title: Concurrent and predictive validation of robotic simulator Tube 3 module.
abstract: OBJECTIVE
  We previously described a new procedure specific module (Tube 3) to allow the practice of vesicourethral anastomosis after robot-assisted radical prostatectomy. Herein, we report a predetermined proficiency level of Tube 3 and preliminary validation to explore whether this new module can lead to performance improvement in the da Vinci system.
  
  
  METHODS
  Eight urology residents and three urology fellows performed the Tube 3 module 1 hour daily for 7 days. The learning curve was depicted through a scatterplot and the stable point was identified through the cumulative sum chart. Concurrent and predictive validations were performed with the da Vinci system. The mean time to complete the task and end product rating score between Tube 3 training group and no Tube 3 training group were compared.
  
  
  RESULTS
  Concerning the learning curve, about 41 repetitions comprising about 5 hours were needed to achieve this stable point when the mean time to complete Tube of 384 seconds was set as a target. With regarding to the concurrent and predictive validation, there significant differences were evident in the mean time to complete 16 needle passages and the vesicourethral anastomosis and the end product rating score.
  
  
  CONCLUSIONS
  The virtual reality (VR) simulator can yield sufficient improvement in technical performance in Tube 3 within 5 hours. The acquired proficiency can be transferable to the vesicourethral anastomosis using the da Vinci system.
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seung Bin
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Pyun
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyung Keun
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Je Jong
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung Gu
authors.initials: SG
authors.lastname: Kang
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D002983:Clinical Competence; D003198:Computer Simulation; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D059032:Learning Curve; D008297:Male; D011468:Prostatectomy / Q000193:education* / Q000379:methods; D065287:Robotic Surgical Procedures / Q000193:education* / Q000379:methods; D000066908:Simulation Training / Q000379:methods; D014521:Urethra / Q000601:surgery; D001743:Urinary Bladder / Q000601:surgery; D014584:User-Computer Interface
keywords: Computer simulation; Learning curve; Robotics