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Ong K, Bald P, Dryhurst D, Ahmed S, Yusuf GT, Lunawat R, Sriprasad S, Thapa G, Tirnoveanu A, Webb R, Rahman E. The design and validation of a low-cost trans perineal (TP) prostate biopsy simulator for training: improving trainees' confidence and cognitive targeting skills. World J Urol 2023:10.1007/s00345-023-04387-y. [PMID: 37129680 PMCID: PMC10153043 DOI: 10.1007/s00345-023-04387-y] [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: 01/03/2023] [Accepted: 03/27/2023] [Indexed: 05/03/2023] Open
Abstract
PURPOSE The aim of this research was to create a novel and low-cost TP prostate biopsy simulator that has face, content and construct validity with high educational value. METHODS This research developed a trans perineal prostate (TP) biopsy simulator using 3D-printed moulds and tissue-mimicking materials. Important regions (anterior, mid, and posterior zones) were coded with different colours. Ultrasound visible abnormal lesions were embedded in the prostate phantom. Expert and novice participants in TP biopsies were recruited. Essential skills were identified through the consensus of six experts. These skills were assessed through tasks performed by participants. This included the accuracy and timing of systematic and target biopsies. Immediate feedback was determined by the colour of the biopsy cores taken. A survey was distributed to evaluate its realism and educational value. RESULTS The material cost of one simulator was £7.50. This simulator was proven to have face, content, and construct validity. There was a significant difference (p = 0.02) in the accuracy of systematic biopsies between both experts and novices. Significant difference was also observed (p = 0.01), in accurately identifying target lesion on ultrasound between both groups. Participants rated the overall realism of the simulator 4.57/5 (range 3-5). 100% of the experts agreed that introducing this simulator to training will be beneficial. 85.7% of the participants strongly agree that the simulator improved their confidence in TP biopsies. CONCLUSION There is value in integrating this proof-of-concept TP prostate biopsy simulator into training. It has highly rated educational value and has face, content, and construct validity.
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Affiliation(s)
- Kelly Ong
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Philip Bald
- Institute of Mechanical Engineers (IMechE), London, UK
| | - David Dryhurst
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Saif Ahmed
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Gibran Tim Yusuf
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Rahul Lunawat
- Princess Royal University Hospital, Farnborough Common, Bromley, Kent, BR6 8ND, UK
| | - Seshadri Sriprasad
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Gauri Thapa
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Alice Tirnoveanu
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Richard Webb
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK
| | - Eqram Rahman
- Institute of Medical Sciences, Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, Rowan Williams Court, 30 Pembroke Court, Chatham Maritime, Kent, ME4 4UF, UK.
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Khan RN, Siddiqui NA. The Use of Formative Assessment in Postgraduate Urology Training: A Systematic Review. Cureus 2022; 14:e27162. [PMID: 36017282 PMCID: PMC9393543 DOI: 10.7759/cureus.27162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/05/2022] Open
Abstract
Formative assessment is an essential component of surgical training. However, it is not usually a mandatory component in postgraduate curricula. The purpose of this study is to identify and evaluate how formative assessments are integrated into postgraduate urology training in programs across the globe. This study consisted of a systemic review to see how formative assessments are being implemented in various urology programs globally. A total of 427 articles were identified for the literature review. Of these, only 10 were included and critically appraised. These studies explored various techniques for exploration of formative assessments in urology training programs, which included established tools, such as portfolio reviews, and direct observations of procedure skills (DOPS); novel tools, including the Dutch urology practical skills (D-UPS) program and Ottawa surgical competency operating room evaluation (O-SCORE); and curricular models. Nine of the 10 articles favored their potential utility in formative assessments. Current literature involving formative assessments in postgraduate urology programs is scarce, and available resources have a high heterogeneity between them. More structured formative assessments need to be incorporated into surgical training programs, and affiliated training institutions should be encouraged to integrate them into their curricula.
