Advances in evaluating and delivering nontechnical skills training: The use of simulation, robotics, artificial intelligence and virtual reality

PURPOSE OF REVIEW: Nontechnical skills (NTS), such as communication, leadership, and situational awareness, are essential for ensuring surgical safety. However, they are often prioritized less than technical skills. This narrative review summarizes recent technological progress in teaching and evaluating NTS in urology, emphasising the use of simulation, robotic-specific frameworks, and artificial intelligence. RECENT FINDINGS: Validated assessment tools such as NoTSUS and ICARS have been developed to provide objective measures of NTS, particularly to address communication difficulties in the robotic console setting. Recent research indicates that technical seniority does not necessarily correlate with NTS mastery, but the use of distributed and hybrid simulation significantly enhances trainee outcomes. Additionally, the adoption of large language models (LLMs) and machine learning is enabling automated tone and emotion analysis, giving trainees detailed, unbiased feedback. New virtual patient platforms like SimConverse and SimURO provide affordable and psychologically safe environments for repeated NTS practice. SUMMARY: The rapid advancement in urological surgery, marked by increasing use of robotics and greater physical separation from patients, calls for a structured approach to NTS training. Breakthroughs in AI and immersive simulation are shifting NTS from a vague 'soft skill' to a concrete, data-driven, measurable skill. To achieve the best patient results, these digital technologies should be deliberately incorporated into urological education as vital additions to standard technical instruction and mentorship.