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WCE 2017: Assessment of Urology Postgraduate Trainees’ Competencies in Flexible Ureteroscopic Stone Extraction

Vancouver, Canada (UroToday.com) Dr. Mehdi Aloosh, from McGill University, presented data that examined the use of the simulator to assess the competency of urology post-graduate trainees (PGTs). As an introduction to his presentation, Dr. Aloosh explained that flexible ureteroscopic lithotripsy is the gold standard for the management of most ureteral and renal stones and that simulators for this procedure may provide a safe environment and objective assessment of PGT competency. 

For this study, Task 10 on the UroMentor simulator from Simbionix was used to assess competency in ureteroscopic stone extraction skill. Task 10 required each PGT to enter a bladder model using a rigid cystoscope then insert a guidewire into the ureteral orifice under fluoroscopic guidance. After the guidewire was place correctly, a flexible ureteroscope and stone basket was used to extract stones following by examination of the renal calyces. A total of 30 urology PGTs from 4 urology programs in Quebec participated in this study. The Ureteroscopy-Global rating scale was used to assess all the participants. The PGTs also answered a questionnaire after using the trainer. Three experts also participated to set a competency base line. 

The mean score for all PGTs was 20.4 while the mean score for the three experts was 26.0. Based on these numbers, the competency cut-off was set at 19. Based on this, 60% of the 30 participants were rated as competent. PGTs were asked: how close is this simulator to real-life ureteroscopy?, is it useful as an education tool for PGTs?, and do you think the simulator is useful in assessing PGT competency?. They answered on a 1 to 10 scale with a mean rating of 5.3, 6.8, and 5.3 respectively. 

Dr. Aloosh concluded that the UroMentor simulator can be used to assess competency in PGTs and established 19 points to be the competency cut-off point under the Ureteroscopy-Global rating scale. He added that PGTs rated as “competent” in this study were significantly better and faster than those who were not. Lastly he stated that future studies with larger sample sizes are needed to confirm these results. 

Presented by: Sero Andonian, MD, MSc, FRCSC, FACS

Authors: Mehdi Aloosh, Felix Couture, Nader Fahmy, Mostafa Elhilali, Sero Andonian
Affiliation: Division of Urology, McGill University, Montreal, Quebec, Canada

Written by: Renai Yoon, Department of Urology, University of California-Irvine at 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.