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Prudhomme T, Matillon X, Dengu F, de Mazancourt E, Pinar U, Gondran-Tellier B, Freton L, Vallée M, Dominique I, Felber M, Khene ZE, Fortier E, Lannes F, Michiels C, Grevez T, Szabla N, Bardet F, Kaulanjan K, Pradère B, Deschamps JY, Branchereau J. Residents and patients benefit from surgical simulation on a live porcine model, could we consider it as ethical? Prog Urol 2021; 31:618-626. [PMID: 34158220 DOI: 10.1016/j.purol.2021.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/16/2021] [Accepted: 01/29/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The objective was to evaluate, by self-questionnaire, the feeling of participants in surgical training sessions on a live porcine model. METHODS A computerized questionnaire (GoogleForm ©) was sent to the members of the French Association of Urologists-in-Training (AFUF) (fellows and residents). Only questionnaires from Urologists-in-training who had participated in surgical training sessions were included. The sessions consisted of performing surgeries such as laparoscopic nephrectomies or laparoscopic cystectomies. RESULTS Overall, 198 met the inclusion criteria. A total of 36.4% (72/198) of the participants were fellows and 63.6% (126/198) were residents. According to the participants, the main interest of sessions was to be able to train for emergency situations. A total of 79.8% (158/198) of the participants wanted surgical simulation to become compulsory. To their opinion, the main advantage of surgical simulation on a live porcine model was: technical progress in 87.4% (173/198) of cases. A total of 13.1% (26/198) of the participants found it was unethical to perform the first technical procedures on live animal models. A total of 65.7% (130/198) of the participants considered that there is currently no system of substitution. CONCLUSION For the participants, surgical training on a live porcine model allows technical progress while training for serious emergency situations. Surgeons and patients could benefit from this risk-free mock surgical scenario. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- T Prudhomme
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, 44093 Nantes, France; Centre de Recherche en Transplantation et Immunologie (CRTI), UMR1064, INSERM, Université de Nantes, Nantes, France; Department of Urology, Kidney Transplantation and Andrology, Toulouse University Hospital, Toulouse, France.
| | - X Matillon
- Department of Urology and Transplantation, Hospices civils de Lyon, Lyon, France
| | - F Dengu
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
| | - E de Mazancourt
- Department of Urology and Transplantation, Hospices civils de Lyon, Lyon, France
| | - U Pinar
- Department of Urology, University Paris Saclay, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - B Gondran-Tellier
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - L Freton
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France
| | - I Dominique
- Department of Urology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - M Felber
- Department of Urology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Z-E Khene
- Department of Urology, University Hospital of Rennes, Rennes, France
| | - E Fortier
- Department of Urology, Montpellier University Hospital, Montpellier, France
| | - F Lannes
- Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France
| | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - T Grevez
- Department of Urology, Tours University Hospital, Tours, France
| | - N Szabla
- Department of Urology and Transplantation, Caen University Hospital, Caen, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - K Kaulanjan
- Department of Urology, Pointe à Pitre University Hospital, Guadeloupe, France
| | - B Pradère
- Department of Urology, Tours University Hospital, Tours, France
| | - J-Y Deschamps
- Emergency and Critical Care Unit, ONIRIS, School of Veterinary Medecine, La Chantrerie, Nantes, France
| | - J Branchereau
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU de Nantes, 44093 Nantes, France; Centre de Recherche en Transplantation et Immunologie (CRTI), UMR1064, INSERM, Université de Nantes, Nantes, France; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom
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[Practical skills training : How suitable is Peyton's four-step approach for residents in urology?]. Urologe A 2021; 60:475-483. [PMID: 33201297 DOI: 10.1007/s00120-020-01390-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of residency is to acquire medical skills and abilities. One didactic model is "Peyton's four-step approach". The aim of the present study was to develop and evaluate a modified Peytonian approach for group interactions. The aim was to develop a course for the acquisition of practical skills and training assistants in suture techniques for urology. METHODS A prospective study was conducted with a total of 38 participants and 6 tutors. In a modified four-step Peytonian approach, various suturing and knotting techniques were taught in a structured manner. Tutors evaluated the procedural activity using observation sheets. In addition, the learning method was evaluated by the participants and the tutors at the end of the course. In order to check the long-term learning success, a renewed survey of the participants was conducted after 6 months. RESULTS 80% of the participants rated the modified teaching method as useful and 83% of the tutors rated the procedural implementation as good. Fluid movement sequences were difficult independent of the technique taught. After 6 months, the participants significantly improved their procedural skills in all techniques that were taught. CONCLUSION This paper defines a four-step Peyton-based approach to teaching practical skills such as suturing and knotting used in urological training. The modified teaching method improved practical skills used in urology. This method should be considered in continuing education to promote self-confidence and increase the competence in surgical skills.
