title: High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.
abstract: Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants.
  
  
  
  Educational impact was assessed by means of qualitative individual module-specific feedback and a quantitative cross-sectional survey among residents and supervisors. Twenty out of 26 Dutch teaching hospitals participated. The survey focussed on practical aspects, the D-UPS curriculum in general, and the impact of the D-UPS curriculum on the development of technical and non-technical skills.
  
  
  
  A considerable survey response of 95 % for residents and 76 % for supervisors was obtained. Modules were attended by junior and senior residents, supervised by a urologist, and peer teaching was used. Ninety percent of supervisors versus 67 % of residents judged the D-UPS curriculum as an important addition to current residency training (p = 0.007). Participants' aggregated general judgement of the modules showed a substantial percentage favorable score (M ± SE: 57 ± 4 %). The impact of training on, e.g., knowledge of materials/equipment and ability to anticipate on complications was high, especially for junior residents (77 ± 5 and 71 ± 7 %, respectively). Focus points for improvement of the D-UPS curriculum according to the participants include adaptation of the training level to residents' level of experience and focus on logistics.
  
  
  
  The simulation-based D-UPS curriculum has a high educational impact. Residents and supervisors consider the curriculum to be an important addition to current residency training. Focus points for improvement of the D-UPS curriculum according to the participants include increased attention to logistics and integration of a spiral learning approach.
authors.affiliation: Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. a.h.de.vries@hotmail.com.
authors.forename: Anna H
authors.initials: AH
authors.lastname: de Vries
authors.affiliation: Department of Urology, Alrijne Hospital, Leiden, The Netherlands.|Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
authors.forename: Barbara M A
authors.initials: BM
authors.lastname: Schout
authors.affiliation: School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: van Merriënboer
authors.affiliation: Department of Urology, University Medical Center Leiden, Leiden, The Netherlands.
authors.forename: Rob C M
authors.initials: RC
authors.lastname: Pelger
authors.affiliation: Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.|School of Health Professions Education, Maastricht University, Maastricht, The Netherlands.
authors.forename: Evert L
authors.initials: EL
authors.lastname: Koldewijn
authors.affiliation: 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: Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.|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: D002983:Clinical Competence; D003198:Computer Simulation; D003430:Cross-Sectional Studies; D003479:Curriculum; D004521:Educational Measurement; D006785:Hospitals, University; D006801:Humans; D007396:Internship and Residency; D009426:Netherlands; D011795:Surveys and Questionnaires; D013520:Urologic Surgical Procedures / Q000193:education*
keywords: Curriculum development; Practical skills; Residents; Simulation; Urology