Presentation Authors: Sarah Bube*, Roskilde, Denmark, Rikke Hansen, Copenhagen, Denmark, Claus Dahl, Roskilde, Denmark, Lars Konge, Copenhagen, Denmark, Nessn Azawi, Roskilde, Denmark
Introduction: To develop a simulator-based test with ability to discriminate between competency levels and establish a pass/fail score for proficiency-based simulator training in TURB.
Methods: Forty-nine doctors were recruited from Departments of Urology in the Oresund Region, Denmark in the period of Apr to Sept 2018. Prior to inclusion, the TURB MentorTM virtual reality (VR) simulator, Simbionix, was assessed at an expert meeting selecting clinically relevant cases and metrics. Training sessions were done on identical simulators at two simulation training centers at Department of Urology, Roskilde Zealand University Hospital and Copenhagen Academy for Medical Education and Simulation. All participants performed three TURB procedures on the VR simulator. Simulator metrics were analyzed with analysis of variance (ANOVA) and metrics with ability to discriminate between groups were combined in a total simulator score (TSS). Finally, a pass/fail score was identified using the contrasting groups&[prime] method.
Results: Elleven simulator metrics were found eligible of which four had significant discrimination ability between the three competency levels: resected pathology (%) (p=0.008), cutting in bladder wall (n) (p=0.004), time (s) (p=0.034), and inspection of bladder wall (%) (p=0.002). The internal structure of the TSS [(resected pathology*inspection of bladder wall)/time] was acceptable with intraclass correlation, Cronbach&[prime]s α: 0.85. The mean TSS was significantly lower in the novice group than in the intermediates (p=0.011) and experienced group (p < 0.001) (Table 1). A pass/fail score of 21 was identified (Fig 1).
Conclusions: Validity evidence for a VR simulator-based test has been established including a pass/fail score identifying TURB competence. The test can be used for accreditation in a proficiency-based TURB simulator training program prior to supervised procedures.