Multicenter validation of a consensus-based hydrogel simulator for ultrasound guided percutaneous nephrolithotomy using modern education theory

You have accessJournal of UrologyCME1 Apr 2023PD01-05 MULTICENTER VALIDATION OF A CONSENSUS-BASED HYDROGEL SIMULATOR FOR ULTRASOUND GUIDED PERCUTANEOUS NEPHROLITHOTOMY USING MODERN EDUCATION THEORY Lauren Shepard, Nathan Schuler, Aaron Saxton, Patrick Saba, Andrew Cook, Tyler Holler, David Tzou, Karen Stern, Helena Chang, Justin Ahn, Thomas Tailly, Thomas Chi, and Ahmed Ghazi Lauren ShepardLauren Shepard More articles by this author , Nathan SchulerNathan Schuler More articles by this author , Aaron SaxtonAaron Saxton More articles by this author , Patrick SabaPatrick Saba More articles by this author , Andrew CookAndrew Cook More articles by this author , Tyler HollerTyler Holler More articles by this author , David TzouDavid Tzou More articles by this author , Karen SternKaren Stern More articles by this author , Helena ChangHelena Chang More articles by this author , Justin AhnJustin Ahn More articles by this author , Thomas TaillyThomas Tailly More articles by this author , Thomas ChiThomas Chi More articles by this author , and Ahmed GhaziAhmed Ghazi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003218.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ultrasound-guided approaches for percutaneous nephrolithotomy (US-PCNL) offer several advantages, including significant reduction in radiation exposure; however, they have not been readily adapted. Some of the contributing factors include the lack of a standard training platform and curriculum that has been uniformly approved by experts. As such, there is a current need for a realistic simulator. Herein, we used a consensus-based educational approach for development and multicenter validation of a high-fidelity non-biohazardous PCNL simulator. METHODS: Consensus was reached on a high-fidelity PCNL simulator with 12 international experts using a Delphi methodology over three rounds. The 284 questions were categorized into overall utility, anatomical components, tissue fidelity, and assessment of surgical performance. A hydrogel prototype replicating mechanical properties was developed for experts to evaluate prior to its validation by comparing performances of 20 experts and 28 novices from 5 centers as well as evaluating the models ability to improve novice performance with repeated practice. RESULTS: Consensus (>80% agreement) was reached in 31.3% of questions, within which 65% achieved 100% consensus. The prototype prone PCNL simulator included anatomical landmarks (11th and 12th rib, iliac crest), realistic external and ultrasound appearance with appropriate tactile properties, and a water tight distensible pelvicalyceal system with a stone for laser lithotripsy and retrograde ureteroscopy (Figure 1A). A weighted evaluation checklist was also developed via consensus. Experts agreed that >89.2% of prototype and checklist components conformed to the consensus statement. Novices and experts were graded for US-guided lower pole access, with statistically significant differences for checklist score (42.3±19.0% vs 93.4±4.6%, p<0.001). Furthermore, novices significantly improved both lower pole and upper pole access score (p<0.01, p<0.001) respectively with repeated (x5) training sessions (Figure 1B). CONCLUSIONS: This non-biohazardous benchtop simulator for US-PCNL developed using expert consensus and validated via an educational approach at multiple centers can provide safe, realistic training in a risk-free environment. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e64 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Shepard More articles by this author Nathan Schuler More articles by this author Aaron Saxton More articles by this author Patrick Saba More articles by this author Andrew Cook More articles by this author Tyler Holler More articles by this author David Tzou More articles by this author Karen Stern More articles by this author Helena Chang More articles by this author Justin Ahn More articles by this author Thomas Tailly More articles by this author Thomas Chi More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement PDF downloadLoading ...