Publications (4)10.59 Total impact
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Article: Development and implementation of centralized simulation training: evaluation of feasibility, acceptability and construct validity.
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ABSTRACT: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? A competent urologist should not only have effective technical skills, but also other attributes that would make him/her a complete surgeon. These include team-working, communication and decision-making skills. Although evidence for effectiveness of simulation exists for individual simulators, there is a paucity of evidence for utility and effectiveness of these simulators in training programmes that aims to combine technical and non-technical skills training. This article explains the process of development and validation of a centrally coordinated simulation program (Participants - South-East Region Specialist Registrars) under the umbrella of the British Association for Urological Surgeons (BAUS) and the London Deanery. This program incorporated training of both technical (synthetic, animal and virtual reality models) and non-technical skills (simulated operating theatres). OBJECTIVES: • To establish the feasibility and acceptability of a centralized, simulation-based training-programme. • Simulation is increasingly establishing its role in urological training, with two areas that are relevant to urologists: (i) technical skills and (ii) non-technical skills. MATERIALS AND METHODS: • For this London Deanery supported pilot Simulation and Technology enhanced Learning Initiative (STeLI) project, we developed a structured multimodal simulation training programme. • The programme incorporated: (i) technical skills training using virtual-reality simulators (Uro-mentor and Perc-mentor [Symbionix, Cleveland, OH, USA], Procedicus MIST-Nephrectomy [Mentice, Gothenburg, Sweden] and SEP Robotic simulator [Sim Surgery, Oslo, Norway]); bench-top models (synthetic models for cystocopy, transurethral resection of the prostate, transurethral resection of bladder tumour, ureteroscopy); and a European (Aalborg, Denmark) wet-lab training facility; as well as (ii) non-technical skills/crisis resource management (CRM), using SimMan (Laerdal Medical Ltd, Orpington, UK) to teach team-working, decision-making and communication skills. • The feasibility, acceptability and construct validity of these training modules were assessed using validated questionnaires, as well as global and procedure/task-specific rating scales. RESULTS: • In total 33, three specialist registrars of different grades and five urological nurses participated in the present study. • Construct-validity between junior and senior trainees was significant. Of the participants, 90% rated the training models as being realistic and easy to use. • In total 95% of the participants recommended the use of simulation during surgical training, 95% approved the format of the teaching by the faculty and 90% rated the sessions as well organized. • A significant number of trainees (60%) would like to have easy access to a simulation facility to allow more practice and enhancement of their skills. CONCLUSIONS: • A centralized simulation programme that provides training in both technical and non-technical skills is feasible. • It is expected to improve the performance of future surgeons in a simulated environment and thus improve patient safety.BJU International 08/2012; · 2.84 Impact Factor -
Article: Effectiveness of procedural simulation in urology: a systematic review.
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ABSTRACT: We analyzed studies validating the effectiveness and deficiencies of simulation for training and assessment in urology. We documented simulation types (synthetic, virtual reality and animal models), participant experience level and tasks performed. The feasibility, validity, cost-effectiveness, reliability and educational impact of the simulators were also evaluated. The MEDLINE®, EMBASE™ and PsycINFO® databases were systematically searched until September 2010. References from retrieved articles were reviewed to broaden the search. The study included case reports, case series and empirical studies of training and assessment in urology using procedural simulation. The model name, training tasks, participant level, training duration and evaluation scoring were extracted from each study. We also extracted data on face, content and construct validity. Most studies suitably addressed content, construct and face validation as well as the feasibility, educational impact and cost-effectiveness of simulation models. Synthetic, animal and virtual reality models were demonstrated to be effective training and assessment tools for junior trainees. Few investigators looked at the transferability of skills from simulation to real patients. Current simulation models are valid and reliable for the initial phase of training and assessment. For advanced and specialist level skill acquisition animal models can be used but availability is limited due to supply shortages and ethical restrictions. More research is needed to validate simulated environments for senior trainees and specialists.The Journal of urology 07/2011; 186(1):26-34. · 4.02 Impact Factor -
Article: Face, content and construct validity of a virtual reality simulator for robotic surgery (SEP Robot).
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ABSTRACT: This study aims to establish face, content and construct validation of the SEP Robot (SimSurgery, Oslo, Norway) in order to determine its value as a training tool. The tasks used in the validation of this simulator were arrow manipulation and performing a surgeon's knot. Thirty participants (18 novices, 12 experts) completed the procedures. The simulator was able to differentiate between experts and novices in several respects. The novice group required more time to complete the tasks than the expert group, especially suturing. During the surgeon's knot exercise, experts significantly outperformed novices in maximum tightening stretch, instruments dropped, maximum winding stretch and tool collisions in addition to total task time. A trend was found towards the use of less force by the more experienced participants. The SEP robotic simulator has demonstrated face, content and construct validity as a virtual reality simulator for robotic surgery. With steady increase in adoption of robotic surgery world-wide, this simulator may prove to be a valuable adjunct to clinical mentorship.Annals of The Royal College of Surgeons of England 03/2011; 93(2):152-6. · 1.23 Impact Factor -
Article: Current status of robotic partial nephrectomy.
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ABSTRACT: In recent years, robotic partial nephrectomy has emerged as a technique for treatment of small renal masses alongside laparoscopic and open partial nephrectomy. Since this technique is still in a phase of adoption, many technical improvements, alterations and early experiences are published. We aim to review the recent literature, focus on recent advances in techniques and give an overview of published series. Recent series confirm the feasibility of robotic partial nephrectomy and demonstrate perioperative data and short-term oncological outcomes that are at least comparable to laparoscopic series. The development of better renorrhaphy techniques and optimal use of the robotic features to gain console surgeon independence seem to be the main focus. Also alternative hilar control, early unclamping and off-clamp techniques are being developed to lower the ischaemic effect on the kidney. The learning curve seems to be less steep than laparoscopic techniques. Robotic partial nephrectomy proves to be a well tolerated and efficacious minimally invasive option in the treatment of renal lesions. Main areas of interest are decreasing warm ischaemia time and modified renal closure techniques.Current opinion in urology 09/2010; 20(5):371-4. · 2.50 Impact Factor
Top co-authors
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Institutions
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2011–2012
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King's College London
- MRC Centre for Transplantation
London, ENG, United Kingdom
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2010
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AZ Sint-Jan Brugge-Oostende
Brugge, VLG, Belgium
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