Assessment of photoselective vaporization of prostate skills during Urology Objective Structured Clinical Examinations (OSCE).
BACKGROUND
We evaluated the use of the GreenLight Simulator (GL-SIM) (American Medical Systems, Guelph, ON) in the skill assessment of postgraduate trainees (PGTs) in photoselective vaporization of the prostate (PVP). We also sought to determine whether previous PVP experience or GL-SIM practice improved performance.


METHODS
PGTs in postgraduate years (PGY-3 to PGY-5) from all 4 Quebec urology training programs were recruited during 2 annual Objective Structured Clinical Examinations (OSCEs). During a 20-minute OSCE station, PGTs were asked to perform 2 exercises: (1) identification of endoscopic landmarks and (2) a PVP of a 30-g normal prostate. Grams vaporized, global scores, and number of correct anatomical landmarks were recorded and correlated with PGY level, practice on the GL-SIM, and previous PVP experience.


RESULTS
In total, 25 PGTs were recruited at each OSCE, with 13 PGTs participating in both OSCEs. When comparing scores from the first and second OSCEs, there was a significant improvement in the number of grams vaporized (2.9 vs. 4.3 g; p = 0.003) and global score (100 vs. 165; p = 0.03). There was good correlation between the number of previously performed PVPs and the global score (r = 0.4, p = 0.04). Similarly, PGTs with previous practice on the GL-SIM had significantly higher global score (100.6 vs. 162.6; p = 0.04) and grams vaporized (3.1 vs. 4.1 g; p = 0.04) when compared with those who did not practice on GL-SIM. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM (32.7% vs. 10.2%; p = 0.009). PGY level did not significantly affect grams vaporized or global score (p > 0.05).


CONCLUSIONS
Performance on the GL-SIM at OSCEs significantly correlated with previous practice on the GL-SIM and previous PVP experience rather than PGY level. Furthermore, there were significantly more competent PGTs among those who had previously practiced on the GL-SIM.
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC; ; Department of Urology, Benha University, Benha, Egypt;
Yasser A
YA
Noureldin
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC; ; Department of Urology, Suez Canal University, Ismailia, Egypt.
Mohamed A
MA
Elkoushy
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC;
Nader
N
Fahmy
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC;
Serge
S
Carrier
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC;
Mostafa M
MM
Elhilali
Department of Surgery, Division of Urology, McGill University Health Centre, Montreal QC;
Sero
S
Andonian