Incorporation of the fluoroless C-Arm Trainer at the American Urological Association hands on training percutaneous renal access

World J Urol. 2018 Jul;36(7):1149-1155. doi: 10.1007/s00345-018-2219-5. Epub 2018 Feb 17.

Abstract

Objectives: To assess for usefulness and validity evidence for incorporating the C-Arm Trainer (CAT) simulator into the annual AUA hands on course for training percutaneous nephrolithotomy (PCNL).

Materials and methods: The course started with a didactic session followed by four stations for training the "bull's eye" technique using the CAT simulator. Each station included a pre-test, 30-min practice on the simulator, and post-test. All participants were assessed using a 4-item checklist. All participants were asked to fill in a qualitative self-assessment questionnaire after the pre- and the post-test, and respond to a course evaluation questionnaire and post-course survey.

Results: A total of 38 physicians, who attended the hands on course, voluntarily participated in the study. Only 21.1% had previous practice on PCNL simulators. Compared with the results of the checklist total score and the qualitative self-assessment questionnaire scores after the pre-test, there was significant improvement in the checklist total score (p < 0.001), temporal demands (p = 0.003), situational stress (p = 0.003, and performance (0.003) after the post-test. A total of 14 (36%) participants responded to the course evaluation questionnaire, 50% evaluated the course as excellent, 28.6% as very good, and 21.4% as good. Unfortunately, only five (13%) participants responded to the post-course survey, 4/5 implemented the new competencies and knowledge into their practice, and 3/5 have attempted to obtain fluoroscopic guided PCA without assistance.

Conclusion: The CAT simulator was considered useful for training the percutaneous renal access procedure. There was significant improvement in the qualitative and quantitative assessment parameters after the post-test compared with the pre-test.

Keywords: Assessment; Percutaneous Nephrolithotomy; Skills; Training.

MeSH terms

  • Adult
  • Checklist
  • Clinical Competence
  • Female
  • Fluoroscopy
  • Humans
  • Kidney Calices / diagnostic imaging
  • Male
  • Nephrolithotomy, Percutaneous / education*
  • Nephrolithotomy, Percutaneous / instrumentation*
  • Prospective Studies
  • Simulation Training / methods*
  • Ultrasonography, Interventional