The Effect of Bench Model Fidelity on Endourological Skills: A Randomized Controlled Study

PURPOSE: Complex skills, such as ureteroscopy and stone extraction, are increasingly taught to novice urology trainees using bench models in surgical skills laboratories. We determined whether hands-on training improved the performance of novices more than those taught only by a didactic session and whether there was a difference in the performance of subjects taught on a low versus a high fidelity model. MATERIALS AND METHODS: We randomized 40 final year medical students to a didactic session or 1 of 2 hands-on training groups involving low or high fidelity bench model practice. Training sessions were supervised by experienced endourologists. Testing involved removal of a mid ureteral stone using a semirigid ureteroscope and a basket. Blinded examiners tested subjects before and after training. Performance was measured by a global rating scale, checklist, pass rating and time needed to complete the task. RESULTS: There was a significant effect of hands-on training on endourological performance (p 0. 05). The low fidelity model cost Canadian 20 to produce, while the high fidelity model cost Canadian 3, 700 to purchase. CONCLUSIONS: Hands-on training using bench models can be successful for teaching novices complex endourological skills. A low fidelity bench model is a more cost-effective means of teaching ureteroscopic skills to novices than a high fidelity model.