• simulation;
  • urology;
  • virtual reality;
  • clinical competence;
  • teamwork;
  • surgery

Study Type – Therapy (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

Simulation-based training can provide urology trainees with the opportunity to develop their technical and non-technical skills in a safe and structured environment. Despite its promised benefits, incorporation of simulation into current curricula remains minimal.

This paper provides a comprehensive review of the current status of simulation for both technical and non-technical skills training as it pertains to urology. It provides a novel framework with contextualised examples of how simulation could be incorporated into a stage-specific curriculum for trainees through to experienced urologists, thus aiding its integration into current training programmes.


• Changes to working hours, new technologies and increased accountability have rendered the need for alternative training environments for urologists.

• Simulation offers a promising arena for learning to take place in a safe, realistic setting.

• Despite its benefits, the incorporation of simulation into urological training programmes remains minimal.

• The current status and future directions of simulation for training in technical and non-technical skills are reviewed as they pertain to urology.

• A framework is presented for how simulation-based training could be incorporated into the entire urological curriculum.


• The literature on simulation in technical and non-technical skills training is reviewed, with a specific focus upon urology.


• To fully integrate simulation into a training curriculum, its possibilities for addressing all the competencies required by a urologist must be realized.

• At an early stage of training, simulation has been used to develop basic technical skills and cognitive skills, such as decision-making and communication.

• At an intermediate stage, the studies focus upon more advanced technical skills learnt with virtual reality simulators.

• Non-technical skills training would include leadership and could be delivered with in situ models.

• At the final stage, experienced trainees can practise technical and non-technical skills in full crisis simulations situated within a fully-simulated operating rooms.


• Simulation can provide training in the technical and non-technical skills required to be a competent urologist.

• The framework presented may guide how best to incorporate simulation into training curricula.

• Future work should determine whether acquired skills transfer to clinical practice and improve patient care.