How useful and realistic is the uro trainer for training transurethral prostate and bladder tumor resection...

We evaluated the face and content validity (novice and expert opinions of realism and usefulness) of the Uro Trainer (Karl Storz GmbH, Tuttlingen, Germany), a simulator for transurethral resection procedures, to ascertain whether it is justifiable to continue the validation process by performing prospective experimental studies.

Between 2006 and 2008, 104 urologists and urology residents performed a transurethral bladder tumor resection and/or transurethral prostate resection procedure on the Uro Trainer, and rated simulator usefulness and realism on a 10-point scale (1-not at all useful/realistic/poor, 10-very useful/realistic/excellent). Participants were classified as experts (more than 50 procedures performed) or novices (50 or fewer procedures performed). Because the literature offered no guidelines for interpreting our data, we used criteria from other studies to interpret the results.

A total of 161 questionnaires were analyzed from 97 (21% experts, 79% novices) and 64 (30% experts, 70% novices) participants who performed transurethral prostate resection and transurethral bladder tumor resection procedures, respectively. Mean usefulness, realism and overall scores varied from 5.6 to 8.2 (SD 1.4-2.5). Measured by validity criteria from other studies, Uro Trainer face and content validity was unsatisfactory, with ratings on only 3%, 5% and 8% of the parameters interpreted as positive, moderately acceptable and good, respectively.

Measured against criteria from other validation studies, Uro Trainer face and content validity appears to be unsatisfactory. Modification of the simulator seems advisable before further experimental validation studies are initiated. The lack of general guidelines for establishing face and content validity suggests a need for consensus about appropriate methods for evaluating the validity of simulators.