Validation of the GreenLight™ Simulator and development of a training curriculum for photoselective vaporisation of the prostate

BJU Int. 2015 Jun;115(6):994-1003. doi: 10.1111/bju.12842. Epub 2014 Dec 7.

Abstract

Objectives: To assess face, content and construct validity, and feasibility and acceptability of the GreenLight™ Simulator as a training tool for photoselective vaporisation of the prostate (PVP), and to establish learning curves and develop an evidence-based training curriculum.

Subjects and methods: This prospective, observational and comparative study, recruited novice (25 participants), intermediate (14) and expert-level urologists (seven) from the UK and Europe at the 28th European Association of Urological Surgeons Annual Meeting 2013. A group of novices (12 participants) performed 10 sessions of subtask training modules followed by a long operative case, whereas a second group (13) performed five sessions of a given case module. Intermediate and expert groups performed all training modules once, followed by one operative case. The outcome measures for learning curves and construct validity were time to task, coagulation time, vaporisation time, average sweep speed, average laser distance, blood loss, operative errors, and instrument cost. Face and content validity, feasibility and acceptability were addressed through a quantitative survey.

Results: Construct validity was demonstrated in two of five training modules (P = 0.038; P = 0.018) and in a considerable number of case metrics (P = 0.034). Learning curves were seen in all five training modules (P < 0.001) and significant reduction in case operative time (P < 0.001) and error (P = 0.017) were seen. An evidence-based training curriculum, to help trainees acquire transferable skills, was produced using the results.

Conclusion: This study has shown the GreenLight Simulator to be a valid and useful training tool for PVP. It is hoped that by using the training curriculum for the GreenLight Simulator, novice trainees can acquire skills and knowledge to a predetermined level of proficiency.

Keywords: GreenLight; PVP; education; laser prostatectomy; simulation; urology training.

Publication types

  • Comparative Study
  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Computer Simulation
  • Female
  • Humans
  • Laser Therapy / instrumentation*
  • Laser Therapy / methods*
  • Learning Curve
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostate / surgery*
  • Prostatectomy / education*
  • Prostatectomy / instrumentation
  • Prostatectomy / methods
  • Surgeons / education
  • Surgeons / statistics & numerical data
  • Surgery, Computer-Assisted / education*
  • Surgery, Computer-Assisted / instrumentation
  • Surgery, Computer-Assisted / methods
  • User-Computer Interface