The effect of bench model fidelity on endourological skills: a randomized controlled study.
OBJECTIVE
Complex skills, such as ureteroscopy and stone extraction, are increasingly taught to novice urology trainees using bench models in surgical skills laboratories. We determined whether hands-on training improved the performance of novices more than those taught only by a didactic session and whether there was a difference in the performance of subjects taught on a low versus a high fidelity model.


METHODS
We randomized 40 final year medical students to a didactic session or 1 of 2 hands-on training groups involving low or high fidelity bench model practice. Training sessions were supervised by experienced endourologists. Testing involved removal of a mid ureteral stone using a semirigid ureteroscope and a basket. Blinded examiners tested subjects before and after training. Performance was measured by a global rating scale, checklist, pass rating and time needed to complete the task.


RESULTS
There was a significant effect of hands-on training on endourological performance (p <0.01). With respect to bench model fidelity the low fidelity group did significantly better than the didactic group (p <0.05). However, no significant difference was found between the high and low fidelity groups (p >0.05). The low fidelity model cost Canadian $20 to produce, while the high fidelity model cost Canadian $3,700 to purchase.


CONCLUSIONS
Hands-on training using bench models can be successful for teaching novices complex endourological skills. A low fidelity bench model is a more cost-effective means of teaching ureteroscopic skills to novices than a high fidelity model.
Matsumoto
Edward D
ED
Department of Surgery and Centre for Research in Education at the University Health Network, University of Toronto, Ontario, Canada.
Hamstra
Stanley J
SJ
Radomski
Sidney B
SB
Cusimano
Michael D
MD
D002983:Clinical Competence; D004504:Education, Medical, Undergraduate; D006801:Humans; D009864:Ontario; D018666:Ureteroscopy; D013520:Urologic Surgical Procedures; D014572:Urology / Q000193:education*