Evaluation of Laparoscopic Curricula in American Urology Residency Training

Purpose: The goal of this study is to evaluate the role of laparoscopic curricula and simulation technology in urology residency training from the perspectives of residents over a 2-year period. Materials and Methods: An anonymous survey was given to urology residents attending the American Urological Association Basic Sciences Course in 2008 and 2009. We evaluated laparoscopic simulator use within a curriculum and use of simulators outside of a curriculum. Face and content validity of simulators were analyzed on a 5-point Likert scale questionnaire. Responses were compared using the unpaired Student t test and chi-square with P < 0.05 considered significant. Results: There were 114 surveys (81.4% response rate) and 76 surveys (43% response rate) evaluated from 2008 and 2009, respectively. Access to a surgical simulator increased from 74.6% to 78%. The percentage of programs with a laparoscopic curriculum expanded from 16.9% to 44%. In 2009, simulators were used more frequently by residents in programs with curricula compared with residents without curricula (P = 0.03). In 2008, 48% of residents and in 2009 72% of residents reported using simulators as "never'' or "once or twice a year.'' Of residents, 93% stated that urology programs should use laparoscopic curricula and 82% think simulators should be involved in the curricula. One third of residents agreed that simulators are helpful for skill acquisition, and 80% described their current laparoscopic curriculum as inadequate. Conclusions: The number of urology programs that have invested in simulators continues to expand. Despite access to laparoscopic simulators, residents rarely use them. Residents in programs with laparoscopic curricula report using surgical simulators more often than residents without curricula. Laparoscopic curricula are important, and the incorporation of simulators enhances surgical education.