Shaping the future of endourology: role of education, simulation and uro-technology: a scoping review by the EAU Section of Endourology.

PURPOSE OF REVIEW: This scoping review synthesizes contemporary evidence on the role of simulation, uro-technology and structured training curricula in shaping the next generation of endourologists, both inside and outside of the operating theatre. RECENT FINDINGS: A broad range of simulation platforms - spanning low-fidelity benchtop models, virtual reality systems and high-fidelity hybrid simulators - have demonstrated validity in endourological training across ureteroscopy, percutaneous nephrolithotomy, transurethral surgery and laparoscopy, with several also showing skill transfer to the clinical environment. Proficiency-based progression curricula such as the Endoscopic Stone Treatment Steps 1 and 2, and the ENTRY project for transurethral bladder tumour resection, represent the current standard of structured competency-based training. Artificial intelligence is rapidly evolving and shaping simulation training by facilitating automated performance assessment and personalized, adaptive feedback. Simulation in paediatric endourology unfortunately remains a considerable gap. SUMMARY: Endourological training is at a turning point in history where simulation and uro-technology are shifting the learning phase away from the operating theatre. Structured, PBP-based curricula with objective performance metrics offer the most robust framework for competency development and new technologies will help individualize the learning pathway, assuring proficiency is reached prior to clinical exposure. Several hurdles still need to be taken before this can be made widely available for all urological trainees.