Establishing a national high fidelity cadaveric emergency urology simulation course to increase trainee preparedness for independent on-call practice: a prospective observational study

BMC Medical Education

Suzanne Biers¹  Sophia Cashman¹  James Armitage¹  Thomas Ellul²  Krishna Narahari²  Oleg Tatarov²  Jonathan Featherstone²  Owen Hughes³  Pradeep Bose⁴  Neil Fenn⁴  Nicholas Bullock⁵ 

[1] Department of Urology, Addenbrooke’s Hospital, Cambridge, UK;Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK;Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK;Specialist Registrar Education Lead, British Association of Urological Surgeons, London, UK;Department of Urology, Swansea Bay University Health Board, Swansea, UK;Division of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, UK;Department of Urology, Cardiff and Vale University Health Board, Cardiff, UK;

关键词: Urological emergency;    Training;    Education;    Simulation;    Cadaveric;   

DOI  :  10.1186/s12909-020-02268-1

来源: Springer

【 摘 要 】

BackgroundWhilst competence in the management of a wide range of urological emergencies is a requirement for certification in urology, many conditions are uncommon and exposure during training may be limited. This prospective observational study sought to evaluate the feasibility and effectiveness of a standardised cadaveric emergency urology simulation course aimed at improving operative confidence and competence prior to independent on-call practice in the United Kingdom.MethodsA two-day cadaveric emergency urology simulation course supported by the British Association of Urological Surgeons (BAUS) was implemented at two pilot centres. All delegates that undertook one of the initial series of courses were invited to complete online pre- and post-course questionnaires relating to prior operative experience, documented competence and perceived confidence in being able to perform specific emergency procedures independently. Primary outcome was a self-reported ‘confidence score’ selected from a linear numeric scale ranging from 1 (not at all confident to perform a given procedure independently) to 10 (fully confident). Statistical analysis was undertaken using SPSS Statistics for Mac Version 25 and the paired student’s t-test used to compare mean pre- and post-course scores.ResultsOne hundred and four delegates undertook the course during the study period. Of these, 85 (81.7%) completed the pre-course survey and 67 (64.4%) completed the post-course survey, with 61 (58.7%) completing both. The greatest proportion of respondents were Speciality Trainees in Urology of ST5 level or higher (equivalent of Resident/Fellows with 4 or more years of surgical training; n = 31, 36.5%). Delegates reported variable pre-course exposure, with most experience reported in loin approach to the kidney (median 10) and least in exploration and packing of a transurethral resection cavity and emergency nephrectomy (median 0). Following course completion, a statistically significant increase in confidence score was observed for each procedure, with the greatest increases seen for shunt for priapism (4.87 to 8.80, p < 0.001), ureteric reimplantation (3.52 to 7.33, p < 0.001) and primary ureteric anastomosis (3.90 to 7.49, p < 0.001).ConclusionsA standardised high fidelity cadaveric simulation course is feasible and significantly improves the confidence of trainees in performing a wide range of emergency procedures to which exposure is currently limited.

【 授权许可】

CC BY