Construct validity of urosim® simulator for learning transurethral resection of bladder tumor

Objective: There is an increasing trend to incorporate Simulator-based training in urology residency programs. The study was designed to determine the construct validity of UroSim® for that we compared the performance of transurethral resection of bladder tumor (TURBT) between experts and novices. Material and methods: We conducted a cross sectional study at a university hospital to determine the construct validity of UroSim® for TURBT. We compared the outcome measures between experts (urology consultants) and novices (residents) to determine relationship between clinical experience and performance on simulator. Primary outcome measure was resection time and secondary outcome measures were safety, bleeding, and visualization during TURBT on UroSim. We requested participant to resect three tumors to assess the test content of the simulator. Comparison of continuous variables such as resection time, resection, bleeding control, and visualization and blood loss using student t test. Comparison of categorical variable, i.e. perforation of bladder, using Fischer exact test. Results: We included 30 experts and 30 novices. There was a statistically significant difference in the mean resection time between the groups (196±67.4 sec versus 374.6±179.7 sec; p=0.01), suggesting a positive relationship between clinical experience and performance on simulator. Additionally, safety parameters, namely, bleeding control, inadvertent cuts into bladder wall, ureteric orifices, and bladder perforations varied between the two groups. Conclusion: We observed significant differences of parameters in performance between experts and novices. Simulator is a useful tool for teaching TURBT as it demonstrates good construct validity and recommended in urology training for teaching psychomotor skills.