title: Initial Content Validation Results of a New Simulation Model for Flexible Ureteroscopy: The Key-Box.
abstract: We sought to test the content validity of a new training model for flexible ureteroscopy: the Key-Box.
  
  
  
  Sixteen medical students were randomized to undergo a 10-day training consisting of performing 10 different exercises aimed at learning specific movements with the flexible ureteroscope, and how to catch and release stones with a nitinol basket using the Key-Box (n = 8 students in the training group, n = 8 students in the nontraining control group). Subsequently, an expert endourologist (O.T.) blindly assessed skills acquired by the whole cohort of students through two exercises on ureteroscope manipulation and one exercise on stone capture selected among those used for the training. A performance scale (1-5) assessing different steps of the procedure was used to evaluate each student. Time to complete the exercises was measured. Mann-Whitney Rank Sum test was used for comparisons between the two groups.
  
  
  
  Mean scores obtained by trained students were significantly higher compared with those obtained by nontrained students (all p < 0.001). All trained students were able to complete the two exercises on ureteroscope manipulation within 3 minutes, whereas two students (25%) were not able to finish the exercise on stone capture. Conversely, four (50%) and six (75%) nontrained students were not able to finish one out of the two exercises on ureteroscope manipulation and the exercise on stone capture, respectively. The mean time to complete the three exercises was 76.3, 69.9, and 107 and 172.5, 137.9, and 168 seconds in the trained and nontrained groups, respectively (all p < 0.001).
  
  
  
  The K-Box®seems to be a valid easy-to-use training model for initiating novel endoscopists to flexible ureteroscopy.
authors.affiliation: 1 Division of Experimental Oncology/Unit of Urology, URI , IRCCS Ospedale San Raffaele, Milan, Italy .|2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .
authors.forename: Luca
authors.initials: L
authors.lastname: Villa
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .|3 Department of Urology, Marmara University School of Medicine , Istanbul, Turkey .
authors.forename: Tarik Emre
authors.initials: TE
authors.lastname: Şener
authors.affiliation: 4 Department of Urology, University Hospital Southampton NHS Trust , Southampton, United Kingdom .
authors.forename: Bhaskar K
authors.initials: BK
authors.lastname: Somani
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .|5 Department of Urology, University Hospital Centre of Quebec City , Quebec, Canada .
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cloutier
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .|6 Department of Urology, University of Messina , Messina, Italy .
authors.forename: Salvatore
authors.initials: S
authors.lastname: Butticè
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .|7 Department of Urology, Città della Salute e della Scienza, Turin, Italy .
authors.forename: Francesco
authors.initials: F
authors.lastname: Marson
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .
authors.forename: Steeve
authors.initials: S
authors.lastname: Doizi
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .|8 Department of Urology, IRCCS San Raffaele Scientific Institute , Ville Turro Division, Milan, Italy .
authors.forename: Silvia
authors.initials: S
authors.lastname: Proietti
authors.affiliation: 2 Department of Urology, Tenon Hospital, Pierre and Marie Curie University , Paris, France .
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
mesh_terms: D003479:Curriculum; D004503:Education, Medical, Graduate; D004867:Equipment Design; D006801:Humans; D015203:Reproducibility of Results; D000066908:Simulation Training; D013337:Students, Medical; D020709:Ureteroscopes; D018666:Ureteroscopy / Q000193:education* / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult
keywords: flexible ureteroscopy; learning curve; training model; ureteroscopy curriculum