An important step forward for the European ENTRY project

The ENTRY (EuropeaN Training in uRology) project, focusing on transurethral bladder resection, i.e. the endoscopic removal of bladder tumours, continues. ENTRY is an educational project financed by a three-year European Erasmus fund with Humanitas University in collaboration with the Spanish Fundacio Puigvert, an important hospital specialised in the treatment of urological pathologies and in clinical research, and the Belgian Orsi Academy.

This ambitious project will last about three years and involve 150 resident doctors. The aim is to innovate urologists’ training by teaching them how to use the latest medical devices while reducing complications. This project also contributes to the need for more uniform training of specialist doctors across the different European countries.

Consensus conference

In October 2022, a consensus meeting was held in Barcelona with 15 European experts, one third of whom were Italian, to validate the quality of the previously designed bladder cancer resection procedure. This was done by using the qualitative Delphi method, which allows to collect the opinions of a group of experts; the specialists infact discussed for three hours and expressed their opinions on all the procedure’s phases. “In order to validate the procedure,” explains Professor Nicolò Maria Buffi    Director of the School of Specialisation in Urology at Humanitas University, “we have divided the procedure into six stages and for each of these stages, there are 15-20 discussion points that cover the entire surgical procedure starting from the time the patient enters the operating theatre. During the meeting, the experts reviewed every single point of the procedure in order to identify errors or deviations from what should be optimal executions. “This methodology is called proficiency-based progression (PBP) training and was developed by Professor Anthony Gallagher from the Orsi Academy. This method,’ Buffi informs, ‘improves surgical performance by as much as 60%, which means a 60% reduction in complications and errors’.

Methodology validation

The next step is what is called ‘Construct validity’: each centre that participated in the Barcelona meeting is asked to make 4 or 5 videos of surgical operations performed by both novices and experienced specialists, in order to understand what are the limits of the two groups of urologists and identify the differences between experts and the novices. “The next step is to create a curriculum vitae applied to a simulation system,” Buffi explains, “and then to conduct a randomised prospective study in these reference centres involving 150 European urology residents. The aim is to validate the teaching method and to understand whether the specialists who have followed this type of pathway are actually better prepared. And he concludes – the actual randomised study will start within a year’.