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Aslam AU, Philipraj J, Jaffrey S, Buchholz N. A global snapshot of endourology residency training. Arch Ital Urol Androl 2020; 92. [PMID: 33016052 DOI: 10.4081/aiua.2020.3.219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 04/01/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Urology has become more complex over the last decades with surgical sophisticated technologies such as endoscopy, laparoscopy and robotic surgery. As these minimally invasive methods gain popularity throughout the world, this has led in some countries to a serious training gap as compared to other countries, and between generations of surgeons within national training systems. There is a huge heterogeneity in urological training between countries, whether developed or developing. This paper attempts to shed some light onto global urological training, comparing a significant number of various national systems, and to outline global tendencies in urological training. It will enable interested readers to see where their own system stands in international comparison, and hopefully enable them to identify training needs to achieve global quality standards. MATERIALS AND METHODS This is a questionnaire-based assessment which was sent to 240 members of U-merge from 62 countries. In addition, there is ample literature on the requirements of structured training programs and assessments, and we have tried to briefly outline the key points in this paper. RESULTS We received responses from 32 countries Urology residency training is hugely heterogenous between countries. Only 44% of nations use a structured training program with assessments. Others use the Halstedian apprenticeship approach. Notably, some developing countries do use modern teaching and assessment methods, whereas some developed countries still use the outmoded apprenticeship model. For the interested reader, results have been tabled in detail, and training systems described country by country. CONCLUSIONS Our results have shown a huge heterogeneity in quality urology training between countries and within continents. In systems without national structure of training, it can be assumed that such differences exist even between hospitals/ training institutions. There is no doubt in times of globalization with resident and doctor migration and exchanges that training needs structure and standardization. The still huge gap in developing countries to catch up and be able to afford latest surgical and learning technologies need to be addressed with the help of responsible outreach programs.
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Affiliation(s)
- Asad Ullah Aslam
- U-merge Ltd. (Urology for emerging countries), London, UK; Dept. of Urology, Letterkenny University Hospital, Saolta Healthcare Group.
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Acosta T, Sutton JM, Dotters-Katz S. Improving Learners' Comfort With Cesarean Sections Through the Use of High-Fidelity, Low-Cost Simulation. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:10878. [PMID: 32175471 PMCID: PMC7062555 DOI: 10.15766/mep_2374-8265.10878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 09/07/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Several studies have demonstrated effective simulation-based training for laparoscopic procedures in OB/GYN, but limited simulation curricula exist for abdominal procedures, particularly cesarean sections (CSs). METHODS We developed a high-fidelity modification of an existing CS model costing about $25 and incorporated it into a 90-minute teaching simulation event for medical students and OB/GYN residents in a single academic program. The simulation included a structured curriculum, pre-/postsimulation surveys, a surgical instrument review, a mannequin with the CS model containing a fetus in breech position, and live video streaming. Our surveys assessed participants' comfort with the procedure and its related components on a 5-point scale, and we used a paired t test to analyze our data. RESULTS Twenty-two learners (eight third-year medical students, one fourth-year medical student, three first-year residents, four second-year residents, one third-year resident, four fourth-year residents, and one unknown level) participated in this simulation. We found a statistically significant improvement in perceived CS instrument knowledge, suturing skills, and satisfaction with the model among all participants. Only third-year medical students had a statistically significant increase in comfort level in performing a CS after the simulation. Video streaming engaged a wider audience, but poor lighting and audio limited its efficacy. DISCUSSION Using this simulation model at the end of medical school or early in residency may have the greatest positive effect on resident comfort with CSs. This low-cost and versatile model can be used across educational settings, including OB/GYN interest group activities, intern boot camp, and interprofessional emergency drills.
