70(1):81–7. https://doi.org/10.5173/ceju.2017.913.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Lentz AC, Rodríguez D, Davis LG, Apoj M, Kerfoot BP, Perito P, Henry G, Jones L, Carrion R, Mulcahy JJ, Munarriz R. Simulation Training in Penile Implant Surgery: Assessment of Surgical Confidence and Knowledge With Cadaveric Laboratory Training. Sex Med. 2018;6(4):332–38. https://doi.org/10.1016/j.esxm.2018.09.001.

  74. Anderson O, Davis R, Hanna GB, Vincent CA. Surgical adverse events: a systematic review. Am J Surg. 2013 Aug;206(2):253–62. https://doi.org/10.1016/j.amjsurg.2012.11.009.

    Article  PubMed  Google Scholar 

  75. Somasundram K, Spence H, Colquhoun AJ, Mcilhenny C, Biyani CS, Jain S. Simulation in urology to train non-technical skills in ward rounds. BJU Int. 2018 Oct;122(4):705–12. https://doi.org/10.1111/bju.14402.

    Article  PubMed  Google Scholar 

  76. Leuschner S, Leuschner M, Kropf S, Niederbichler AD. Non-technical skills training in the operating theatre: a meta-analysis of patient outcomes. Surgeon. 2019 Aug;17(4):233–43. https://doi.org/10.1016/j.surge.2018.07.001.

    Article  PubMed  Google Scholar 

  77. Ounounou E, Aydin A, Brunckhorst O, Khan MS, Dasgupta P, Ahmed K. Nontechnical skills in surgery: a systematic review of current training modalities. J Surg Educ. 2019 Jan-Feb;76(1):14–24. https://doi.org/10.1016/j.jsurg.2018.05.017.

    Article  PubMed  Google Scholar 

  78. Brewin J, Tang J, Dasgupta P, Khan MS, Ahmed K, Bello F, Kneebone R, Jaye P. Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in urology. BJU Int. 2015 Jul;116(1):156–62. https://doi.org/10.1111/bju.12875.

    Article  PubMed  Google Scholar 

  79. Young M, Kailavasan M, Taylor J, Cornford P, Colquhoun A, Rochester M, Hanchanale V, Somani B, Nabi G, Garthwaite M, Gowda R, Reeves F, Rai B, Doherty R, Gkentzis A, Athanasiadis G, Patterson J, Wilkinson B, Myatt A, Biyani CS, Jain S. The success and evolution of a urological “boot camp” for newly appointed UK urology registrars: incorporating simulation, nontechnical skills and assessment. J Surg Educ. 2019 Sep–Oct;76(5):1425–32. https://doi.org/10.1016/j.jsurg.2019.04.005.

    Article  CAS  PubMed  Google Scholar 

  80. Biyani CS, Hanchanale V, Rajpal S, Jain S, Garthwaite M, Cartledge J, Somani B, Cornford P, Gowda B, Koenig P, Reeves F, Rogawski K, Myatt A, Eardley I, Terry T. First urology simulation boot camp in the United Kingdom. Afr J Urol. 2017;23(3):258–67. https://doi.org/10.1016/j.afju.2017.03.002.

    Article  Google Scholar 

  81. Hanchanale V, Kailavasan M, Rajpal S, et al. Impact of urology simulation boot camp in improving endoscopic instrument knowledge. BMJ Simul Technol Enhanced Learn. 2019;5:151–4. https://doi.org/10.1136/bmjstel-2018-000313.

    Article  Google Scholar 

  82. Sundelin MO, Silva JDC, Daele AV, Savopoulos V, Pirola GM, Ranasinghe S, Cleynenbreugel BV, Biyani CS, Kailavasan M. Urology simulation boot camp: a perspective from non-UK delegates. Actas Urol Esp. 2021;45(1):49–56. https://doi.org/10.1016/j.acuro.2020.03.013.

