National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients

Background: Transurethral resection of bladder tumours (TURBT) is the initial diagnostic treatment for patients with bladder cancer. TURBT is not an easy procedure to master and simulator training may play a role in improving the learning curve. Objective: To implement a national training programme...

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Main Authors: Sarah H. Bube, Pernille S. Kingo, Mia G. Madsen, Juan L. Vásquez, Thomas Norus, Rikke G. Olsen, Claus Dahl, Rikke B. Hansen, Lars Konge, Nessn Azawi
Format: Article
Language:English
Published: Elsevier 2022-05-01
Series:European Urology Open Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666168322000556
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author Sarah H. Bube
Pernille S. Kingo
Mia G. Madsen
Juan L. Vásquez
Thomas Norus
Rikke G. Olsen
Claus Dahl
Rikke B. Hansen
Lars Konge
Nessn Azawi
author_facet Sarah H. Bube
Pernille S. Kingo
Mia G. Madsen
Juan L. Vásquez
Thomas Norus
Rikke G. Olsen
Claus Dahl
Rikke B. Hansen
Lars Konge
Nessn Azawi
author_sort Sarah H. Bube
collection DOAJ
description Background: Transurethral resection of bladder tumours (TURBT) is the initial diagnostic treatment for patients with bladder cancer. TURBT is not an easy procedure to master and simulator training may play a role in improving the learning curve. Objective: To implement a national training programme for simulation-based mastery learning in TURBT and explore operating theatre performance after training. Design, setting, and participants: From June 2019 to March 2021, 31 doctors at urology departments in Denmark performed two pretraining TURBT procedures on patients, followed by proficiency-based mastery learning on a virtual reality simulator and then two post-training TURBTs on patients. Outcome measurements and statistical analyses: Operating theatre performances were video-recorded and assessed by two independent, blinded raters using the Objective Structured Assessment for Transurethral Resection of Bladder Tumours Skills (OSATURBS) assessment tool. Paired-sample t tests were used to compare pretraining and post-training analyses and independent t tests for between-group comparisons. This trial is registered at ClinicalTrials.gov as NCT03864302. Results and limitations: Before training, novices had significantly lower performance scores in comparison to those with intermediate experience (p = 0.017) and experienced doctors (p < 0.001). After training, novices significantly improved their clinical performance score (from 11.4 to 17.1; p = 0.049, n = 10). Those with intermediate experience and experienced doctors did not benefit significantly from simulator training (p = 0.9 and p = 0.8, respectively). Conclusions: Novices improved their TURBT performance in the operating theatre after completing a proficiency-based training programme on a virtual reality simulator. Patient summary: We trained surgeons in an operation to remove bladder tumours using a virtual reality simulator. Novice doctors improved their performance significantly after the training, but the training effects for more experienced doctors were minimal. Therefore, we suggest the introduction of mandatory simulator training in the residency programme for urologists.
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spelling doaj.art-8ab78f34f4e24efaa2c0f51919c15dde2022-12-22T02:06:58ZengElsevierEuropean Urology Open Science2666-16832022-05-01392935National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in PatientsSarah H. Bube0Pernille S. Kingo1Mia G. Madsen2Juan L. Vásquez3Thomas Norus4Rikke G. Olsen5Claus Dahl6Rikke B. Hansen7Lars Konge8Nessn Azawi9Department of Urology, Zealand University Hospital, Roskilde, Denmark; Copenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Corresponding author. Department of Urology, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark. Tel.: +45 6133 9183.Department of Urology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Urology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Urology, Zealand University Hospital, Roskilde, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Urology, Zealand University Hospital, Roskilde, DenmarkCopenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark; Urological Research Unit, Department of Urology, Rigshospitalet, Copenhagen, DenmarkDepartment of Urology, Capio Ramsay Santé, Hellerup, DenmarkCopenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark; Department of Urology, Herlev Hospital, Gentofte, DenmarkCopenhagen Academy for Medical Education and Simulation, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkDepartment of Urology, Zealand University Hospital, Roskilde, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkBackground: Transurethral resection of bladder tumours (TURBT) is the initial diagnostic treatment for patients with bladder cancer. TURBT is not an easy procedure to master and simulator training may play a role in improving the learning curve. Objective: To implement a national training programme for simulation-based mastery learning in TURBT and explore operating theatre performance after training. Design, setting, and participants: From June 2019 to March 2021, 31 doctors at urology departments in Denmark performed two pretraining TURBT procedures on patients, followed by proficiency-based mastery learning on a virtual reality simulator and then two post-training TURBTs on patients. Outcome measurements and statistical analyses: Operating theatre performances were video-recorded and assessed by two independent, blinded raters using the Objective Structured Assessment for Transurethral Resection of Bladder Tumours Skills (OSATURBS) assessment tool. Paired-sample t tests were used to compare pretraining and post-training analyses and independent t tests for between-group comparisons. This trial is registered at ClinicalTrials.gov as NCT03864302. Results and limitations: Before training, novices had significantly lower performance scores in comparison to those with intermediate experience (p = 0.017) and experienced doctors (p < 0.001). After training, novices significantly improved their clinical performance score (from 11.4 to 17.1; p = 0.049, n = 10). Those with intermediate experience and experienced doctors did not benefit significantly from simulator training (p = 0.9 and p = 0.8, respectively). Conclusions: Novices improved their TURBT performance in the operating theatre after completing a proficiency-based training programme on a virtual reality simulator. Patient summary: We trained surgeons in an operation to remove bladder tumours using a virtual reality simulator. Novice doctors improved their performance significantly after the training, but the training effects for more experienced doctors were minimal. Therefore, we suggest the introduction of mandatory simulator training in the residency programme for urologists.http://www.sciencedirect.com/science/article/pii/S2666168322000556Bladder cancerProficiency-based trainingSurgical skills assessmentSimulationTransurethral resection of bladder tumour
spellingShingle Sarah H. Bube
Pernille S. Kingo
Mia G. Madsen
Juan L. Vásquez
Thomas Norus
Rikke G. Olsen
Claus Dahl
Rikke B. Hansen
Lars Konge
Nessn Azawi
National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
European Urology Open Science
Bladder cancer
Proficiency-based training
Surgical skills assessment
Simulation
Transurethral resection of bladder tumour
title National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
title_full National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
title_fullStr National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
title_full_unstemmed National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
title_short National Implementation of Simulator Training Improves Transurethral Resection of Bladder Tumours in Patients
title_sort national implementation of simulator training improves transurethral resection of bladder tumours in patients
topic Bladder cancer
Proficiency-based training
Surgical skills assessment
Simulation
Transurethral resection of bladder tumour
url http://www.sciencedirect.com/science/article/pii/S2666168322000556
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