BACKGROUND: The European School of Urology (ESU) started the European Urology Residents Education Programme (EUREP) in 2003 for final year urology residents, with hands-on training (HOT) added later in 2007. OBJECTIVE: To assess the geographical reach of EUREP, trainee demographics, and individual quality feedback in relation to annual methodology improvements in HOT. DESIGN, SETTING, AND PARTICIPANTS: From September 2014 to October 2017 (four EUREP courses) several new features have been applied to the HOT format of the EUREP course: 1:1 training sessions (2015), fixed 60-min time slots (2016), and standardised teaching methodology (2017). The resulting EUREP HOT format was verified by collecting and prospectively analysing the following data: total number of participants attending different HOT courses; participants' age; country of origin; and feedback obtained annually. RESULTS AND LIMITATIONS: A total of 796 participants from 54 countries participated in 1450 HOT sessions over the last 4 yr. This included 294 (20%) ureteroscopy (URS) sessions, 237 (16.5%) transurethral resection (TUR) sessions, 840 (58%) basic laparoscopic sessions, and 79 (5.5%) intermediate laparoscopic sessions. While 712 residents (89%) were from Europe, 84 (11%) were from non-European nations. Of the European residents, most came from Italy (16%), Germany (15%), Spain (15%), and Romania (8%). Feedback for the basic laparoscopic session showed a constant improvement in scores over the last 4 yr, with the highest scores achieved last year. This included feedback on improvements in tutor rating (p=0.017), organisation (p<0.001), and personal experience with EUREP (p<0.001). Limitations lie in the difficulties associated with the use of an advanced training curriculum with wet laboratory or cadaveric courses in this format, although these could be performed in other training centres in conjunction with EUREP. CONCLUSIONS: The EUREP trainee demographics show that the purpose of the course is being achieved, with excellent feedback reported. While European trainees dominate the demographics, participation from a number of non-European countries suggests continued ESU collaboration with other national societies and wider dissemination of simulation training worldwide. PATIENT SUMMARY: In this paper we look at methodological improvements and feedback for the European Urology Residents Education Programme hands-on-training over the last 4 yr.

AMC University Hospital Amsterdam The Netherlands

Department of Urology and Andrology General Hospital Hall in Tirol Austria

Department of Urology and Kidney Transplant Grande Ospedale Metropolitano Reggio Calabria Italy; School of Medicine Hofstra University New York NY USA; Life and Health Sciences Research Institute School of Medicine University of Minho Braga Portugal

Department of Urology and Oncology St Antonius Hospital Gronau Germany

Department of Urology Athens Medical Centre Athens Greece

Department of Urology Azienda Ospedaliero Universitaria di Careggi Florence Italy

Department of Urology Charles University 2nd Faculty of Medicine and University Hospital Motol Prague Czech Republic

Department of Urology Charles University Prague Czech Republic

Department of Urology Erasme Hospital University Clinics of Brussels Brussels Belgium

Department of Urology Fundaciò Puigvert Universitat Autònoma de Barcelona Barcelona Spain

Department of Urology Havenziekenhuis Rotterdam The Netherlands

Department of Urology Institut Mutualiste Montsouris Paris France

Department of Urology Ospedale San Raffaele Turro Milan Italy

Department of Urology SLK Klinikum Heilbronn Heilbronn Germany

Department of Urology St James's University Hospital Leeds Teaching Hospitals NHS Leeds UK

Department of Urology St John of God Hospital Vienna Austria

Department of Urology The North West London Hospitals NHS Trust Imperial College Healthcare NHS London UK

Department of Urology University Hospital Gasthuisberg Katholieke Universiteit Leuven Leuven Belgium

Department of Urology University Hospital Motol Prague Czech Republic

Department of Urology University Hospital Pilsen Pilsen Czech Republic

Department of Urology University of Athens Athens Greece

Department of Urology University of Southampton Southampton UK

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