title: Simulation-based ureteroscopy skills training curriculum with integration of technical and non-technical skills: a randomised controlled trial.
abstract: BACKGROUND
  Current training modalities within ureteroscopy have been extensively validated and must now be integrated within a comprehensive curriculum. Additionally, non-technical skills often cause surgical error and little research has been conducted to combine this with technical skills teaching. This study therefore aimed to develop and validate a curriculum for semi-rigid ureteroscopy, integrating both technical and non-technical skills teaching within the programme.
  
  
  METHODS
  Delphi methodology was utilised for curriculum development and content validation, with a randomised trial then conducted (n = 32) for curriculum evaluation. The developed curriculum consisted of four modules; initially developing basic technical skills and subsequently integrating non-technical skills teaching. Sixteen participants underwent the simulation-based curriculum and were subsequently assessed, together with the control cohort (n = 16) within a full immersion environment. Both technical (Time to completion, OSATS and a task specific checklist) and non-technical (NOTSS) outcome measures were recorded with parametric and non-parametric analyses used depending on the distribution of our data as evaluated by a Shapiro-Wilk test.
  
  
  RESULTS
  Improvements within the intervention cohort demonstrated educational value across all technical and non-technical parameters recorded, including time to completion (p < 0.01), OSATS scores (p < 0.001), task specific checklist scores (p = 0.011) and NOTSS scores (p < 0.001). Content validity, feasibility and acceptability were all demonstrated through curriculum development and post-study questionnaire results.
  
  
  CONCLUSIONS
  The current developed curriculum demonstrates that integrating both technical and non-technical skills teaching is both educationally valuable and feasible. Additionally, the curriculum offers a validated simulation-based training modality within ureteroscopy and a framework for the development of other simulation-based programmes.
authors.affiliation: MRC Centre for Transplantation, King's College London, Department of Urology, Guy's and St. Thomas' NHS Foundation Trust, King's Health Partners, London, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Brunckhorst
authors.forename: Shahab
authors.initials: S
authors.lastname: Shahid
authors.forename: Abdullatif
authors.initials: A
authors.lastname: Aydin
authors.forename: Craig
authors.initials: C
authors.lastname: McIlhenny
authors.forename: Shahid
authors.initials: S
authors.lastname: Khan
authors.forename: Syed Johar
authors.initials: SJ
authors.lastname: Raza
authors.forename: Arun
authors.initials: A
authors.lastname: Sahai
authors.forename: James
authors.initials: J
authors.lastname: Brewin
authors.forename: Fernando
authors.initials: F
authors.lastname: Bello
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
authors.forename: Muhammad Shamim
authors.initials: MS
authors.lastname: Khan
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
authors.forename: Kamran
authors.initials: K
authors.lastname: Ahmed
mesh_terms: D000328:Adult; D002983:Clinical Competence; D015331:Cohort Studies; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D000066908:Simulation Training / Q000379:methods*; D011795:Surveys and Questionnaires; D018666:Ureteroscopy / Q000193:education*; D055815:Young Adult