title: The Simbla TURBT Simulator in Urological Residency Training: From Needs Analysis to Validation.
abstract: To investigate the value of the physical Simbla Transurethral Resection of a Bladder Tumor (TURBT) simulator as an educational tool within urological residency training, by means of a training needs analysis (TNA) and assessment of its feasibility, acceptability, and face, content, and construct validity.
  
  
  
  To analyze the training needs for TURBT, procedural steps and pitfalls were identified and the TNA was completed during an expert consensus meeting. Participants (n = 76) were divided into three groups based on their experience in TURBT: novices, intermediates, and experts. Participants performed two standardized TURBT procedures on the simulator. Face validity and content validity, as well as feasibility and acceptability, were assessed with a quantitative survey. Construct validity was assessed by comparing the performance of novices, intermediates, and experts on resection time, quality of tumor resection, and overall performance.
  
  
  
  Of the 21 procedural steps and 17 pitfalls defined in TNA, 13 steps and 8 pitfalls were covered by the Simbla. Participants rated the Simbla's overall realism (face validity) with a score of 8 of 10 (range 6-9). The simulator was judged to be most useful (content validity) for learning eye-hand coordination: score 8 (6-10). All aspects regarding realism and usefulness were rated above the acceptability threshold of 6/10. Intermediates (100%) and experts (96%) considered the Simbla to be a useful educational tool within the urological curriculum. Resection time was longer for novices than for experts (p < 0.05; construct validity). In addition, the overall performance of novices was rated lower compared with intermediates and experts, and novices showed more irradical resections and bladder perforations (all p < 0.05).
  
  
  
  The Simbla TURBT simulator is a valid, feasible, and acceptable educational tool for training procedural skills and may be implemented in the urological curriculum to complement learning in clinical practice. TNA is valuable in defining training objectives and evaluating the educational value of a simulator.
authors.affiliation: 1 Department of Urology, Catharina Hospital , Eindhoven, The Netherlands .
authors.forename: Anna H
authors.initials: AH
authors.lastname: de Vries
authors.affiliation: 1 Department of Urology, Catharina Hospital , Eindhoven, The Netherlands .
authors.forename: Hilde G J
authors.initials: HG
authors.lastname: van Genugten
authors.affiliation: 1 Department of Urology, Catharina Hospital , Eindhoven, The Netherlands .
authors.forename: Ad J M
authors.initials: AJ
authors.lastname: Hendrikx
authors.affiliation: 1 Department of Urology, Catharina Hospital , Eindhoven, The Netherlands .|2 School of Health Professions Education, Maastricht University , Maastricht, The Netherlands .
authors.forename: Evert L
authors.initials: EL
authors.lastname: Koldewijn
authors.affiliation: 3 Department of Urology, Alrijne Hospital , Leiden, The Netherlands .|4 Netherlands Institute for Health Services Research (NIVEL) , Utrecht, The Netherlands .
authors.forename: Barbara M A
authors.initials: BM
authors.lastname: Schout
authors.affiliation: 5 Department of Urology, Radboud University Medical Center , Nijmegen, The Netherlands .
authors.forename: Irene M
authors.initials: IM
authors.lastname: Tjiam
authors.affiliation: 2 School of Health Professions Education, Maastricht University , Maastricht, The Netherlands .
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: van Merriënboer
authors.affiliation: 6 Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University , Maastricht, The Netherlands .
authors.forename: Arno M M
authors.initials: AM
authors.lastname: Muijtjens
authors.affiliation: 4 Netherlands Institute for Health Services Research (NIVEL) , Utrecht, The Netherlands .|7 Department of Public and Occupational Health, EMGO Institute for Health and Care Research , Amsterdam, The Netherlands .
authors.forename: Cordula
authors.initials: C
authors.lastname: Wagner
mesh_terms: D000328:Adult; D002983:Clinical Competence; D032921:Consensus; D003479:Curriculum; D004867:Equipment Design; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D000066908:Simulation Training; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014572:Urology / Q000193:education*; D014584:User-Computer Interface