Increasing trends of simulation-aided training in urolithiasis: a PubMed review over 23 years

INTRODUCTION: Simulation devices represent a great aid for endourological training, with the possibility to overcome the difficulties due to lack of expertise and need for repeated procedures. With the growth of high-fidelity simulations and the standardization of training programs, an increased interest in research is to be witnessed. With this trend review, we aimed to draw a picture of the changes in simulation-aided training over the last 23 years. EVIDENCE ACQUISITION: Literature search on simulation-assisted endourological training was performed through PubMed database, retrieving 91 included papers since 2001. Papers were labelled and divided in subgroups according to the type of simulation device and surgical procedure. Each subgroup was then divided into two time periods to compare and identify the contrast of different decades: period-1 (2001-2012) and period-2 (2013-2023). EVIDENCE SYNTHESIS: A total of 91 original articles have been published in the last 23 years, with an overall increasing trend by +214% (P=0.003). A growth in publications on simulation-aided training has been witnessed for ureteroscopy (+236%; P=0.009), percutaneous nephrolithotomy (+138%; P=0.008), and a combination of the procedures (+267%; P<0.001). Among the devices used for simulation, the application of 3D-printed (all published in period 2; P=0.008) and bench models (+400%; P<0.001) rose, while the interest towards animal models (-43%; P=0.006) and virtual reality (-36%; P=0.009) has decreased. CONCLUSIONS: A steep increase in training with the aid of different simulation devices has been observed in the last decades. The positive effect on teaching and education of trainees in endourological procedures for urolithiasis is undeniable, as also demonstrated by the progressive integration in educational programs worldwide.