title: Validation of computer-based training in ureterorenoscopy.
abstract: OBJECTIVE
  To evaluate the outcome of training both urological novices and experts, using the recently developed UroMentor (Simbionix Ltd, Israel) trainer, that provides a realistic simulation of rigid and flexible ureterorenoscopy (URS).
  
  
  METHODS
  Twenty experienced urologists (total number of previous flexible URSs 21-153) were monitored during simulated flexible URS for treating a lower calyceal stone, and the outcome was correlated with individual experience. A score was compiled based on the variables recorded, including total operation time, stone contact time, complications such as bleeding or perforation, and treatment success. A further five urological residents with no endourological experience were trained on the UroMentor in rigid URS for ureteric stone treatment. Their acquired clinical skills were subsequently compared to those of five urological residents who received no simulator training.
  
  
  RESULTS
  All 20 experienced urologists disintegrated the stone on the simulator, and the score achieved was related to their personal experience; there was a significant difference in performance in those with < 40 and > 80 previous flexible URSs. For the five urological residents with no endourological experience, simulator training improved their skills, and comparison with urological residents who had received no simulator training showed advantages for the trained residents. After being trained on the simulator, the group performed better in the first four URSs on patients.
  
  
  CONCLUSIONS
  Individual experience correlates with individual performance on the simulator. Simulator training was helpful in improving clinical skills. Although the distribution of computer-based simulators is limited by high prices, virtual reality-based training has the potential to become an important tool for clinical education.
authors.affiliation: Department of Urology, University Hospital Mannheim, Germany. thomas.knoll@uro.ma.uni-heidelberg.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Knoll
authors.forename: Lutz
authors.initials: L
authors.lastname: Trojan
authors.forename: Axel
authors.initials: A
authors.lastname: Haecker
authors.forename: Peter
authors.initials: P
authors.lastname: Alken
authors.forename: Maurice Stephan
authors.initials: MS
authors.lastname: Michel
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003198:Computer Simulation / Q000592:standards; D003194:Computer-Assisted Instruction / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D004502:Education, Medical, Continuing / Q000379:methods* / Q000592:standards; D004724:Endoscopy / Q000379:methods* / Q000592:standards; D006801:Humans; D013663:Teaching / Q000379:methods; D013664:Teaching Materials; D013997:Time Factors; D014514:Ureteral Calculi / Q000601:surgery; D018666:Ureteroscopy / Q000592:standards; D014572:Urology / Q000193:education*