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

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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.

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Abbreviations

AUA:

American Urological Association

PCNL:

Percutaneous nephrolithotomy

PCA:

Percutaneous renal access

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Acknowledgements

The authors would like to acknowledge the help of Kelsey Holden from the American Urological Association, Kaitlin Youwer, and WISH technicians at the University of Washington.

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Authors and Affiliations

  1. Department of Surgery, WWAMI Institute for Simulation in Healthcare (WISH), University of Washington, Seattle, WA, USA

    Yasser A. Noureldin & Robert M. Sweet

  2. Department of Urology, Benha Faculty of Medicine, Benha University, Benha, Egypt

    Yasser A. Noureldin

  3. The Smith Institute for Urology, Hofstra Northwell School of Medicine, New Hyde Park, NY, USA

    David M. Hoenig, Sammy E. Elsamra, Geoffrey Gaunay, Piruz Motamedinia & Zeph Okeke

  4. Department of Urology, NYU School of Medicine, New York, NY, USA

    Philip Zhao

  5. Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA

    Joshua Stern

  6. Yale University School of Medicine, New Haven, CT, USA

    Piruz Motamedinia

  7. Icahn School of Medicine at Mt. Sinai, New York, NY, USA

    Ardeshir R. Rastinehad

  8. Department of Urology, University of Washington, Seattle, WA, USA

    Robert M. Sweet

Authors
  1. Yasser A. Noureldin
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  2. David M. Hoenig
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  3. Philip Zhao
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  4. Sammy E. Elsamra
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  5. Joshua Stern
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  6. Geoffrey Gaunay
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  7. Piruz Motamedinia
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  8. Zeph Okeke
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  9. Ardeshir R. Rastinehad
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  10. Robert M. Sweet
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Contributions

Yasser A. Noureldin: Study design, data collection, data analysis, manuscript writing. David M. Hoenig: Study design, data collection and Manuscript editing. Philip Zhao: Manuscript editing. Sammy E. Elsamra: Data collection, Manuscript editing. Joshua Stern: Data collection, Manuscript editing. Geoffrey Gaunay: Data collection, Manuscript editing. Piruz Motamedinia: Data collection, Manuscript editing. Zeph Okeke: Data collection, Manuscript editing. Ardeshir R. Rastinehad: Data collection, Manuscript editing. Robert M. Sweet: Study design, Data collection and Manuscript editing

Corresponding author

Correspondence to Robert M. Sweet.

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Conflict of interest

Authors declare no conflict of interest.

Ethics statement

This study was conducted according to the Declaration of Helsinki 2013 and its amendments, and according to the ethical standards of the American Urological Association and the University of Washington. Signed consents were collected from all participants.

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Noureldin, Y.A., Hoenig, D.M., Zhao, P. et al. Incorporation of the fluoroless C-Arm Trainer at the American Urological Association hands on training percutaneous renal access. World J Urol 36, 1149–1155 (2018). https://doi.org/10.1007/s00345-018-2219-5

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  • DOI: https://doi.org/10.1007/s00345-018-2219-5

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