Task deconstruction facilitates acquisition of transurethral resection of prostate skills on a virtual reality trainer.
OBJECTIVE
To determine whether task deconstruction is superior to full-task training for the acquisition of transurethral resection skills on a transurethral resection of prostate (TURP) virtual reality trainer previously validated for use in residency training.


METHODS
Eighteen first- and second-year medical students with no previous exposure to TURP in the operating room participated in the study. The subjects were randomized to two treatment arms: full-task TURP training versus task deconstruction training. A 5-minute full-task exercise was done as a pretest and posttest in both groups. Training time was held constant at 45 minutes for both groups. The first group practiced the full-task resection for 45 minutes, while the second group performed four deconstructed tasks for a total of 45 minutes. This comprised of cystoscopy and identification of anatomy, coagulation, cutting, and complete resection exercises. Statistical analysis was performed by the Mann-Whitney test.


RESULTS
There was a significant difference in improvement comparing the pretest and posttest performance between the two groups, favoring task deconstruction over full-task training in the amount of tissue resected and grams resected/time on cutting pedal. There was no significant difference noted in number of bleeders coagulated, fluid consumed/gram resected, or bleeders coagulated/time on coagulation pedal. There was no difference in perforation rate between two groups. The mean approval rating of the curricular experience on the simulator was 4.0/5.0 in the task deconstruction group and 3.1/5.0 in the case of the full-task training group.


CONCLUSIONS
For the acquisition of transurethral resection skills, task deconstruction is superior to full-task training alone, in training novices on the virtual reality TURP trainer. Such a study provides more validity evidence to the unique value of simulation in the urology minimally invasive curriculum.
Kishore
Thekke Adiyat
TA
Department of Urologic Surgery, SimPORTAL, University of Minnesota, Minneapolis, Minnesota 55455-0392, USA.
Beddingfield
Richard
R
Holden
Timothy
T
Shen
Yunhe
Y
Reihsen
Troy
T
Sweet
Robert M
RM