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Checcucci E, Puliatti S, Pecoraro A, Piramide F, Campi R, Carrion DM, Esperto F, Afferi L, Veneziano D, Somani B, Vásquez JL, Fiori C, Mottrie A, Amato M, N'Dow J, Porpiglia F, Liatsikos E, Rivas JG, Cacciamani GE. ESRU-ESU-YAU_UROTECH Survey on Urology Residents Surgical Training: Are We Ready for Simulation and a Standardized Program? EUR UROL SUPPL 2024; 61:18-28. [PMID: 38384440 PMCID: PMC10879935 DOI: 10.1016/j.euros.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 02/23/2024] Open
Abstract
Background Currently, the landscape of surgical training is undergoing rapid evolution, marked by the initial implementation of standardized surgical training programs, which are further facilitated by the emergence of new technologies. However, this proliferation is uneven across various countries and hospitals. Objective To offer a comprehensive overview of the existing surgical training programs throughout Europe, with a specific focus on the accessibility of simulation resources and standardized surgical programs. Design setting and participants A dedicated survey was designed and spread in May 2022 via the European Association of Urology (EAU) mail list, to Young Urologist Office (YUO), Junior membership, European Urology Residents Education Program participants between 2014 and 2022, and other urologists under 40 yr, and via the EAU Newsletter. Intervention A 64-item, online-based survey in accordance with the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) using the platform of Survey Monkey (Portland, OR, USA) was realized. Outcome measurements and statistical analysis The study involved an assessment of the demographic characteristics. Additionally, it explored the type of center, availability of various surgical approaches, presence of training infrastructure, participation in courses, organization of training, and participants' satisfaction with the training program. The level of satisfaction was evaluated using a Likert-5 scale. The subsequent sections delved into surgical training within the realms of open, laparoscopic, robotic, and endoscopic surgery, each explored separately. Finally, the investigation encompassed the presence of a structured training course and the availability of a duly validated final evaluation process. Results and limitations There were 375 responders with a completion rate of 82%. Among them, 75% were identified as male, 50.6% were young urologists, 31.7% were senior residents, and 17.6% were junior residents. A significant majority of participants (69.6%) were affiliated with academic centers. Regarding the presence of dry lab training facilities, only 50.3% of respondents indicated its availability. Among these centers, 46.7% were primarily focused on laparoscopy training. The availability of virtual and wet lab training centers was even more limited, with rates of 31.5% and 16.2%, respectively. Direct patient involvement was reported in 80.5% of cases for open surgery, 58.8% for laparoscopy, 25.0% for robotics, and 78.6% for endourology. It is worth noting that in <25% of instances, training followed a well-defined standardized program comprising both preclinical and clinical modular phases. Finally, the analysis of participant feedback showed that 49.7% of respondents expressed a satisfaction rating of either 4 or 5 points with respect to the training program. The limitations of our study include the low response rate, predominance of participants from academic centers, and absence of responses from individuals not affiliated with the EAU network. Conclusions The current distribution of surgical training centers falls short of ensuring widespread access to standardized training programs. Although dry lab facilities are relatively well spread, the availability of wet lab resources remains restricted. Additionally, it appears that many trainees' initial exposure to surgery occurs directly with patients. There is a pressing need for continued endeavors to establish uniform training routes and assessment techniques across various surgical methodologies. Patient summary Nowadays, the surgical training landscape is heterogeneous across different countries. The implementation of a standardized training methodology to enhance the overall quality of surgical training and thereby improving patient outcomes is needed.
