Multi-institutional validation of an OSATS for the assessment of cystoscopic and ureteroscopic skills

Omer Burak Argun, Kristin Chrouser, Sanket Chauhan, Manoj Monga, Bodo Knudsen, Geoffrey N. Box, David I. Lee, Matthew T. Gettman, Lauren H. Poniatowski, Qi Wang, Troy E. Reihsen, Robert M. Sweet

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Purpose We evaluated the internal and construct validity of an assessment tool for cystoscopic and ureteroscopic cognitive and psychomotor skills at a multi-institutional level. Materials and Methods Subjects included a total of 30 urology residents at Ohio State University, Columbus, Ohio; Penn Presbyterian Medical Center, Philadelphia, Pennsylvania; and Mayo Clinic, Rochester, Minnesota. A single external blinded reviewer evaluated cognitive and psychomotor skills associated with cystoscopic and ureteroscopic surgery using high fidelity bench models. Exercises included navigation, basketing and relocation; holmium laser lithotripsy; and cystoscope assembly. Each resident received a total cognitive score, checklist score and global psychomotor skills score. Construct validity was assessed by calculating correlations between training year and performance scores (both cognitive and psychomotor). Internal validity was confirmed by calculating correlations between test components. Results The median total cognitive score was 91 (IQR 86.25, 97). For psychomotor performance residents had a median total checklist score of 7 (IQR 5, 8) and a median global psychomotor skills score of 21 (IQR 18, 24.5). Construct validity was supported by the positive and statistically significant correlations between training year and total cognitive score (r = 0.66, 95% CI 0.39-0.82, p = 0.01), checklist scores (r = 0.66, 95% CI 0.35-0.84, p = 0.32) and global psychomotor skills score (r = 0.76, 95% CI 0.55-0.88, p = 0.002). The internal validity of OSATS was supported since total cognitive and checklist scores correlated with the global psychomotor skills score. Conclusions In this multi-institutional study we successfully demonstrated the construct and internal validity of an objective assessment of cystoscopic and ureteroscopic cognitive and technical skills, including laser lithotripsy.

Original languageEnglish (US)
Pages (from-to)1098-1106
Number of pages9
JournalJournal of Urology
Issue number4
StatePublished - Oct 1 2015

Bibliographical note

Publisher Copyright:
© 2015 American Urological Association Education and Research, Inc.


  • endoscopy
  • internship and residency
  • psychomotor performance
  • ureter
  • urinary bladder


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