Simulating Success



Simulation-based training for surgeons has been available for many years; however, there was little evidence for its benefits until recently.

The complexity of modern keyhole operations led to the uptake of simulation to help trainees reach a suitable standard in a safe environment. This approach was influenced by the use of simulators in aviation and the military. However, a lack of robust evidence for patient benefit has hampered the uptake of simulation-based training and not all trainees get this experience before operating on a patient.

“Urology was the first surgical specialty to put simulation on the curriculum in 2014, but it never became compulsory,” says Professor Prokar Dasgupta from Kings College London.

With funding from TUF, Prokar and his colleague Dr Abdullatif Aydin set up an international trial, called SIMULATE, to gather evidence on the impact of simulation training. Half of the 65 urology trainees taking part were trained traditionally and half received additional simulation training.

Over the course of the trial, trainees across Asia, Europe and North America performed over 1,100 procedures on patients. The results, which were published in the journal European Urology, showed that those who received simulation training reached a higher level of proficiency on average, with fewer minor and severe complications.

“For the first time, we’ve demonstrated that simulation is not just a confidence booster; it actually makes a massive difference to patients. Our results have had a very warm welcome from across the surgical community as it’s an example for most surgical specialties,” says Abdullatif.

The team plans to do further research into the surgical impact of newer simulation methods and non-technical skills, such as leadership and communication.

“Educational trials like this are very difficult to get funding for, but The Urology Foundation put their faith in us. We were very grateful for that because, without that funding, this trial would not have happened,” says Prokar.

“We owe it to our patients to provide the best care that we can, by the best-trained surgeons. I think the next challenge would be the implementation of this in the UK and other parts of the world.”