title: Full immersion simulation: validation of a distributed simulation environment for technical and non-technical skills training in Urology.
abstract: OBJECTIVE
  To evaluate the face, content and construct validity of the distributed simulation (DS) environment for technical and non-technical skills training in endourology. To evaluate the educational impact of DS for urology training.
  
  
  METHODS
  DS offers a portable, low-cost simulated operating room environment that can be set up in any open space. A prospective mixed methods design using established validation methodology was conducted in this simulated environment with 10 experienced and 10 trainee urologists. All participants performed a simulated prostate resection in the DS environment. Outcome measures included surveys to evaluate the DS, as well as comparative analyses of experienced and trainee urologist's performance using real-time and 'blinded' video analysis and validated performance metrics. Non-parametric statistical methods were used to compare differences between groups.
  
  
  RESULTS
  The DS environment demonstrated face, content and construct validity for both non-technical and technical skills. Kirkpatrick level 1 evidence for the educational impact of the DS environment was shown. Further studies are needed to evaluate the effect of simulated operating room training on real operating room performance.
  
  
  CONCLUSIONS
  This study has shown the validity of the DS environment for non-technical, as well as technical skills training. DS-based simulation appears to be a valuable addition to traditional classroom-based simulation training.
authors: Kings Health Partners, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors: James
authors: J
authors: Brewin
authors: Imperial College, London, UK.
authors: Jessica
authors: J
authors: Tang
authors: Kings Health Partners, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors: Prokar
authors: P
authors: Dasgupta
authors: Kings Health Partners, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors: Muhammad S
authors: MS
authors: Khan
authors: Kings Health Partners, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors: Kamran
authors: K
authors: Ahmed
authors: Imperial College, London, UK.
authors: Fernando
authors: F
authors: Bello
authors: Imperial College, London, UK.
authors: Roger
authors: R
authors: Kneebone
authors: Kings Health Partners, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors: Peter
authors: P
authors: Jaye
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003198:Computer Simulation / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020728:Transurethral Resection of Prostate / Q000193:education*; D014572:Urology / Q000193:education*; D014584:User-Computer Interface
keywords: TURP; distributed simulation; non-technical skills; simulated operating room; simulation