title: Development and Validation of a Novel Skills Training Model for Retrograde Intrarenal Surgery.
abstract: OBJECTIVE
  The aim of this study is to validate a training model that combines the use of nonbiologic and biologic simulators as well as live porcine animal model in endoscopic retrograde intrarenal surgery (RIRS).
  
  
  METHODS
  A total of 60 urologists took part in this study, and the activity lasted for 2 days. The training model was divided into three modules: Module-I, related to the acquisition of basic theoretical knowledge; Module-II, consisting of an internship with bench models; and Module III, in which animal models were used. First, trainees practiced with animals without using a lesion model (placement of an ureteral access sheath under fluoroscopic guidance and flexible ureterorenoscopy). Afterward, they practiced on a porcine animal model of bilateral renal lithiasis. Performance was measured using a validated global rating score and RIRS checklist score. Face and content validation as well as constructive validation provided by trainees in front of 15 experts were performed during the practice.
  
  
  RESULTS
  Face and content validations were satisfactory. "Individual" constructive validity showed statistical significance between the first and the last time that trainees practiced on an animal model. Statistical significance was also found between trainees and expert scores. There were 73.4% of trainees who increased their skills by more than 40%.
  
  
  CONCLUSIONS
  This RIRS training model allows for the acquisition of technical knowledge and skills as face, content, and constructive validation show. A structured use of nonbiologic, biologic, and animal model simulators allows the increase of RIRS skills.
authors.affiliation: 1 Department of Endourology-Endoscopy, Minimally Invasive Surgery Centre Jesús Usón , Cáceres, Spain .
authors.forename: Federico
authors.initials: F
authors.lastname: Soria
authors.affiliation: 1 Department of Endourology-Endoscopy, Minimally Invasive Surgery Centre Jesús Usón , Cáceres, Spain .
authors.forename: Esther
authors.initials: E
authors.lastname: Morcillo
authors.affiliation: 2 Department of Urology, University Hospital Clinico San Carlos , Madrid, Spain .
authors.forename: Alvaro
authors.initials: A
authors.lastname: Serrano
authors.affiliation: 3 Department of Urology, University Hospital La Paz , Madrid, Spain .
authors.forename: Ramon
authors.initials: R
authors.lastname: Cansino
authors.affiliation: 4 Department of Urology, University Hospital Miguel Servet , Zaragoza, Spain .
authors.forename: Jorge
authors.initials: J
authors.lastname: Rioja
authors.affiliation: 5 Department of Urology, University Hospital La Princesa , Madrid, Spain .
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Fernandez
authors.affiliation: 1 Department of Endourology-Endoscopy, Minimally Invasive Surgery Centre Jesús Usón , Cáceres, Spain .
authors.forename: Julia
authors.initials: J
authors.lastname: de la Cruz
authors.affiliation: 6 Department of Urology, Uz Hospital , Leuven, Belgium .
authors.forename: Ben
authors.initials: B
authors.lastname: Van Cleynenbreugel
authors.affiliation: 7 Scientific Director, Minimally Invasive Surgery Centre Jesús Usón , Cáceres, Spain .
authors.forename: Francisco M
authors.initials: FM
authors.lastname: Sanchez-Margallo
mesh_terms: D000818:Animals; D002983:Clinical Competence; D007396:Internship and Residency; D007669:Kidney Calculi / Q000601:surgery*; D008953:Models, Anatomic; D000066908:Simulation Training / Q000379:methods*; D013552:Swine; D018666:Ureteroscopy / Q000193:education*; D014572:Urology / Q000193:education*