Different training programs have been developed to improve trainee outcomes in urology. However, evidence on the optimal training methodology is sparse. Our aim was to provide a comprehensive description of the training programs available for urological robotic surgery and endourology, assess their validity, and highlight the fundamental elements of future training pathways. We systematically reviewed the literature using PubMed/Medline, Embase, and Web of Science databases. The validity of each training model was assessed. The methodological quality of studies on metrics and curricula was graded using the MERSQI scale. The level of evidence (LoE) and level of recommendation for surgical curricula were awarded using the educational Oxford Centre for Evidence-Based Medicine classification. A total of 75 studies were identified. Many simulators have been developed to aid trainees in mastering skills required for both robotic and endourology procedures, but only four demonstrated predictive validity. For assessment of trainee proficiency, we identified 18 in robotics training and six in endourology training; however, the majority are Likert-type scales. Although proficiency-based progression (PBP) curricula demonstrated superior outcomes to traditional training in preclinical settings, only four of six (67%) in robotics and three of nine (33%) in endourology are PBP-based. Among these, the Fundamentals of Robotic Surgery and the SIMULATE curricula have the highest LoE (level 1b). The lack of a quantitative synthesis is the main limitation of our study. Training curricula that integrate simulators and PBP methodology have been introduced to standardize trainee outcomes in robotics and endourology. However, evidence regarding their educational impact remains restricted to preclinical studies. Efforts should be made to expand these training programs to different surgical procedures and assess their clinical impact.

中文翻译：

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机器人辅助手术和腔内泌尿外科培训的现行标准：系统评价


已经开发了不同的培训计划来改善泌尿外科的实习生结果。然而，关于最佳训练方法的证据很少。我们的目标是全面描述可用于泌尿外科机器人手术和腔腔泌尿外科的培训计划，评估其有效性，并强调未来培训途径的基本要素。我们使用 PubMed/Medline、Embase 和 Web of Science 数据库系统评价了文献。评估了每个训练模型的有效性。使用 MERSQI 量表对指标和课程的研究方法质量进行分级。使用教育性牛津循证医学中心分类授予证据水平 （LoE） 和外科课程推荐水平。共确定了 75 项研究。已经开发了许多模拟器来帮助受训者掌握机器人和腔内泌尿外科手术所需的技能，但只有四种证明了预测有效性。为了评估学员的熟练程度，我们确定了 18 名机器人培训学员和 6 名腔内泌尿外科培训学员;然而，大多数是李克特型量表。尽管基于能力的进展 （PBP） 课程在临床前环境中显示出优于传统培训的结果，但机器人学的 6 个课程中只有 4 个 （67%） 和腔内泌尿学的 9 个 （33%） 课程中只有 3 个 （33%） 是基于 PBP 的。其中，机器人手术基础和 SIMULATE 课程的 LoE 最高（1b 级）。缺乏定量综合是我们研究的主要局限性。引入了集成模拟器和 PBP 方法的培训课程，以标准化机器人学和腔腔泌尿学的学员结果。 然而，关于其教育影响的证据仍然仅限于临床前研究。应努力将这些培训计划扩展到不同的外科手术并评估其临床影响。