title: Task deconstruction facilitates acquisition of transurethral resection of prostate skills on a virtual reality trainer.
abstract: 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.
authors.affiliation: Department of Urologic Surgery, SimPORTAL, University of Minnesota, Minneapolis, Minnesota 55455-0392, USA.
authors.forename: Thekke Adiyat
authors.initials: TA
authors.lastname: Kishore
authors.forename: Richard
authors.initials: R
authors.lastname: Beddingfield
authors.forename: Timothy
authors.initials: T
authors.lastname: Holden
authors.forename: Yunhe
authors.initials: Y
authors.lastname: Shen
authors.forename: Troy
authors.initials: T
authors.lastname: Reihsen
authors.forename: Robert M
authors.initials: RM
authors.lastname: Sweet