Evidence map›Paper›PMID 42229882›Full record

SynthesisBJU international2026

Proficiency-based training and evidence-based methodology: a systematic review and meta-analysis.

Ruben De Groote, Edoardo Beatrici, Maria Peraire Lores, Stefano Puliatti, Marco Amato, Elio Mazzone, Rui Farinha, Artur Paludo, Claudia Collà Ruvolo, Eleonora Balestrazzi and 12 more

Abstract readSystematic ReviewMeta-AnalysisReview
In one paragraph

Synthesis in BJU international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Ruben De GrooteORSI Academy, Ghent, Belgium.
Edoardo BeatriciORSI Academy, Ghent, Belgium.
Maria Peraire LoresORSI Academy, Ghent, Belgium.
Stefano PuliattiDepartment of Urology, University of Modena and Reggio Emilia, Modena, Italy.
Marco AmatoDepartment of Urology, University of Modena and Reggio Emilia, Modena, Italy.
Elio MazzoneDepartment of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.ORCID 0000-0003-1932-1800
Rui FarinhaORSI Academy, Ghent, Belgium.
Artur PaludoClinic Hospital of Porto Alegre, Urology, Porto Alegre, Brazil.
Claudia Collà RuvoloORSI Academy, Ghent, Belgium.ORCID 0000-0001-8110-7341
Eleonora BalestrazziORSI Academy, Ghent, Belgium.
Luigi NoceraDepartment of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Carlo Andrea BraviORSI Academy, Ghent, Belgium.
Federico PiramideORSI Academy, Ghent, Belgium.
Marco PaciottiORSI Academy, Ghent, Belgium.
Adele PiroORSI Academy, Ghent, Belgium.
Silvia RebuffoORSI Academy, Ghent, Belgium.
Gabriele SorceORSI Academy, Ghent, Belgium.ORCID 0000-0003-2436-2412
Ben Van CleynenbreugelDepartment of Development and Regeneration, KU Leuven, Leuven, Belgium.
Brendan P BuntingSchool of Psychology, Ulster University, Coleraine, UK.
Wouter EveraertsDepartment of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium.
Alexandre MottrieORSI Academy, Ghent, Belgium.
Anthony G GallagherORSI Academy, Ghent, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess adherence of self-labelled proficiency-based progression (PBP) studies to evidence-based PBP criteria and examine associations with training outcomes.

methodsA systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and registered in the International Prospective Register of Systematic Reviews. PubMed, CENTRAL, EMBASE, MEDLINE, and Scopus were searched from inception to 1 March 2023. Prospective English-language studies on healthcare procedural training reporting objective performance outcomes were included; non-prospective, non-quantitative, non-procedural, non-English studies, and reviews were excluded. Pre-specified outcomes included adherence to 18 evidence-based PBP criteria and objective performance metrics (errors, steps, time); secondary outcomes included proficiency benchmark achievement and Likert ratings. Data extraction was performed independently by multiple reviewers. Study quality was assessed using the Medical Education Research Study Quality Instrument and risk of bias by two investigators. Effect sizes were pooled using random-effects models (DerSimonian-Laird), expressed as the ratio of means (ROM) for continuous outcomes and bias-corrected odds ratios for dichotomous outcomes.

resultsOf 646 studies identified 175 met inclusion criteria. In the PBP studies (n = 18), 94% fulfilled minimum criteria (use of a proficiency benchmark, its quantitative definition, and requirement for demonstration prior to progression) vs 36% of non-PBP studies (n = 157). If all PBP criteria were included, 83% of PBP studies used these criteria vs only 2% of non-PBP-studies. In quantitative analysis (27 randomised clinical studies, 761 participants), ROM results showed that PBP training reduced the number of performance errors by 58% (P < 0.001) and procedural time by 28% (P = 0.006), increasing number of steps performed by 22% (P = 0.03). When stratified based on number of criteria fulfilled, meta-regression demonstrated that increasing the number of PBP criteria fulfilled was associated with progressive and systematic trainee performance improvement.

conclusionsThe more training methodologies adhere to established PBP criteria, the better training outcome will be.

Indexed as

Clinical CompetenceHumanscompetency‐basedProficiency‐based progressionskillssurgerytraining

Identifiers

PMID42229882
PMCPMC13550815

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.