Framework for incorporating simulation into urology training.
OBJECTIVE
• Changes to working hours, new technologies and increased accountability have rendered the need for alternative training environments for urologists. • Simulation offers a promising arena for learning to take place in a safe, realistic setting. • Despite its benefits, the incorporation of simulation into urological training programmes remains minimal. • The current status and future directions of simulation for training in technical and non-technical skills are reviewed as they pertain to urology. • A framework is presented for how simulation-based training could be incorporated into the entire urological curriculum.


METHODS
• The literature on simulation in technical and non-technical skills training is reviewed, with a specific focus upon urology.


RESULTS
• To fully integrate simulation into a training curriculum, its possibilities for addressing all the competencies required by a urologist must be realized. • At an early stage of training, simulation has been used to develop basic technical skills and cognitive skills, such as decision-making and communication. • At an intermediate stage, the studies focus upon more advanced technical skills learnt with virtual reality simulators. • Non-technical skills training would include leadership and could be delivered with in situ models. • At the final stage, experienced trainees can practise technical and non-technical skills in full crisis simulations situated within a fully-simulated operating rooms.


CONCLUSIONS
• Simulation can provide training in the technical and non-technical skills required to be a competent urologist. • The framework presented may guide how best to incorporate simulation into training curricula. • Future work should determine whether acquired skills transfer to clinical practice and improve patient care.
Arora
Sonal
S
Department of Surgery and Cancer, Imperial College London, London, UK.
Lamb
Benjamin
B
Department of Surgery and Cancer, Imperial College London, London, UK.
Undre
Shabnam
S
Department of Surgery and Cancer, Imperial College London, London, UK.
Kneebone
Roger
R
Department of Surgery and Cancer, Imperial College London, London, UK.
Darzi
Ara
A
Department of Surgery and Cancer, Imperial College London, London, UK.
Sevdalis
Nick
N
Department of Surgery and Cancer, Imperial College London, London, UK.
D002983:Clinical Competence; D003198:Computer Simulation; D004501:Education, Medical / Q000379:methods / Q000458:organization & administration / Q000639:trends*; D006801:Humans; D014572:Urology / Q000193:education*