Validation of the Advanced Scope Trainer for Flexible Ureterorenoscopy Training

OBJECTIVE To validate the Advanced Scope Trainer (AST; Mediskills, Northampton, UK). The AST is a currently unvalidated simulator, developed for flexible ureterorenoscopy (fURS) training. This study aims to assess the face, content, construct, and concurrent validity to assess the level of transferability of skills to the operating room. MATERIALS AND METHODS This prospective, observational, and comparative study recruited novices (n = 19) and trainees (n = 34), with participants performing a diagnostic fURS, followed by removal of a lower pole stone, on the AST. Fifteen participants performed a fURS on fresh frozen cadavers to assess concurrent validity. Trainees were supervised by expert urologists (n = 7) during each procedure. Performance was evaluated using the validated Objective Structured Assessment of Technical Skills (OSATS) assessment. Face and content validity were demonstrated by anonymous surveys from participants and faculty. RESULTS Face validity assessment revealed that trainees found the simulator was 76% realistic (3.8/5 on a Likert scale). Laser stone fragmentation (4.11 ± 0.85) and manual stone extraction (4.03 ± 0.85) were thought to be the most realistic components and guidewire insertion (3.14 ± 1.35) the least. Participants also believed the simulator to be useful, giving transferrable skills to take into the operating room, demonstrating content validity. Using an OSATS assessment, concurrent validity was demonstrated in "respect for tissue" (P = .0105) and "time and motion" (P = .0196). Construct validity was also demonstrated when comparing novices to trainees (mean OSATS 10.11 ± 2.28 vs 23.89 ± 5.38). CONCLUSION This study has demonstrated face, content, construct, and concurrent validity of the AST for fURS training. Further evaluation is necessary to demonstrate construct and predictive validity of skills gained using the model.