Medical interns' knowledge and training regarding urethral catheter insertion and insertion-related urethral injury in male patients

BMC Medical Education

Brian S Buckley¹  Marie Carmela M Lapitan²  Manuel Manalo³ 

[1] Department of Surgery, Philippine General Hospital, University of the Philippines, Manila;National Institutes of Health, University of the Philippines, Manila;Division of Urology, Department of Surgery, Philippine General Hospital, University of the Philippines, Manila

关键词: urethral;    injuries;    medical;    education;    urinary catheterization;   

Others  :  1154012
DOI  :  10.1186/1472-6920-11-73

 received in 2011-04-27, accepted in 2011-09-27,  发布年份 2011

【 摘 要 】

Background

Improper catheterization can lead to urethral injury. Yet research from four continents suggests training of junior doctors in catheterization is insufficient. European research suggests a majority of catheterization related morbidities occur when the procedure is performed by interns.

Methods

To assess the knowledge and practices of medical interns relating to urethral catheterization and iatrogenic urethral injury secondary to traumatic catheter insertion, a questionnaire survey was conducted of all first year medical interns at a tertiary national university hospital in the Philippines. The questionnaire contained 17 items covering 4 areas: methods of training in catheterization and level of experience; perceived adequacy of training; theoretical knowledge of catheterization; the mechanisms of catheter-related urethral injury.

Results

225/240 interns (94%) completed the survey (130 (57.8%) female). 125 (55.6%) responded that they had adequate theoretical training and 150 (66.7%) adequate practical training. All had performed more than 10 catheterizations and 204 (90%) were supervised when they first performed catheterization. Despite relatively high levels of experience and confidence, deficits were identified in detailed knowledge of correct catheterization procedures and of risks associated with urethral injury.

Conclusions

More thorough training of incoming medical interns in urinary catheterization may help to reduce the risk of complications and injury. Training should be universal and thought given to its timing within the curriculum. Training should include step by step instruction in the process, emphasis on history taking and awareness of factors associated with increased risk of urethral injury.

【 授权许可】

   
2011 Manalo et al; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Carter H, Chan D: Section III: Basic Instrumentation and Cystoscopy. 9th edition. Edited by Wein AJ, Kavoussi LR, Novick AC, Partic AW, Peters CA. Campbell-Walsh Urology; 2007:161-70.
• [2]Thomas AZ, Giri SK, Meagher D, Creagh T: Avoidable Iatrogenic Complications of Urethral Catheterization and Inadequate Intern Training in a Tertiary-care Teaching Hospital. British Journal of Urology 2009, 104:1109-12.
• [3]Kashefi C, Messer K, Barden R, Sexton C, Parsons JK: Incidence and prevention of iatrogenic urethral injuries. Journal of Urology 2008, 179:2254-8.
• [4]Dobrowolski ZF, Weglarz W, Jakubik P, Lipczynski W, Dobrowolska B: Treatment of posterior and anterior urethral trauma. BJU International 2002, 89:752-4.
• [5]GMC: Tomorrow's doctors. Outcomes and standards for undergraduate medical education. [http://www.gmc-uk.org/education/undergraduate/tomorrows_doctors.asp] webcite 2009.
• [6]Bigot P, Rouprêt M, Orsat M, Benoist N, Larré S, Chautard D, et al.: Evaluation of the practical skills of final year medical students: example of bladder catheterization. Prog Urol 2008, 18(2):125-31.
• [7]Cetti RJ, Singh R, Bissell L, Shaw R: The urological foot soldier: are we equipping our foundation-year doctors? Ann R Coll Surg Engl (Suppl) 2010, 92:284-7.
• [8]Eziyi AK, Ademuyiwa SO, Eziyi JAE, Salako AA, Aderounmu AOA, Oyedeji ASA: Knowledge and experience of medical students with male urethral catheterization. East Cent Afr J Surg 2009, 14(2):18-24.
• [9]Patel M, Oosthuizen G, Child S, Windsor JA: Training effect of skills courses on confidence of junior doctors performing clinical procedures. [http://www.nzma.org.nz/journal/121-1275/3085/] webciteNew Zealand Medical Journal 2008., 121(1275)