■ The ultimate goal of surgical education is to ensure competency, reduce error, and improve patient safety.

■ The primary methods of assessment in medical education are based on testing factual knowledge.

■ The ACGME core competencies and the OSATS and OSCE have provided a foundation for a paradigm shift in this concept. In the information age, factual knowledge may be less important.

■ "The student should not be taught what to know, but rather where to find information (trusted sources), how to discriminate among the literally thousands of facts, and, once the correct information is found, how to make the correct decision."

■ Virtual reality simulation is a promising tool that when built into such a dynamic curriculum will be used for objectively training and assessing procedural cognitive and technical skills.

■ A mechanism of funding for postgraduate education skill acquisition, development, training validation, and assessment needs to be implemented before this goal becomes a reality.

As laparoscopic skills become more widely disseminated, laparoscopic skills trainers representing complete procedures for laparoscopic urology procedures are desperately needed and are currently under development by numerous universities and simulation companies.

nSimbionix, Cleveland, OH. "Surgical Science, Göteborg, Sweden. PDublin, Ireland.

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