LLM in Urodynamic Education

Urodynamic testing, including cystometry, pressure-flow studies, and electromyography, represents the gold standard for the objective evaluation of lower urinary tract dysfunction. Despite its clinical importance, urodynamic interpretation requires advanced analytical skills, including simultaneous assessment of vesical, abdominal, and detrusor pressures, recognition of technical artifacts, and application of established nomograms. Consequently, mastery of urodynamic interpretation during urology residency training remains challenging and highly dependent on variable case exposure and faculty availability.

This prospective, single-center educational study is designed to assess the effectiveness of a large language model (LLM) configured as an interactive educational tutor in improving urology residents' urodynamic interpretation skills and learning curve. The study aims to determine whether structured, AI-assisted mentorship can provide a standardized and scalable alternative to traditional apprenticeship-based training.

Eligible participants include urology residents without prior formal urodynamic course certification. The educational intervention utilizes a curated library of 45 fully anonymized urodynamic tracings performed in accordance with International Continence Society standards. These cases represent a balanced spectrum of normal findings and common urodynamic diagnoses, including bladder outlet obstruction, detrusor overactivity, and reduced bladder compliance. All cases are validated by experienced urologists prior to inclusion.

The training protocol consists of sequential phases: a baseline assessment (pre-test), structured theoretical instruction delivered via an LLM-based tutoring interface, supervised case analysis with artifact recognition, interactive mentored interpretation, an intermediate assessment (mid-test), reinforcement through independent interpretation followed by AI-guided debriefing, and a final post-test evaluation. Case difficulty across assessment phases is balanced using a stratified randomization approach to ensure equivalent technical complexity.

Participant performance is evaluated using a predefined 16-item objective scoring system assessing technical validity, numerical parameter interpretation, and diagnostic synthesis. All assessments are independently reviewed by two blinded urologists, with adjudication by a third expert in cases of disagreement. Changes in interpretation accuracy over time are used to quantify the learning curve associated with LLM-assisted education.

All urodynamic data are fully anonymized prior to use, and no patient-identifiable information is shared. Participation is voluntary, and written informed consent is obtained from all residents. The study is conducted following institutional ethical standards and aims to provide evidence for the role of large language models as interactive tutors in advanced medical education.