increasing difficulty, moving to the next step once competence in the previous has been attained. This study aimed to compare theory-based training recommendations with how surgeons are trained in reality and thus construct a modular training pathway for use in RARP. METHODS: This multi-institutional, prospective, observational, longitudinal study was conducted using 15 urology trainees from across Europe and Australia. They utilised a validated training tool and data regarding surgeons’ stage of training and progress was collected for analysis. With reference to training recommended in the literature, a modular pathway for RARP training was constructed. RESULTS: 15 surgeons were assessed by their mentors in 425 RARP cases over eight months (range 7-79). There were substantial differences in the order of RARP stages according to the chronology of the procedure, difficulty level and the order in which surgeons were trained in reality. Difficulty for stages of RARP level as recommended by ERUS ranged from I-IV. Median case number for first attempting a stage of RARP ranged from 1-5 (minimum case number 1, maximum case number 59). “Stage 4: Initiation of the console” was the most frequently attempted stage (372 attempts by 15 trainees). “Stage 17: Lymph node dissection” was least frequently attempted (82 attempts by 11 trainees). A new modular training route has been designed (Figure 1). This incorporates the stages of RARP with the following order of priority: difficulty level > median case number of first attempt > most frequently undertaken in surgical training. CONCLUSIONS: An evidence-based modular training pathway has been developed. This should be used to aid surgeons, ensuring that they operate within their capabilities as they progress through their training. Source of Funding: None MP11-04 LEARNING CURVE IN ROBOT-ASSISTED RADICAL PROSTATECTOMY: PRACTICE MAKES PERFECT, BUT WHAT PRACTICE? Catherine Lovegrove*, London, United Kingdom; Giacomo Novara, Padua, Italy; Khurshid Guru, Buffalo, NY; Alex Mottrie, Aalst, Belgium; Ben Challacombe, London, United Kingdom; Johar Raza, Buffalo, NY; Henk Van der Poel, Amsterdam, Netherlands; James Peabody, Detroit, MI; Rick Popert, Prokar Dasgupta, Kamran Ahmed, London, United Kingdom INTRODUCTION AND OBJECTIVES: Reduced training hours and novel technology require that surgical training be adapted accord- ingly. Effective use of observation, simulation and clinical practice can enhance progression along the learning curve and promote patient safety. This study sought to examine the effect of prior experience in dry-lab simulation, robotic simulation and clinical experience on the learning curve for technical skills in robot-assisted radical prostatec- tomy (RARP). METHODS: A multi-institutional, prospective, observational, longitudinal study was conducted using a validated training tool with a scoring scale to measure technical competence in RARP procedural stages. 15 urology trainees and their mentors from Europe and Australia were recruited to examine their learning curves for the pro- cedure. Their previous experiences were noted to assess what effect this had on the technical competence attained. RESULTS: Over eight months, 15 surgeons were assessed by their mentors in 425 RARP cases (range 7-79). Seven surgeons (46.67%) had prior console experience (range 2-8 months). This was associated with a significant difference in scores attained in six of the 17 procedural stages (p<0.05), particularly more challenging steps such as “posterior bladder neck transection” (p¼0.017), “seminal vesicle dissection” (p¼0.029) and “apical dissec- tion of the prostate” (p<0.001). 11/15 surgeons had experience of robotic simulation (73.34%). This related to significantly higher scores in four stages, notably “apical dissection of the prostate” (p¼0.026) and “lymph node dissection” (p¼0.034). 9/15 (60%) surgeons had utilised dry-lab simulation. This was significantly associated to greater technical skill in five stages of RARP. Again, more challenging steps such as “dissection of prostate pedicle and neurovascular bundle +/- nerve preservation” (p¼0.028) and “vesicourethral anastomosis” (p¼0.006). Of steps where there was a difference related to prior experience, 10/15 (66.67%) were difficulty level III or IV. CONCLUSIONS: Prior experience in robotic or dry-lab simula- tion and console experience was associated with significantly greater technical skill in numerous stages of RARP. More difficult steps were frequently associated with a difference in the learning curve attained. Results should be used to design modular curricula to optimise surgical training experiences. Source of Funding: None MP11-05 IS SEEING BELIEVING? TECHNICAL MENTORSHIP DURING ROBOT-ASSISTED SURGERY Ahmed Hussein*, Somayeh Shafiei, Mohamed Sharif, Basel Ahmad, Ehsan Esfahani, Khurshid Guru, Buffalo, NY INTRODUCTION AND OBJECTIVES: Cognitive and mental workload assessment may play a critical role in defining successful mentorship. We sought to elucidate the cognitive performance metrics of surgical mentor during robot-assisted surgery, and to identify if viewing operative performance of surgical trainees is similar to per- forming robot-assisted surgery for a surgical mentor METHODS: An IRB approved study enrolled 51 robot-assisted surgical procedures performed by single surgeon between 2013 and e112 THE JOURNAL OF UROLOGY â Vol. 195, No. 4S, Supplement, Friday, May 6, 2016