LAUSR

BACKGROUND Basic simulation training in endourology was established with the endoscopic stone treatment step 1(EST s1), which is now recognised worldwide for training and examination. Following on from EST s1, the EST s2 was started by the EAU sections. OBJECTIVE We describe the methodology used in the development of Endoscopic Stone treatment step 2(EST s2) assessment curriculum. MATERIAL AND METHODS The "full-life cycle curriculum development" template was followed for curriculum development, focussing on intermediate training of EST protocol with complex endourological tasks. A cognitive task analysis(CTA) was run in accordance with EAU Urolithiasis guidelines. The protocol and its details underwent a first consensus by Delphi method with EULIS(EAU Urolithiasis Section) experts in March 2017. Once the outcome and metrics were decided, curriculum development was carried out. Purpose-built stones were developed, and simulator system requirement was defined. Preliminary testing was done in EUREP 2019 and in phase five the protocol was finalised with full tutor instruction sheet. RESULTS The EST-s2/A curriculum development, took 38 months and involved EAU Uro-technology and urolithiasis sections with coordination from the European School of Urology (ESU) training group. Starting from the initial CTA, a 1277-word revision with preliminary task description was produced. Nine intermediate skills were identified and included in the final training protocol. The training content and session evaluations were carried out by 26 experts and 16 final year trainees respectively. While the experts agreed that EST s2/A protocol was well structured (96%), covered the complex endourological manoeuvres (92%) and was useful to optimise and improve hands-on-training sessions (92%), the overall evaluation was scored 4.25/5 by trainees. CONCLUSION We describe the development methodology for intermediate endoscopic stone treatment curriculum, which also provides a roadmap on developing other hands-on training protocols in future.