440
The Accreditation Council for Graduate Medical Education (ACGME), the gov-
erning body of American medical residencies, is tasked with assuring that residents
are properly trained before independent practice. In their most recent release of
requirements for urology residencies, the ACGME states that residencies are
responsible for “developing the skills, knowledge, and attitudes leading to profi-
ciency in all the domains of clinical competency requires the resident physician to
assume personal responsibility for the care of individual patients.” The way in
which residencies need to reach this goal is never explicitly stated. Despite no
requirements from the ACGME at the time of this writing, residencies are increas-
ingly using simulation and skills laboratories to help residents master a number of
surgical skills (Fig. 24.1). In the following chapter, the currently available simula-
tion options in urology will be discussed including open surgery, laparoscopy,
robotics, and endoscopy.
(^570)
60
50
40
30
Percentage (%)
20
10
0
Trainees
Specialists
Trainees
Specialists
4
3
2
Mean Likert Score
Generic Skills
Cystoscopy
Ureteroscopy
TURP
Nephrectomy
Basic
Surgical Skills
Cystoscopy
Ureteroscopy
TURP
PercutaneousRenal SurgeryNephrectomy
1
0
ab
Fig. 24.1 Results of survey of 263 urological trainees and specialists comparing perception of
need for additional training and whether or not simulation had been used for training [ 173 ]. (a) Is
additional training required to develop technical skills? Likert scale: (1 = strongly disagree – 5 =
strongly agree) Key: TURP transurethral resection of the prostate. (b) Percentage of trainees and
specialists who had simulation experience in technical skills training. Likert scale: (1 = strongly
disagree – 5 = strongly agree) Key: TURP transurethral resection of the prostate
W. Baas et al.