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Affiliation(s)
- Tatiana Acosta
- Resident, Department of Obstetrics and Gynecology, Duke University Medical Center
| | - Jill Marie Sutton
- Clinical Associate Professor, Department of Obstetrics and Gynecology, Brody School of Medicine at East Carolina University
- Director of Undergraduate Medical Education, Department of Obstetrics and Gynecology, Brody School of Medicine at East Carolina University
| | - Sarah Dotters-Katz
- Assistant Professor, Department of Obstetrics and Gynecology, Duke University School of Medicine
- Director of Undergraduate Medical Education, Department of Obstetrics and Gynecology, Duke University School of Medicine
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Silvestre J, Hernandez JM, Lee DI. Disparities in Pediatric Operative Experience during Urology Residency Training. Urology 2019; 127:24-29. [DOI: 10.1016/j.urology.2019.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/01/2019] [Accepted: 02/04/2019] [Indexed: 12/28/2022]
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Flanders D, Pirpiris A, Corcoran N, Forsyth R, Grills R. Lessons Learned and New Challenges: Re-evaluation of End-User Assessment of a Skills-Based Training Program for Urology Trainees. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2019; 6:2382120519834552. [PMID: 30886895 PMCID: PMC6415477 DOI: 10.1177/2382120519834552] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 01/31/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To re-assess the perceived benefit and relevance of simulation sessions to Victorian urology trainees and to identify areas for potential improvement. SUBJECTS AND METHODS All trainees attending skills training sessions between 2011 and 2016 were asked to complete a structured questionnaire at the completion of the session. The questionnaire included 11 topic areas ranging from the year of surgical training to degree of usefulness of the session, including several sections for free-text response to offer more detailed feedback. Sessions were examined both individually and collectively to assess end-user satisfaction with the structure and content of the program. RESULTS In total, 24 individual skills sessions were held over the 6-year period, with a total of 355 attendees. Of these, 331 attendees completed the majority of the questionnaire, a response rate of over 93%. Overall 88% of the surveyed attendees stated that they had both the support of their supervising consultant and the flexibility of workload to attend the session; 90% of trainees felt that there was adequate reading material provided prior to the skills session, an improvement from 76% in the previous study period; and 97% of those surveyed felt that the existing session structure was appropriate and the same proportion found the sessions both useful and interesting, compared with just 63% in the previous study period. Analysis of individual topics demonstrates some variability in outcome measures, but for nearly every assessed parameter, greater than 90% of participants agreed that the session fulfilled the expected criteria. New topics developed since the 2011 analysis, including renal transplant and vascular repair, also had high levels of satisfaction. The practical models used have been refined and achieved higher scores than those in the previous assessment period. CONCLUSION The urology skills-based training program has been well received by the surveyed trainees and is now embedded and accepted as part of the Victorian training program. The format of the sessions has matured and the overall rating, both individually and collectively, was high. There has been a clear increase in satisfaction across most areas assessed when compared with previous feedback. Despite this, there remain areas that can be improved, such as the amount and quality of available equipment and the inclusion of video demonstrations of operative techniques.
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Affiliation(s)
- Damian Flanders
- Department of Urological Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Athina Pirpiris
- Department of Urological Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
| | - Niall Corcoran
- Department of Urology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Surgery, The University of Melbourne, Melbourne, VIC, Australia
- Australian Prostate Cancer Research Centre Epworth, Melbourne, VIC, Australia
- Urology Department, Frankston Hospital, Melbourne, VIC, Australia
| | - Robert Forsyth
- Urology Department, Ballarat Health Services, Ballarat, VIC, Australia
- St John of God Health Care, Ballarat, VIC, Australia
- Urological Society of Australia and New Zealand, Sydney, NSW, Australia
| | - Richard Grills
- Department of Urological Surgery, University Hospital Geelong, Barwon Health, Geelong, VIC, Australia
- Urological Society of Australia and New Zealand, Sydney, NSW, Australia
- Department of Surgery, Deakin University, Geelong, VIC, Australia
