Abdullatif Aydin, Gordon H Muir, Manuela E Graziano, Muhammad Shamim Khan, Prokar Dasgupta and Kamran Ahmed

BJU Int. 2015 Jun;115(6):994-1003. doi: 10.1111/bju.12842. Epub 2014 Dec 7.


To assess face, content and construct validity and feasibility and acceptability of the GreenLightTM Simulator, and to establish learning curves and develop an evidence-based training curriculum.

Subjects and Methods

This prospective, observational and comparative study, recruited novice (n=25), intermediate (n=14) and expert-level urologists (n=7) from the United Kingdom and Europe at the 28th EAU Annual Meeting, 2013. A group of novices (n=12) performed 10 sessions of subtask training modules followed by a long operative case, whereas a second group (n=13) performed five sessions of a given case module. Intermediate and expert groups performed all training modules once, followed by one operative case. The outcome measures for learning curves and construct validity were time to task, coagulation time, vaporization time, average sweep speed, average laser distance, blood loss, operative errors, and instrument cost. Face and content validity, feasibility and acceptability were addressed through a quantitative survey.


Construct validity was demonstrated in two of five training modules (p=0.038; p=0.018) and in a considerable number of case metrics (p=0.034). Learning curves were observed in all five training modules (p<0.001) and significant reduction in case operative time (p<0.001) and error (p=0.017) were seen. An evidence-based training curriculum, to help trainees acquire transferable skills, was produced using the results.


This study has demonstrated the GreenLightTM SIM to be a valid and useful training tool for PVP training. It is hoped that by using the training curriculum for the GreenLightTM SIM, novice trainees can acquire skills and knowledge to a predetermined level of proficiency.

Study Video by AMS