    Article  CAS  PubMed  Google Scholar 

  83. Somani BK, Van Cleynenbreugel B, Gözen AS, Skolarikos A, Wagner C, Beatty J, Barmoshe S, Gaya Sopena JM, Kalogeropoulos T, Faba OR, Salas RS, Schmidt M, Siena G, Pini G, Palou J, Geraghty R, Veneziano D. Outcomes of European Basic Laparoscopic Urological Skills (EBLUS) examinations: results from European School of Urology (ESU) and EAU Section of Uro-Technology (ESUT) over 6 years (2013-2018). Eur Urol Focus. 2020 Nov 15;6(6):1190–4. https://doi.org/10.1016/j.euf.2019.01.007.

    Article  PubMed  Google Scholar 

  84. Ahmed K, Khan R, Mottrie A, Lovegrove C, Abaza R, Ahlawat R, Ahlering T, Ahlgren G, Artibani W, Barret E, Cathelineau X, Challacombe B, Coloby P, Khan MS, Hubert J, Michel MS, Montorsi F, Murphy D, Palou J, Patel V, Piechaud PT, Van Poppel H, Rischmann P, Sanchez-Salas R, Siemer S, Stoeckle M, Stolzenburg JU, Terrier JE, Thüroff JW, Vaessen C, Van Der Poel HG, Van Cleynenbreugel B, Volpe A, Wagner C, Wiklund P, Wilson T, Wirth M, Witt J, Dasgupta P. Development of a standardised training curriculum for robotic surgery: a consensus statement from an international multidisciplinary group of experts. BJU Int. 2015 Jul;116(1):93–101. https://doi.org/10.1111/bju.12974.

    Article  PubMed  Google Scholar 

  85. Ahmed K, Patel S, Aydin A, Veneziano D, van Cleynenbreugel B, Gözen AS, Skolarikos A, Sietz C, Lahme S, Knoll T, Redorta JP, Somani BK, Sanguedolce F, Liatsikos E, Rassweiler J, Khan MS, Dasgupta P, Sarica K. European Association of Urology Section of Urolithiasis (EULIS) consensus statement on simulation, training, and assessment in urolithiasis. Eur Urol Focus. 2018 Jul;4(4):614–20. https://doi.org/10.1016/j.euf.2017.03.006.

    Article  PubMed  Google Scholar 

  86. Somani B, Brouwers T, Veneziano D, Gözen A, Ahmed K, Liatsikos E, Sarica K, Palou J, Rassweiler J, Biyani CS, Oliveira TR, Mottrie A, Gallagher A, Breda A, Poppel HV, McIllhenney C, Sedelaar M, Puliatti S, Jain S, Loenen RV, Cleynenbreugel BV. Standardization in Surgical Education (SISE): development and implementation of an innovative training program for urologic surgery residents and trainers by the European School of Urology in Collaboration with the ESUT and EULIS sections of the EAU. Eur Urol. 2021 Mar;79(3):433–4. https://doi.org/10.1016/j.eururo.2020.12.003.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Hospital das Forças Armadas - Polo Lisboa, Lisboa, Portugal

    Tiago Oliveira

  2. Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal

    Afonso Castro & Sérgio Pereira

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  1. Tiago Oliveira
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  2. Afonso Castro
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  1. St James’s University Hospital, Leeds, UK

    Chandra Shekhar Biyani

  2. Catholic University Leuven, Leuven, Belgium

    Ben Van Cleynenbreugel

  3. Onze Lieve Vrouwziekenhuis Hospital, Aalst, Belgium

    Alexandre Mottrie

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Oliveira, T., Castro, A., Pereira, S. (2022). Costs in Surgical Training, Does It Outweigh the Benefits?. In: Biyani, C.S., Van Cleynenbreugel, B., Mottrie, A. (eds) Practical Simulation in Urology . Springer, Cham. https://doi.org/10.1007/978-3-030-88789-6_23

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