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Simulation

Cystoscopy

Simulation

Materials and Preparation

  • Station ideally has two residents and on faculty preceptor
  • Equipment per station:
    • One cystoscope (Including a 30 Degree optic, bridge and sheath)
    • One 1000 cc bag normal saline
    • One IV tubing
    • One camera and light cord
    • One endoscopy tower
    • Simulation model (see below)

Simulators to be Used

  • Equipment needed per station (ideally two residents/station)
  • One white common balloon and one small rubber ball cored to a size equal to the outer sheath diameter of the cystoscope
  • Two clips (hemostats or common alligator clips) for ureters.
  • One 10 cc syringe with a 25 gauge tuberculin needle and blue food coloring for demonstrating ureteral patency
  • Red Sharpie marker to draw details on bladder model
  • Tuberculin syringe with 25 gauge needle
  • Blue food dye
  • Surgical or egg crate foam sections measuring approximately 12" x 24"
Cystoscopy simulation equipment.
Simulation equipment. Rubber ball for urethra cored.
Blown up balloon marked up with a red Sharpie.
Balloon blown up and marked. Balloon inverted and rubber ball in place.
Hemostat/alligator clip mimicking a ureteric orifice and syringe injecting blue dye mimicking a patent ureter demonstration.
Hemostat/alligator clip placed on outside mimicking a ureteric orifice. Tuberculin syringe injecting blue food dye mimicking a patent ureter demonstration.

Two sections of surgical foam or egg crate foam for support of model

Cystoscopy simulation model being taped onto surgical foam.
Tape to hold model in place. The model being taped onto surgical foam. Beginning simulation

Lab Sequence

  1. The intended sequence of events for this lab involves an initial OSATS (observed structured assessment of technical skills):
    1. 5 minutes cystoscopy assembly OSATS and
    2. 5 minute diagnostic cystoscopy OSATS.

The faculty should make certain that none of the equipment is damaged and only intervene if damage to the equipment appears eminent.

Competency Assessment

  1. Cystocope Assembly
    • Residents should be able to assemble the cystoscope correctly and identify the parts correctly in less than five minutes to be considered competent in this task
    • Correctly assembling and obtaining an image is necessary for competency
    • Correctly naming and proper order of assembly will be noted as mastery of this task
  2. Diagnostic Cystoscopy
  • Residents should be able to identify both ureteric orifices and identified each of the intra-vesicle pathologic features in less than five minutes in order to be considered competent.

Competency is obtained if all intra-vesical landmarks and their location are noted.

Properly rotating the scope to maximize the use of the angled lens and minimize urethral manipulation and torque will be noted as mastery of this task.