The University of Florida (UF) Department of Urology is working with the UF Center for Safety, Simulation & Advanced Learning Technologies (CSSALT) on improving simulator-based training in ultrasound-guided prostate biopsy (PBx). A mixed reality PBx simulator has been designed and built with a prior DoD grant to CSSALT and used for competency-based training in PBx at five academic health centers in North America (UF, Jefferson, Toronto General Hospital, Princess Margaret Cancer Centre, Malcom Randall VA Medical Center). The simulator was used to (a) develop the concept of template deviation, a new metric in units of mm of how closely actual biopsy cores match a systematic prostate biopsy (sPBx) template, (b) propose and validate a competency threshold of 5 mm for template deviation and (c) develop and validate a pitch-neutral methodical technique for side-fire systematic prostate biopsy that Dr. Stringer of UF Urology has adopted and started teaching to residents, including in the urology clinics. The PBx simulator can be used to train in TRUS-guided: side-fire transrectal, end-fire transrectal and transperineal PBx. An expandable library of 3 different prostates is currently available. Results of a multi-center study on the efficacy of the simulator and pitch-neutral technique have been submitted for presentation at the AUA 2020 meeting.
Preliminary results are reported at:
- Lampotang S, Stringer T, Moy L, Lizdas D, Wakim J, Zhang Z, Yu Y, Cooper LA, Otto B: Baseline prevalence and magnitude of spatial deviations in a simulator from the transrectal ultrasound prostate biopsy template. Journal of Urology – Vol. 201, No. 4S, Supplement, May 4, 2019 – https://www.auajournals.org/doi/pdf/10.1097/01.JU.0000555931.36243.e8