Presentation Authors: Domenico Veneziano*, Reggio Calabria, Italy, Achilles Ploumidis, Athens, Greece, Giuseppe Basile, Reggio Calabria, Italy, Silvia Proietti, Milano, Italy, Theodore Tokas, Tirol, Austria, Guido Kamphuis, amsterdam, Netherlands, Ben Van Cleynenbreugel, Louvain, Belgium, Ali Gozen, Heilbronn, Germany, Alberto Breda, Joan Palou, Barcelona, Spain, Kemal Sarica, Instambul, Turkey, Evangelos Liatsikos, Patras, Greece, Kamran Ahmed, London, United Kingdom, Bhaskar Somani, southampton, United Kingdom
Introduction: The Endoscopic Stone Treatment step 1 (EST s1) protocol has been developed after 2 years of collaboration between different EAU sections. In this study we add construct validity evidence to the ESTs1 training and assessment curriculum
Methods: The EST s1 curriculum includes: 1)flexible cystoscopy; 2)rigid cystoscopy and safety guidewire placement; 3)semi-rigid ureteroscopy, placement of working guidewire and access sheath; 4)flexible ureteroscopy. Data collection for adding validity evidence was performed during the annual 2016 EAU EUREP meeting in Prague. 124 participants provided information on their endoscopic logbook and carried out the 4 tasks during a single one-to-one DVD-recorded session. Recordings were anonymised and re-assessed independently by the 5 experts. Inter-rater reliability for internal structure test was checked on a sample of 5 videos by the calculation of intra-class correlation coefficient. Breakpoint analysis was used to define proficiency, by comparing the specific clinical background of each participant with his performance on the simulator. Residents enrolled as participants filled-up questionnaires for test content assessment of the entire protocol. Scores provided in all questionnaires were Likert-scale based, ranging from 1 (I do not agree) to 5 (I fully agree).
Results: A total of 124 participants took part in this study. The breakpoint analysis and corresponding case load for flexible cystoscopy, rigid cystoscopy, semi-rigid URS and flexible URS showed a significant change in performance curve at 36, 41, 67 and 206 seconds respectively corresponding to 30, 60, 25 and 120 clinical cases for each of these tasks. EST s1 was scored highly by both experts and residents as a valid training tool correctly representing the procedures performed with each task recommended as a part of training curriculum. Experts felt that this curriculum is best used during the third year of residency training in Europe. Data are summarized in table 1.
Conclusions: All validation criteria for EST s1 were met. The protocol is now established as a standard training and assessment tool for Endoscopic skills in Europe. Further data should test its potential application in different geographic areas.