BACKGROUND Hands-on training in urology for medical students is characterized by several challenges. We tried to improve our practical training day using peer teaching/peer-assisted learning and simulators. METHODS An average of 116 students participated in our practical training day every semester between 2007/2008 and summer semester 2011. We evaluated students' satisfaction, human resources, and student to teacher ratio before and after the restructuring. RESULTS After the restructuring in 2008/2009, all categories showed improvement (1=best; 6=worst). The general rating rose from 2.2 (2008) to 1.45 (2011); practical training improved from 2.85 (2008) to 1.55 (2011). CONCLUSIONS Peer teaching and simulators are reasonable tools in medical education in urology. They increase individual coaching of students and lead to improved satisfaction and subjective learning success. Interprofessional education with the selective use of nursing staff as teachers was widely accepted. With these tools essential hands-on skills in urology can be acquired by all medical students.