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

ObjectivesTo 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 MethodsThis 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. ResultsConstruct 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. ConclusionThis 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.