Face and content validation of TURP and TURB simulation models: an EAU European School of Urology (ESU) Lower Urinary Tract Endoscopy Working Group Study.

Abstract

PURPOSE: To evaluate the educational validity of two bench-top simulators for Transurethral Resection of the Prostate (TURP) and Transurethral Resection of Bladder Tumor (TURB), focusing on their realism, ergonomics, and relevance for structured endourology training.

MATERIALS AND METHODS: Fourteen expert endourologists from multiple European centers assessed both simulators during the European Association of Urology Residents Education Programme (EUREP) 2025. Face validity and content validity were evaluated using 4-point Likert questionnaires. Item-level (I-CVI) and scale-level (S-CVI/Ave) content validity indices were calculated for all items and adjusted for core procedural skills.

RESULTS: Experts rated both simulators highly for anatomical realism, tissue handling, and overall utility (mean scores > 3.5/4). The TURP simulator achieved an adjusted S-CVI/Ave of 0.92 and the TURB simulator 0.97, indicating excellent consensus on their educational adequacy for key procedural steps. Non-modeled features such as bleeding, obturator reflex, and energy modulation received low ratings, reflecting inherent limitations of bench-top simulation. Both models were considered effective for practicing instrument handling and resection depth control in a risk-free, standardized environment.

CONCLUSIONS: The TURP and TURB simulators demonstrated strong face and content validity for core resection training. Their modular, non-biological, and reproducible design supports safe, structured skill acquisition and competency assessment in endourology curricula, offering a practical bridge between theoretical learning and clinical performance.