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Affiliation(s)
- Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, Candiolo, Turin, Italy
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessio Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Federico Piramide
- Department of Urology, AOU San Luigi Gonzaga – University of Turin, Orbassano (To), Piemonte, Italy
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Diego M. Carrion
- Torrejon University Hospital, Madrid, Spain
- Universidad Francisco de Vitoria, Madrid, Spain
| | - Francesco Esperto
- Department of Urology, Campus Biomedico University of Rome, Rome, Italy
| | - Luca Afferi
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | | | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Cristian Fiori
- Department of Urology, AOU San Luigi Gonzaga – University of Turin, Orbassano (To), Piemonte, Italy
| | - Alex Mottrie
- Department of Urology, OLV Hospital, Aalst, Belgium
- ORSI Academy, Melle, Belgium
| | - Marco Amato
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
- Department of Urology, Aberdeen Royal Infirmary, Aberdeen, UK
| | - Francesco Porpiglia
- Department of Urology, AOU San Luigi Gonzaga – University of Turin, Orbassano (To), Piemonte, Italy
| | | | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, Madrid, Spain
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Ghiasian L, Aghili S, Abdolalizadeh P. Impact of COVID-19 on cataract surgical competency of ophthalmology residents. Indian J Ophthalmol 2023; 71:3696-3700. [PMID: 37991306 PMCID: PMC10788761 DOI: 10.4103/ijo.ijo_1242_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/21/2023] [Accepted: 09/04/2023] [Indexed: 11/23/2023] Open
Abstract
CONTEXT Coronavirus disease 2019 (COVID-19) pandemic led to a decrease in elective surgeries. PURPOSE To compare the performance of postgraduate year 4 prepandemic (2018-2019) and pandemic (2021-2022) ophthalmology residents. SETTINGS AND DESIGN This was an observational comparative study conducted at a university-based hospital. METHODS Ophthalmology residents of postgraduate year 4 during prepandemic (2018-2019) and pandemic (2021-2022) time periods were included. The performances of residents in phacoemulsification were scored by a single faculty assessor using the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric for phacoemulsification (ICO-OSCAR: phaco). The scores were compared between the two groups. STATISTICAL ANALYSIS USED The comparisons between the pre- and post-pandemic groups were performed using the Chi-square and Mann-Whitney U test. RESULTS Seventy-one surgeries were rated in each group. All task-specific and global scores of the pandemic group were lower than those of the prepandemic group (all P values < 0.001). The maximum intergroup difference was in capsulorrhexis circular completion (difference of 1.21 score, P < 0.001) and tissue handling (difference of 1.21 score, P < 0.001) among task-specific and global scores, respectively. The residents of the two groups had the highest similarity in irrigation and aspiration (difference of 0.61 score, P < 0.001) from task-specific scores and central eye position from global scores (difference of 0.93 score, P < 0.001). CONCLUSION The COVID-19 pandemic has negatively affected the surgical competency of ophthalmology residents in phacoemulsification.
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Affiliation(s)
- Leila Ghiasian
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - SeyyedSaeed Aghili
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parya Abdolalizadeh
- Department of Ophthalmology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Ghosh P, Kurian AT, Velmurugan D, Tharumaraj M. Impact of COVID-19 pandemic on surgical residency: Residents' perception. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:398. [PMID: 38333163 PMCID: PMC10852176 DOI: 10.4103/jehp.jehp_252_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 02/10/2024]
Abstract
