Durability of Endourologic Skills: Two-Year Follow-Up Study

PURPOSE: To assess the long-term durability of endourologic skills among urology trainees after an intensive technical skills training course. SUBJECTS AND METHODS: Seventeen urology residents participated in a 2-day ureteroscopy course at a surgical skills center. Residents performed rigid ureteroscopy and basket manipulation of a small midureteral stone. Performance was assessed immediately after the course and 1 year and 2 years after training. Residents prospectively tracked all ureteroscopic cases in which they were considered the primary surgeon (i.e., performed greater than 75% of the procedure). Performance was measured using a validated global rating score (GRS), checklist score (CLS), and time required to complete the task. RESULTS: Overall, GRS improved over the 2-year follow-up (P < 0.001), with most of the improvement occurring in the first year (P = 0.03). The CLS and time to complete the task did not change (P = 0.08 and 0.12, respectively). At the 2-year follow-up, the number of cases logged had no significant effect on performance. CONCLUSIONS: Ureteroscopy skills are retained and continue to improve 2 years after completing an intense training session that uses high-fidelity bench models. Ureteroscopic experience is important for the maintenance and development of skills, even though they appear to plateau after 1 year. This result may also reflect a ceiling effect of the assessment tools.