Transurethral Catheterization in Early Training: The Impact of Peer-Led Mentorship

Introduction

Transurethral catheterization (TUC) is a common hospital procedure. According to the literature, junior doctors contribute to the majority of TUC-related injuries. Our aim is to evaluate the immediate and long-term impact of a short procedure-centric TUC workshop on junior doctor's confidence, procedural knowledge, and ability to identify potential complications of catheterization.

Materials and Methods

Intern doctors were invited to attend a one-hour workshop on TUC. A questionnaire was completed before and after the workshop. Three months later, the questionnaire was readministered to assess the workshop's long-term impact. The questionnaire consisted of three domains. A: experience, training, and confidence levels (using 5-point Likert scales), B: procedural knowledge (the highest possible score was 10 points), and C: identification of TUC-related complications (the highest possible score was 3 points).

Results

81 interns participated and reported a confidence level of 3.03 ± 1.05 in performing a straightforward TUC. Preworkshop domain B and domain C were 3.92 ± 1.63 and 1.75 ± 0.69 points, respectively. After the workshop, reported confidence levels improved to 3.71 + 1.02 (p < 0.05). Likewise, the scores in domains B and C increased significantly to 8.85 ± 1.40 (p < 0.005) and 2.65 ± 0.6 (p < 0.005), respectively. Three months later, the same parameters were evaluated, and confidence levels were higher than those of the preworkshop levels at 3.83 ± 0.77 (p < 0.05). The average domain B score was 7.85 ± 1.88 (p < 0.005), and domain C score was 2.69 ± 0.53 (p < 0.005). All scores reported after three months were significantly better than the preworkshop levels (p < 0.005), but there were no statistically significant differences when compared to the immediate postworkshop scores (p > 0.05).

Conclusion

Short peer-led TUC workshops positively impact intern doctors' confidence levels, procedural knowledge, and identifying complications.

The effects of COVID-19 on training within urology: Lessons learned in virtual learning, human factors, non-technical skills and reflective practice

The COVID-19 pandemic has changed training and recruitment in urology in unprecedented ways. As efforts are made to ensure trainees can continue to progress, lessons can be learned to improve training and urological practice even after the acute phase of the pandemic is over. Novel methods of education through virtual learning have burgeoned amidst the social distancing the pandemic has brought. The importance of training in human factors and non-technical skills has also been brought to the fore while operating under the constraints of personal protective equipment and working in new teams and unfamiliar environments. This paper critically appraises the available evidence of how urological training has been affected by COVID-19 and the lessons we have learned and continue to learn going forward.

Level of Evidence

Not Applicable.

Urology boot camp for medical students: improving knowledge and confidence in preparation for clinical practice

Objectives:

Undergraduate exposure to urology is limited and junior doctors often feel underprepared for managing urological problems. We therefore established a one-day urology teaching course which covered the entire British Association of Urological Surgeons curriculum.

Methods:

Graduates of a teaching hospital undertook a survey regarding their practical skills and knowledge in urology ( n=20), with responses compared to a sample of students who attended the boot camp ( n=24).

Results:

Forty per cent of graduates thought they knew most of the curriculum and 0% knew the entire curriculum, increasing to 79.4% and 8.3%, respectively, in the post-boot camp cohort. Forty per cent felt ‘mostly prepared’ for final examinations, increasing to 70.8%; 35% rated their knowledge as ‘good’, increasing to 50%, with a further 12.5% feeling it was ‘excellent’; 0% were ‘very confident’ in examination skills, increasing to 20.8%. One hundred per cent of students thought the boot camp helped in preparation for medical finals, 70.8% felt it better prepared them for foundation training. All course candidates thought the course increased their knowledge and skills in urology.

Conclusion:

This urology boot camp improves medical students’ skills and knowledge. This course would benefit medical students nationally, providing comprehensive, standardised training in urology and preparing students for final examinations and foundation years.

Level of evidence:

Not applicable.

Improving Foundation Year doctors’ confidence with routine suprapubic catheter change using an easily reproducible simulation model

Objective:

Previous studies report low confidence levels amongst junior doctors in changing suprapubic catheters (SPC). We aimed to assess and improve foundation doctors’ confidence in changing an SPC, and to identify factors contributing to a lack in confidence. A teaching session using an easily reproducible simulation model was delivered to improve confidence.

Method:

A teaching session on routine SPC changes was delivered to a cohort of 30 Foundation Year 2 doctors within a single hospital. The teaching session comprised a short presentation followed by a practical session with the teaching models. Trainees completed a questionnaire on self-reported confidence levels in catheterisation prior to, and directly after, the session.

Results:

The self-reported confidence level with SPC changes was measured using a 5-point scale (1 = not very confident, 5= very confident), and following the session, the median score increased from 1 to 4. 100% ( N = 28) of trainees felt the teaching session increased their confidence with routine SPC changes and that the simulation model was a useful tool.

Conclusion:

Some junior doctors report low confidence levels with SPC changes. A teaching session on routine SPC changes using a simulation model may improve confidence

Level of evidence:

2c