title: Evaluation of the educational value of a virtual reality TURP simulator according to a curriculum-based approach.
abstract: OBJECTIVE
  This study aimed to evaluate the place of the TURPsim (Simbionix/VirtaMed, Beit Goal, Israel) within a urologic residency training curriculum, including training needs analysis (TNA) and investigating its validity.
  
  
  METHODS
  Training needs analysis was conducted by an expert panel to identify procedural steps and pitfalls. Performance metrics of the simulator were compared with the TNA results. Participants were distributed according to their level of experience (completed transurethral resection of the prostate [TURP] procedures) as follows: novices (0), intermediates (1-50), and experts (>50). They followed standardized instructions and then performed 2 complete TURP procedures on the TURPsim.
  
  
  RESULTS
  Ten of 22 procedural steps (TNA) and 4 of 11 pitfalls were covered by the TURPsim. A total of 66 participants, 22 in each group, were included. Median general judgment (face and content) about the TURPsim was rated 7.3 (median, 7; range, 3-9). Ninety-three percent of all participants qualified the TURPsim as a useful training model. Intermediates and experts had a significant faster resection time and less blood loss compared with novices (construct) (P = 0.001). Novices needed to re-resect previous lobes, and they also resected the prostate in the incorrect order more frequently compared with intermediates and experts.
  
  
  CONCLUSIONS
  Training needs analysis is of paramount importance in the evaluation process of a training program. This curriculum-based approach including validity of a simulator seems valuable and may narrow the gap between skills laboratory and clinical practice. This study showed face, content, and construct validity of the TURPsim, and this simulator finds its place in the current urologic curriculum to train basic and procedural TURP skills.
authors.affiliation: From the Catharina Hospital Eindhoven, Eindhoven (I.M.T., C.H.B., W.M.B., A.J.H., E.L.K.); Medical Centre Alkmaar (B.M.S.); EMGO Institute (B.M.S.), VU Medical Center, Alkmaar and Amsterdam; Radboud University Nijmegen Medical Centre, Nijmegen (J.A.W.); and Maastricht University, Maastricht (A.J.S.), the Netherlands.
authors.forename: Irene M
authors.initials: IM
authors.lastname: Tjiam
authors.forename: Charlotte H
authors.initials: CH
authors.lastname: Berkers
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Schout
authors.forename: Willem M
authors.initials: WM
authors.lastname: Brinkman
authors.forename: J Alfred
authors.initials: JA
authors.lastname: Witjes
authors.forename: Albert J
authors.initials: AJ
authors.lastname: Scherpbier
authors.forename: Ad J
authors.initials: AJ
authors.lastname: Hendrikx
authors.forename: Evert L
authors.initials: EL
authors.lastname: Koldewijn
mesh_terms: D000328:Adult; D003198:Computer Simulation / Q000592:standards*; D003479:Curriculum; D004502:Education, Medical, Continuing; D004504:Education, Medical, Undergraduate; D005260:Female; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011446:Prospective Studies; D014572:Urology / Q000193:education*; D014584:User-Computer Interface; D055815:Young Adult