BACKGROUND World Health Organization declared COVID-19 outbreak a pandemic, and till the month of March 2023, globally, there have been 761,402,282 confirmed cases of COVID-19, including 6887,000 deaths. In India, almost 44,707,525 cases been recorded till date. Here, almost 30,000,000 cases been recorded after the second wave. The working force fighting this pandemic is majority formed by resident doctors all over the country and globally. MATERIALS AND METHODS This study was conducted among 110 residents pursuing postgraduation in surgery and allied departments in various training institutions in Tamil Nadu for a duration of 6 months (after the second wave). A pretested and validated questionnaire was formulated to assess the effect of COVID-19 pandemic on surgical trainee's residency program from their perspective. The questionnaire contained basic social-demographic details and general information like the details of surgical specialty they are admitted to, the overall details of changes in their surgical residency experience in the times of COVID pandemic and the changes faced by them in their day-to-day clinical, diagnostic, and surgical learning. The questionnaire also investigated the redeployment status of the surgical trainees to COVID treatment units and their perspective on the changes in their clinical research and surgical skills training. RESULTS The study participants, 66%, were aged between 25 and 30 years, followed by 30 and 35 years (25.5%). Almost 80% of the participants belong to the final year of postgraduation; 67.3% of surgical trainees strongly perceives and all 100% of them accept the fact that their surgical residency has been affected by the ongoing pandemic. Fifty percent of the trainees were redeployed to COVID duties for 8 h a day shift and rest attended a minimum of 4 h of COVID duties. More than 75% of the residents had COVID duties of 5-10 h/day and more than 90% of these redeployed trainees involved in COVID duties have expressed that they had been suffering from extra stress and more than 60% were suffering from stress grade between 5 and 10 suggestive of high-stress level. Fifty-nine percent of the postgraduates in the current study mentioned that they require extra-surgical or skill-based training after their postgraduation period. CONCLUSION The influence of COVID-19 on surgical trainees in various institutions of India has been immense due to overburdening of health systems by the large population of the country. Second wave of COVID, especially, has drastically changed the postgraduate surgical trainees' lives. Detrimental effects are not restricted to operative and clinical experience but also the mental health and well-being of them. The observations of the present study make recommendations for the future provision of training through skill-based surgical simulations so that the lost days of their trainings can be compensated and they become the confident surgeons of the future.
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Affiliation(s)
- Puja Ghosh
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Andrew Thomas Kurian
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Dinesh Velmurugan
- Department of Otorhinolaryngology, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
| | - Muthukumar Tharumaraj
- Department of Community Medicine, Bhaarath Medical College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, Tamil Nadu, India
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Rodler S, Bujoreanu CE, Baekelandt L, Volpi G, Puliatti S, Kowalewski KF, Belenchon IR, Taratkin M, Rivas JG, Veccia A, Piazza P, Carrion DM, Cacciamani GE, Esperto F, Checcucci E. The Impact on Urology Residents' Learning of Social Media and Web Technologies after the Pandemic: A Step Forward through the Sharing of Knowledge. Healthcare (Basel) 2023; 11:1844. [PMID: 37444678 DOI: 10.3390/healthcare11131844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023] Open
Abstract
The COVID-19 pandemic has impacted urology residents and their training. However, several new technologies or knowledge platforms as social media (SoMe) and web-based learning solutions have filled this gap. Therefore, we aimed to analyze resident's learning curves of new learning modalities, identify the evidence that is provided in the literature, and evaluate the possible impact of such solutions in the future. We conducted a non-systematic literature search using Medline, PubMed, and Embase. In addition, online resources of national and international urology resident societies were queried. The identified paper described SoMe, webinars, podcasts, pre-recorded surgical videos, educational platforms, and mobile apps in the field of urology that are used to gain access to information, teach and provide feedback to residents, and were used under the conditions of the pandemic. The application of those technologies harbors the risk of mis- and disinformation, but have the potential to provide access to education and validated knowledge, training, and feedback and thereby might democratize training of residents in urology globally.
