Urology Individual Critical Task List: Creation and Validation of a Simulation Curriculum

Individual critical task lists (ICTLs) are skills identified by the U.S. Army for the maintenance of combat readiness in each military occupational specialty, including physicians. These lists vary by medical and surgical specialties and are being utilized by leaders to determine individual deployment capability. The lists for urologists include broader tasks that are not routinely performed in a urology practice. Our goal was to create a simulation curriculum to train urologists and to perform validation testing.

Urology staff and residents at a single military treatment facility underwent a simulation event of urology ICTLs: chest tube, needle decompression, intubation, cricothyroidotomy, and extended focused assessment with sonography for trauma. The simulation was broken down into a pretest, cognitive acquisition, in-person training with subject matter experts for skills acquisition, and a posttest. Content validity questionnaires were administered to participants after the training session. Cognitive acquisition consisted of a series of videos demonstrating task execution and in-person demonstration of tasks and clinical scenarios of when they would be needed. In-person simulation was performed on training mannequins and a sonography simulation trainer.

There were a total of nine participants: three residents and six staff urologists, ranging from postgraduate year 2 to more than 10 years out of residency. The total simulation time was 120 min, including 30 min for pretest and viewing of videos. Knowledge-based questions improved from pretest to posttest significantly (mean of 1.2 to 0.1, P < .001). Confidence performing tasks improved significantly on all tasks (P ≤ .01). All participants felt the simulation to be beneficial and had more comfort with the tasks.

The novel urology ICTL curriculum using simulation is a feasible and well-received way to keep competency on these tasks and maintain readiness. Face and content validity was established for the urology ICTL simulation curriculum, and the curriculum is exportable to equip urologists at other facilities for the urology ICTLs and for deployments, where life-saving interventions may be necessary from urologists that may be outside their ordinary scope of practice.