Page 10 - CUA 2020_Technology and Training_v2

2020 CUA Abstracts

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MP-6.2. Fig. 1. Scope rotation for (A) expert run; and (B) novice run.
MP-6.3 MP-6.4
Evaluating the utility of a novel 3D immersive virtual-reality Development, implementation, and evaluation of a point of care
percutaneous nephrolithotomy simulator ultrasound course for training urology residents
Jason Y. Lee , Luke Reynolds , Monica Farcas 1 Catherine Anne Lovatt , Michael John Uy , Jennifer Hoogenes , Carol
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1 Urology, University of Toronto, Toronto, ON, Canada Bernacci , Edward D. Matsumoto 1
Introduction: Percutaneous nephrolithotomy (PCNL) is the gold standard 1 Department of Surgery, Division of Urology, McMaster University,
treatment for patients with a large stone burden. Gaining safe access into Hamilton, ON, Canada; Department of Medical Radiation Sciences,
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the collecting system is the most critical step of PCNL, but also the most Mohawk College, Hamilton, ON, Canada
technically challenging aspect. There are a variety of methods to teach Support: Mohawk College Department of Radiation Sciences
this important endourological skill, including the use of simulation-based Introduction: Point-of-care ultrasound (PoCUS) is a widely used bedside
methods. In this study, we evaluate three PCNL simulation platforms, tool in urology. Applications include the assessment of an undifferenti-
including a novel, 3D-immersive VR simulator, for potential use in teach- ated acute scrotum, renal colic, and the guidance of suprapubic catheter
ing and assessing PCNL access skills. placement. However, the user-dependent nature of this modality neces-
Methods: Urology residents, fellows, and faculty from our institution were sitates appropriate use and competence. The objective of this study was to
recruited to participate in this study, which included completing standard- develop and evaluate an introductory PoCUS course for urology residents.
ized tasks on three PCNL simulation platforms: the Marion K181 simula- Methods: All urology residents at our institution completed a three-hour,
tor (Marion Surgical), the PercMentor VR simulator (Symbionix), and a online course followed by a three-hour, hands-on seminar involving kid-
porcine inanimate PCNL model (Cook Medical). All participants were ney, bladder, and testicular sonographic scanning. Simulated testicular
given standardized introductions to each of the three simulated platforms phantoms (Fig. 1) and suprapubic catheter models (Fig. 2) were con-
before being asked to complete the standardized tasks — gaining PCNL structed and used in an ultrasound lab. Course material was developed
access using a fluoroscopic-guided technique. Participant demographic by licensed ultrasound technologists, based on the Sonography Canada
and performance data were recorded for analysis. Participants also evalu- National Competency Profiles. Pre- and post-course surveys focused on
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ated the three PCNL simulation platforms. residents’ user confidence, while pre- and post-course multiple-choice
Results: A total of 18 participants (two faculty endourologists, four endou- questionnaires (MCQ) assessed theoretical knowledge.
rology fellows, 12 urology residents) with varying levels of PCNL experi- Results: Fourteen urology residents (PGY 1–5) participated in the course.
ence (78% had performed <10 cases, 17% over 50 cases) completed the Theoretical knowledge in PoCUS improved significantly (p<0.001), as
study. The Marion K181 had higher ratings in all domains compared to the
Perc Mentor (p<0.05) but did not differ in any domain when compared
to the Cook porcine PCNL model. Fluoroscopy time was the variable
that most consistently correlated with participant PCNL experience and
level of training across all three PCNL simulation platforms, but other
performance metrics did not correlate well.
Conclusions: There are a variety of PCNL simulation platforms available
for teaching PCNL access skills. Based on our initial study, there is validity
evidence to support the use of the novel Marion K181 PCNL simulator
as a teaching tool, with high user ratings across domains, but evidence
is yet lacking for use as an assessment tool.
MP-6.4. Fig. 1. Simulated testicular phantoms within the scrotal case (left)
and corresponding sonographic appearance (right).

S110 CUAJ • June 2020 • Volume 14, Issue 6(Suppl2)