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Neumann E, Mayer J, Russo GI, Amend B, Rausch S, Deininger S, Harland N, da Costa IA, Hennenlotter J, Stenzl A, Kruck S, Bedke J. Transurethral Resection of Bladder Tumors: Next-generation Virtual Reality Training for Surgeons. Eur Urol Focus 2018; 5:906-911. [PMID: 29802051 DOI: 10.1016/j.euf.2018.04.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 03/28/2018] [Accepted: 04/16/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND The number of virtual reality (VR) simulators is increasing. The aim of this prospective trial was to determine the benefit of VR cystoscopy (UC) and transurethral bladder tumor resection (TURBT) training in students. DESIGN, SETTING, AND PARTICIPANTS Medical students without endoscopic experience (n=51, median age=25 yr, median 4th academic year) were prospectively randomized into groups A and B. After an initial VR-UC and VR-TURBT task, group A (n=25) underwent a video-based tutorial by a skilled expert. Group B (n=26) was trained using a VR training program (Uro-Trainer). Following the training, every participant performed a final VR-UC and VR-TURBT task. Performance indicators were recorded via the simulator. Data was analyzed by Mann-Whitney U test. INTERVENTION VR cystoscopy and TURBT. RESULTS AND LIMITATIONS No baseline and post-training differences were found for VR-UC between groups. During baseline, VR-TURBT group A showed higher inspected bladder surface than group B (56% vs 73%, p=0.03). Subgroup analysis detected differences related to sex before training (male: 31.2% decreased procedure time; 38.1% decreased resectoscope movement; p=0.02). After training, significant differences in procedure time (3.9min vs 2.7min, p=0.007), resectoscope movement (857mm vs 529mm, p=0.005), and accidental bladder injury (n=3.0 vs n=0.88, p=0.003) were found. Male participants showed reduced blood loss (males: 3.92ml vs females: 10.12ml; p=0.03) after training. CONCLUSIONS Measuring endoscopic skills within a virtual environment can be done easily. Short training improved efficacy and safety of VR-TURBT. Nevertheless, transfer of improved VR performance into real world surgery needs further clarification. PATIENT SUMMARY We investigated how students without endoscopic experience profit from simulation-based training. The safe environment and repeated simulations can improve the surgical training. It may be possible to enhance patient's safety and the training of surgeons in long term.
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Affiliation(s)
- Eva Neumann
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | - Julian Mayer
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | - Giorgio Ivan Russo
- University Tuebingen, Dept. of Urology, Tuebingen, Germany; University of Catania, Urology Section, Catania, Italy
| | - Bastian Amend
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | - Steffen Rausch
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | | | - Niklas Harland
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | | | | | - Arnulf Stenzl
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | - Stephan Kruck
- University Tuebingen, Dept. of Urology, Tuebingen, Germany
| | - Jens Bedke
- University Tuebingen, Dept. of Urology, Tuebingen, Germany.
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de Vries AH, Schout BMA, van Merriënboer JJG, Pelger RCM, Koldewijn EL, Muijtjens AMM, Wagner C. High educational impact of a national simulation-based urological curriculum including technical and non-technical skills. Surg Endosc 2016; 31:928-936. [PMID: 27387182 DOI: 10.1007/s00464-016-5060-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 06/16/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants. METHODS Educational impact was assessed by means of qualitative individual module-specific feedback and a quantitative cross-sectional survey among residents and supervisors. Twenty out of 26 Dutch teaching hospitals participated. The survey focussed on practical aspects, the D-UPS curriculum in general, and the impact of the D-UPS curriculum on the development of technical and non-technical skills. RESULTS A considerable survey response of 95 % for residents and 76 % for supervisors was obtained. Modules were attended by junior and senior residents, supervised by a urologist, and peer teaching was used. Ninety percent of supervisors versus 67 % of residents judged the D-UPS curriculum as an important addition to current residency training (p = 0.007). Participants' aggregated general judgement of the modules showed a substantial percentage favorable score (M ± SE: 57 ± 4 %). The impact of training on, e.g., knowledge of materials/equipment and ability to anticipate on complications was high, especially for junior residents (77 ± 5 and 71 ± 7 %, respectively). Focus points for improvement of the D-UPS curriculum according to the participants include adaptation of the training level to residents' level of experience and focus on logistics. CONCLUSION The simulation-based D-UPS curriculum has a high educational impact. Residents and supervisors consider the curriculum to be an important addition to current residency training. Focus points for improvement of the D-UPS curriculum according to the participants include increased attention to logistics and integration of a spiral learning approach.
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Affiliation(s)
- Anna H de Vries
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
| | - Barbara M A Schout
- Department of Urology, Alrijne Hospital, Leiden, The Netherlands.,Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | | | - Rob C M Pelger
- Department of Urology, University Medical Center Leiden, Leiden, The Netherlands
| | - Evert L Koldewijn
- Department of Urology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.,School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Arno M M Muijtjens
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Cordula Wagner
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.,Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
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