ESU Training and Research Group: Reaching new heights through collaboration

The European School of Urology (ESU) pioneered the “Training and Research” group to develop the training standards of the ESU’s Hands-on Training (HOT) programmes. This initiative was accomplished through close collaboration with the EAU Section of Uro-Technology (ESUT), EAU Section of Urolithiasis (EULIS) and other EAU sections.

Over the last decade, new training protocols in laparoscopy and endourology have been launched. While European training in Basic Laparoscopic Urological Skills (E-BLUS) is now established in Europe and the rest of the world as the basic laparoscopy course and examination [1], the Endoscopic Stone Treatment step-1 (EST-s1) is now validated and established with successful course delivery and examinations conducted in Europe [2,3]. With growing incidence and prevalence of kidney stone disease, there is a need for a training protocol which is scientifically valid, universally accepted and can set a benchmark for training in endourology [4].

A new course for Endoscopic Stone Treatment step-2 (EST-s2) is currently under development which will focus on ballistics and stone fragmentation. The potential of the course was explored during the recent ESUT meeting and there are plans to validate the course in 2018.

Candidates who have successfully completed EST-s1 will have the opportunity to participate in EST-s2 in Berlin and Prague later this year with the goal to validating the protocol. Similar HOT courses dedicated to the lower tract are also being developed and this will lead to standardised training for transurethral resection of prostate (TURP). The cognitive task analysis (CTA) is now completed and the preliminary validation will be carried out during the 16th European Urology Residents Education Programme (EUREP18) this August.

Beyond Europe

The reach of ESU’s HOT courses has gone beyond Europe. With over 24 E-BLUS courses carried out worldwide in 2017, EST-s1 was successfully completed in Poland, Austria, Spain and Turkey and gained growing interest from all over the world. The next step is expansion in Asia. Courses are already planned later this year in Singapore, Thailand and China.

With gradual methodological improvements in the HOT curriculum, positive feedback grows as time passed, particularly the excellent ratings for the trainers, organisation and participants’ experiences. Feedback from 796 participants of 1,450 HOT courses from 54 countries confirmed this rating in both European and non-European countries [5]. ESU’s mission to standardise and harmonise training across Europe has led to an even platform for simulation-based training and assessment for residents with a dedicated one-on-one training per one-hour slot.

As demand for courses and lectures increases, so does the need for trainers in endourology and/or laparoscopy who can carry out the training in a quality-controlled, standardised fashion. With this in mind, the “Training the trainers” course was launched with great success. This completed the first session of the trainer recruitment and certification which took place in Leeds, United Kingdom, overseen by Mr. Bhaskar Somani, Dr. Ben Cleynenbreugel and Mr. Shekhar Biyani.

The course will be incorporated in the EUREP meeting as EUREP is a quintessential platform to increase the number of experts who can deliver these programmes and courses in any part of the world. The feedback received from the initial course was excellent. This will provide a flagship training programme for all trainers and possibly become mandatory before they take up their HOT roles.

The trainee demographics from EUREP show that the objectives of these courses are met with excellent feedback. While European trainees dominate the demographics, participation from a number of non-European countries illustrate ESU’s continued collaboration with national societies, and dissemination of simulation training at a broader scale.

Exciting times lie ahead with new simulation-based curriculums being developed and a greater push for standardising the training methodologies and the trainers. There has never been a better time for simulation-based endourology or laparoscopy training for trainers and trainees.