Multi-Institutional Predictive Validity Study of a Virtu

背景：经尿道前列腺切除术（TURP）仍然是治疗医学上难治性良性前列腺增生（BPH）的金标准手术治疗方法，仅在美国就有大约560万男性出现这种症状。泌尿外科非常关注实施TURP所需技能的培训和评估可能不足。总体研究任务是通过设计、开发、验证和传播新的医疗程序培训系统来提高熟练程度并减少操作错误，本项目的主要目标是检查华盛顿大学建造的新型虚拟现实TURP培训器的预测有效性。该模拟器已经进行了初步的验证研究。将技能从虚拟世界转化到手术室的直接证据是缺乏的，需要在将模拟技术应用到住院医师课程之前进行。我们假设，在这个训练器上练习将减少错误，提高熟练程度

DESCRIPTION (PROVIDED BY APPLICANT): Background: Transurethral resection of the prostate (TURP) remains the gold-standard surgical treatment for medically refractory symptoms of benign prostatic hyperplasia (BPH), a condition that is symptomatic in approximately 5.6 million men in the United States alone. There is great concern in the Urological community that the training and assessment of the skills necessary to perform TURP may be inadequate. With an overall research mission statement to enhance proficiency and diminish operative errors through the design, development, validation and dissemination of novel training systems for medical procedures, the primary goal of this project is to examine predictive validity of a novel virtual reality TURP trainer built at the University of Washington. This simulator has already undergone preliminary validation studies. Direct evidence of translation of skills from the virtual world to the operating room is lacking and needs to occur prior to implementation of simulation technology into the residency curriculum. We hypothesize that practicing on this trainer will lead to diminished errors and increased proficiency among cohorts of surgeons in training (residents). Methods: 90 Urology residents in training from eight institutions will undergo evaluation at their home institution by the Global Surgical Assessment forms on four sequential TURP cases. These cases will also be video-taped, and the median bar component of the case will be assessed by three blinded subject matter experts. Intraoperative metrics contributing to "performance" will also be collected and consist of time to task, tissue resected, number of cuts, blood loss, irrigation use and errors performed. Between cases 2 and 3, half of the residents (randomized within groups sorted by institution and skill-level) will undergo intensive 2 day training on the UW TURP trainer to criterion-level. Similar metrics as taken from the OR will be collected from a full pre-training and post-training TURP on the simulator and correlated with intraoperative metrics. Improvements in performance and number of operative errors will be compared between those residents who trained on the simulator and those who did not.