title: Simulation-based ureteroscopy training: a systematic review.
abstract: OBJECTIVE
  Simulation is a common adjunct to operative training and various modalities exist for ureteroscopy. This systematic review aims the following: (1) to identify available ureteroscopy simulators, (2) to explore evidence for their effectiveness using characteristic criterion, and (3) to provide recommendations for simulation-based ureteroscopy training.
  
  
  METHODS
  The preferred reporting items for systematic reviews and meta-analysis statement guidelines were used. A literature search was performed using the PubMed, EMBASE, and Cochrane Library databases.
  
  
  RESULTS
  In total, 20 articles concerning ureteroscopy simulators were included. Overall, 3 high-fidelity bench models are available. The Uro-Scopic Trainer has demonstrated face, construct, and concurrent validity, whereas the Scope Trainer has undergone content, construct, and predictive validation. The adult ureteroscopy trainer has demonstrated face, content, and construct validity. The URO Mentor is the only available ureteroscopy virtual-reality system; 10 studies were identified demonstrating its face, content, construct, concurrent, and predictive validity. The Uro-Scopic Trainer, the Scope Trainer, and the URO Mentor have demonstrated high educational impact. A noncommercially available, low-fidelity model has demonstrated effectiveness comparable to its high-fidelity counterpart at 185 times lesser than the price of the Uro-Scopic Trainer. The use of porcine models has also been described in 3 studies but require further study.
  
  
  CONCLUSIONS
  Valid models are available for simulation-based ureteroscopy training. However, there is a lack of many high-level studies conducted, and further investigation is required in this area. Furthermore, current research focuses on the technical skills acquisition with little research conducted on nontechnical skills acquisition within ureteroscopy. The next step for ureteroscopy training is a formalized and validated curriculum, incorporating simulation, training models, development of nontechnical skills, and real-life practice.
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Brunckhorst
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Abdullatif
authors.initials: A
authors.lastname: Aydin
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Hamid
authors.initials: H
authors.lastname: Abboudi
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Arun
authors.initials: A
authors.lastname: Sahai
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Muhammad Shamim
authors.initials: MS
authors.lastname: Khan
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom.
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.affiliation: MRC Centre for Transplantation, King's College London, King's Health Partners, London, United Kingdom; Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, United Kingdom. Electronic address: kamran.ahmed@kcl.ac.uk.
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D002983:Clinical Competence; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D008953:Models, Anatomic; D013663:Teaching / Q000379:methods*; D018666:Ureteroscopy / Q000193:education*; D014572:Urology / Q000193:education*; D014584:User-Computer Interface
keywords: Interpersonal and Communication Skills; Patient Care; Practice-Based Learning and Improvement; assessment; retrograde intrarenal surgery (RIRS); simulation; ureterorenoscopy; ureteroscopy; validation