title: Urology residents training in laparoscopic surgery. Development of a virtual reality model.
abstract: BACKGROUND
  The training and learning of residents in laparoscopic surgery has legal, financial and technological limitations. Simulation is an essential tool in the training of residents as a supplement to their training in laparoscopic surgery. The training should be structured in an appropriate environment, with previously established and clear objectives, taught by professionals with clinical and teaching experience in simulation. The training should be conducted with realistic models using animals and ex-vivo tissue from animals. It is essential to incorporate mechanisms to assess the objectives during the residents' training progress.
  
  
  OBJECTIVE
  We present the training model for laparoscopic surgery for urology residents at the University Hospital Valdecilla. The training is conducted at the Virtual Hospital Valdecilla, which is associated with the Center for Medical Simulation in Boston and is accredited by the American College of Surgeons.
  
  
  METHODS
  The model is designed in 3 blocks, basic for R1, intermediate for R2-3 and advanced for R4-5, with 9 training modules. The training is conducted in 4-hour sessions for 4 afternoons, for 3 weeks per year of residence. Residents therefore perform 240 hours of simulated laparoscopic training by the end of the course. For each module, we use structured objective assessments to measure each resident's training progress.
  
  
  RESULTS
  Since 2003, 9 urology residents have been trained, in addition to the 5 who are currently in training. The model has undergone changes according to the needs expressed in the student feedback. The acquisition of skills in a virtual reality model has enabled the safe transfer of those skills to actual practice.
  
  
  CONCLUSIONS
  A laparoscopic surgery training program designed in structured blocks and with progressive complexity provides appropriate training for transferring the skills acquired using this model to an actual scenario while maintaining patient safety.
authors.affiliation: Servicio de Urología, Hospital Universitario Valdecilla , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España. Electronic address: urogbj@humv.es.
authors.forename: J L
authors.initials: JL
authors.lastname: Gutiérrez-Baños
authors.affiliation: Servicio de Urología, Hospital Universitario Valdecilla , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España.
authors.forename: R
authors.initials: R
authors.lastname: Ballestero-Diego
authors.affiliation: Servicio de Urología, Hospital Universitario Valdecilla , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España.
authors.forename: D
authors.initials: D
authors.lastname: Truan-Cacho
authors.affiliation: Servicio de Urología, Hospital Universitario Valdecilla , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España.
authors.forename: C
authors.initials: C
authors.lastname: Aguilera-Tubet
authors.affiliation: Servicio de Urología, Hospital Comarcal de Laredo , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España.
authors.forename: A
authors.initials: A
authors.lastname: Villanueva-Peña
authors.affiliation: Servicio de Cirugía General, Hospital Universitario Valdecilla , Santander, España; Instructor Hospital Virtual Valdecilla, Santander, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Manuel-Palazuelos
mesh_terms: D000818:Animals; D003198:Computer Simulation; D003479:Curriculum; D007396:Internship and Residency / Q000379:methods*; D010535:Laparoscopy / Q000193:education*; D000066908:Simulation Training; D013552:Swine; D014572:Urology / Q000193:education*
keywords: Entrenamiento; Laparoscopia; Laparoscopy; Realidad virtual; Simulación; Simulation; Training; Virtual reality