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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Development and validation of a simulator-based test in transurethral resection of bladder tumours (TURBEST)

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  1. Educational level and first-time PSA testing in general practice

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  2. Successful extraction of sperm cells after autologous bone marrow transplant: a case report

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  3. The prognostic impact of incidental prostate cancer following radical cystoprostatectomy: a nationwide analysis

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  4. Male infertility problems of patients with strict sperm morphology between 5-14% may be missed with the current WHO guidelines

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  1. Lymphopenia and neutropenia are associated with subsequent incident proteinuria in Danish patients with systemic lupus erythematosus

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  2. Simulation-based training for flexible cystoscopy - A randomized trial comparing two approaches

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  3. Development and validation of a multiple-choice questionnaire-based theoretical test in direct ophthalmoscopy

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  4. Needs assessment to identify content for simulation-based curricula in emergency medicine

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Objectives: A prospective observational trial to develop and gather validity evidence using Messick's framework for a simulator-based test in TURB. Methods: Forty-nine doctors were recruited from urology departments (Herlev/Gentofte University Hospital, Rigshospitalet Copenhagen University Hospital and Zealand University Hospital Roskilde) and enrolled from April to September 2018. The TURB Mentor™ virtual reality (VR) simulator was assessed at an expert meeting selecting clinically relevant cases and metrics. Test sessions were done on identical simulators at two university hospitals in Denmark. All participants performed three TURB procedures on the VR simulator. Simulator metrics were analysed with analysis of variance (ANOVA) and metrics with the ability to discriminate between groups were combined in a total simulator score. Finally, a pass/fail score was identified using the contrasting groups' method.Results: Eleven simulator metrics were found eligible and four had significant discrimination ability between competency levels: resected pathology (%) (p = 0.008); cutting in bladder wall (n) (p = 0.004); time (s) (p = 0.034); and inspection of the bladder wall (%) (p = 0.002). The internal structure of the total simulator score [(resected pathology*inspection of the bladder wall)/time] was high with the intraclass correlation coefficient, Cronbach's alpha = 0.85. The mean total simulator score was significantly lower in the novice group than in the intermediate, 15.9 and 25.6, respectively (mean difference = 9.7, p = 0.011) and experienced group, 30.6 (mean difference = 14.7, p < 0.001). A pass/fail score of 22 was identified.Conclusion: We found validity evidence for a newly developed VR simulator-based test and establised a pass/fail score identifying surgical skills in TURB. The TURBEST test can be used in a proficiency-based TURB simulator training programme for accreditation prior to supervised procedures on patients.

Original languageEnglish
JournalScandinavian Journal of Urology
Volume53
Issue number5
Pages (from-to)319-324
Number of pages6
ISSN2168-1805
DOIs
Publication statusPublished - Oct 2019

ID: 59301818