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Affiliation(s)
- Severin Rodler
- Department of Urology, LMU University Hospital, LMU Munich, 81377 Munich, Germany
| | | | - Loic Baekelandt
- Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Gabriele Volpi
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
| | - Stefano Puliatti
- Department of Urology, University of Modena and Reggio Emilia, 42121 Modena, Italy
| | - Karl-Friedrich Kowalewski
- Department of Urology, University Medical Center Mannheim, University of Heidelberg, 68167 Mannheim, Germany
| | - Ines Rivero Belenchon
- Urology and Nephrology Department, Virgen del Rocío University Hospital, Manuel Siurot s/n, 41013 Seville, Spain
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, 119435 Moscow, Russia
| | - Juan Gomez Rivas
- Department of Urology, Hospital Clinico San Carlos, 28040 Madrid, Spain
| | - Alessandro Veccia
- Urology Unit, Azienda Ospedaliera Universitaria Integrata Verona, 37126 Verona, Italy
| | - Pietro Piazza
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Diego M Carrion
- Department of Urology, Torrejon University Hospital, 28850 Madrid, Spain
- Department of Urology, Universidad Francisco de Votoria, 28223 Madrid, Spain
| | | | - Francesco Esperto
- Department of Urology, Campus Biomedico, University of Rome, 00128 Rome, Italy
| | - Enrico Checcucci
- Department of Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
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The state of general surgery residents in Italy after COVID-19 outbreak: a nationwide cross-sectional study. Updates Surg 2023; 75:95-103. [PMID: 36057026 PMCID: PMC9440313 DOI: 10.1007/s13304-022-01370-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/25/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION A significant reorganization of working activities including those of teaching hospitals occurred after COVID-19 outbreak, leading to the need to re-assess the current status of training after the pandemic. This study aimed to investigate the state of general surgery (GS) residency in Italy. The impact of COVID-19 on GS residents was also assessed. METHODS Between October and November 2020, an anonymous online survey was distributed to GS residents across Italy. Email addresses were provided by the Regional Committees of the Italian Polyspecialistic Society of Young Surgeons. The residents completed a set of questions regarding their training schedule and three standardized questionnaires to measure burnout and psychological distress. RESULTS Overall, 1709 residents were contacted and 648 completed the survey. Almost two-thirds of the residents (68.4%, n = 443) reported to not reach the minimum annual operative case volume. According to ordinal logistic regression analysis, two of the most perceived effects of COVID-19 by trainees on training were reduction of surgical activities (OR = 2.21, p < 0.001) and increased concerns about future employment (OR = 1.14, p = 0.025). Loss of training opportunities was also associated with a significant increase of distress (OR = 1.26, p = 0.003) but not with burnout. CONCLUSIONS This study provided a snapshot of the situation of GS residents in Italy after COVID-19 outbreak. Reduction of activities due to pandemic highlighted the need to improve the level of surgical education in our country by implementing all the new available tools for training and ensuring at the same time the well-being of the residents.
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Guerrieri R, Rovati L, Dell’Oglio P, Galfano A, Ragazzoni L, Aseni P. Impact of the COVID-19 Pandemic on Urologic Oncology Surgery: Implications for Moving Forward. J Clin Med 2021; 11:171. [PMID: 35011911 PMCID: PMC8745246 DOI: 10.3390/jcm11010171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/21/2021] [Accepted: 12/28/2021] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic has caused the destruction of routine hospital services globally, leading to an increase in the backlog of elective surgery cases. The aim of the study was to retrospectively investigate the pandemic's impact on the urologic oncology surgical activity of a high-volume center located in Milan, Italy. The number and type of procedures performed in 2020 during the COVID-19 pandemic was evaluated using 2019 data as control. Waiting times for each surgical procedure were compared, on a bimonthly basis, between the two different years. Overall, a 26.7% reduction in the number of urologic oncology surgeries between 2019 and 2020 was observed (2019: 720, 2020: 528). Both the main indication for surgery and the type of procedure performed significantly differed between 2019 and 2020 (all p < 0.0001), with a decrease in the number of radical prostatectomies and an increase in the number of radical cystectomies and radical nephrectomies/nephroureterectomies performed in 2020. Waiting time decreased by 20% between 2019 and 2020, with the most significant reduction seen after the first wave of the COVID-19 pandemic (July-October 2020), in particular for partial nephrectomy and radical prostatectomy, possibly due to the underdiagnosis of cases. In conclusion, in accordance with recommendations by international urological societies on prioritization strategies for oncological procedures, a higher proportion of surgeries for high-risk tumors was performed in 2020 at our center at the expense of procedures for lower risk diseases; however, future implications for patients' prognosis still need to be determined.
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Affiliation(s)
- Rossella Guerrieri
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
| | - Lucrezia Rovati
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy
| | - Paolo Dell’Oglio
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (P.D.); (A.G.)
| | - Antonio Galfano
- Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (P.D.); (A.G.)
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, 28100 Novara, Italy;
| | - Paolo Aseni
- Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milano, Italy; (R.G.); (P.A.)
- Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, 20157 Milano, Italy
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