title: A simulator for teaching transrectal ultrasound procedures: how useful and realistic is it?
abstract: BACKGROUND
  : We describe a new simulator for teaching transrectal ultrasound (TRUS) and present the results of a preliminary evaluation of the simulator's realism and usefulness for training.
  
  
  METHODS
  : A simulator for abdominal ultrasound was adjusted by the developer to enable simulation of TRUS by providing an opening for inserting a dummy rectal probe. To enable TRUS simulation, data from ultrasound prostate imaging of eight real patients obtained with our regular ultrasound machine were transferred to the simulator by connecting the computer of the simulator to the ultrasound machine. These data were used to create images in the TRUS simulator. Residents and urologists used the simulator to perform TRUS in one of the eight patient cases and judged the simulator's realism and usefulness.
  
  
  RESULTS
  : We were able to construct an initial urological module for the TRUS simulator. The images shown on the monitor of the simulator are quite realistic. The simulator can be used without difficulty to collect data, to create cases, and to perform TRUS. The absence of an option for prostate biopsy and the lack of tissue resistance were mentioned as two important shortcomings. Forty-seven participants rated the simulator's overall realism and usefulness for training purposes as 3.8 (standard deviation: 0.7) and 4.0 (standard deviation: 0.8) on a five-point Likert scale, respectively.
  
  
  CONCLUSIONS
  : The simulator we describe can be used as a training tool for TRUS. It enables training with different patient cases and minimizes the burden to patients. Simulation of prostate biopsies should be added to increase the model's usefulness.
authors.affiliation: Department of Urology, Catharina Hospital, Eindhoven, The Netherlands. mleinpersoon@hotmail.com
authors.forename: Marjolein C
authors.initials: MC
authors.lastname: Persoon
authors.forename: Barbara
authors.initials: B
authors.lastname: Schout
authors.forename: Elisabeth J
authors.initials: EJ
authors.lastname: Martens
authors.forename: Irene M
authors.initials: IM
authors.lastname: Tjiam
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Tielbeek
authors.forename: Albert J J A
authors.initials: AJ
authors.lastname: Scherpbier
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Ad J M
authors.initials: AJ
authors.lastname: Hendrikx
mesh_terms: D006801:Humans; D008297:Male; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology; D012007:Rectum / Q000000981:diagnostic imaging*; D013663:Teaching; D018615:Ultrasonography, Doppler, Color; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000295:instrumentation* / Q000379:methods