Simulation – the need for a paradigm shift in urological training

Surgical training based on the Halstedian principle of apprenticeship has not really changed for over a century now. Educationists endeavor constantly to reduce the time taken for students/trainees to achieve competency while meeting safety standards. This is due to the constraints of time, economics, facilities, teachers, regulations, governance and the need to fill manpower gaps in the healthcare system. The increasing demand for clinical productivity from senior physicians, for example, in the United Kingdom has seen a paradigm shift – from the ‘consultant led’ care a decade ago to the ‘consultant delivered’ care provided now. Therefore, experts are able to allocate only a limited time to train students and residents. In addition to the skills required to practise as a physician, surgeons need to achieve competency in various surgical procedures. Training that encompasses development of both technical and nontechnical skills such as knowledge acquisition, team work, communication and interpersonal skills (conveniently grouped under the umbrella of crisis resource management – CRM) can be simulated in a stress-free and safe environment (as there is no Simulation – the need for a paradigm shift in urological training