Global Assessment of Urological Endoscopic Skills (GAUES): development and validation of a novel assessment tool to evaluate endourological skills

Chandra Shekhar Biyani (Lead / Corresponding author), Mithun Kailavasan, Nicholas Rukin, Victor Palit, Bhaskar Somani, Sunjay Jain, Andy Myatt, Ghulam Nabi, Jake Patterson

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
98 Downloads (Pure)


Objective: To develop and evaluate an assessment tool for endourological skills during simulation including cystoscopy, ureteroscopy (URS) and transurethral resection (TUR) procedures.

Methods: We designed a Global Assessment of Urological Endoscopic Skills (GAUES) tool, comprised of nine endourology task-specific and two global-rating skills items. The tool was developed through two rounds of the Delphi process. The GAUES tool was used to assess acquisition of URS and TUR skills of novices (Year 2 core surgical trainees, CT2) and intermediate level trainees (residents at the start of the UK higher surgical training programme in Urology, Speciality Trainee Year 3, ST3) at the Urology Simulation Boot Camp (USBC) between 2016 and 2018. Validity was evaluated by comparing scores between trainees with different levels of urological experience. Inter-rater reliability was also assessed.

Results: We evaluated 130 residents, 52% of trainees were at an intermediate stage of training and 39% were novices. In all, 9% of the anonymous forms were missing demographics. The completion rate of the GAUES tool during the USBC for URS and TUR was 85% and 89%, respectively. Our analysis demonstrated a significant difference in all domains between intermediates and novices at assessment in URS, except for one domain more suited to clinical assessment (P = 0.226). There was excellent intraclass correlation (ICC) overall between the two experts’ judgements, ICC = 0.841 (95% confidence interval 0.767–0.893; P < 0.001, n = 88).

Conclusions: We have developed the novel GAUES tool for cystoscopic, URS and TUR skills. Overall, we demonstrated good face, content and construct validity and excellent reliability, suggesting that the GAUES tool can be useful for endourological skills assessment.

Original languageEnglish
Pages (from-to)665-675
Number of pages11
JournalBJU International
Issue number6
Early online date25 Sept 2020
Publication statusPublished - 6 Jun 2021


  • Simulation
  • Urology
  • Assessment
  • Endourology
  • Skills
  • Ureteroscopy
  • TURP
  • Cystoscopy
  • endourology
  • simulation
  • transurethral resection of the prostate
  • skills
  • assessment
  • #EndoUrology
  • cystoscopy
  • urology
  • ureteroscopy

ASJC Scopus subject areas

  • Urology


Dive into the research topics of 'Global Assessment of Urological Endoscopic Skills (GAUES): development and validation of a novel assessment tool to evaluate endourological skills'. Together they form a unique fingerprint.

Cite this