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01-02-2017

High educational impact of a national simulation-based urological curriculum including technical and non-technical skills

Authors: Anna H. de Vries, Barbara M. A. Schout, Jeroen J. G. van Merriënboer, Rob C. M. Pelger, Evert L. Koldewijn, Arno M. M. Muijtjens, Cordula Wagner

Published in: Surgical Endoscopy | Issue 2/2017

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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Wignall GR, Denstedt JD, Preminger GM, Cadeddu JA, Pearle MS, Sweet RM, McDougall EM (2008) Surgical simulation: a urological perspective. J Urol 179:1690–1699. doi:10.1016/j.juro.2008.01.014 CrossRefPubMed

Hout FA, Nienhuis ED, Robben PB, Frederiks BJ, Legemaate J (2010) Supervision by the Dutch healthcare inspectorate. Eur J Health Law 17:347–360CrossRefPubMed

Abrams P, Brausi M, Buntrock S, Ebert T, Hashim H, Tiselius HG, Wyndaele JJ (2012) The future of urology. Eur Urol 61:534–540. doi:10.1016/j.eururo.2011.11.005 CrossRefPubMed

Le CQ, Lightner DJ, VanderLei L, Segura JW, Gettman MT (2007) The current role of medical simulation in american urological residency training programs: an assessment by program directors. J Urol 177:288–291. doi:10.1016/j.juro.2006.08.106 CrossRefPubMed

Reznick RK, MacRae H (2006) Teaching surgical skills—changes in the wind. N Engl J Med 355:2664–2669. doi:10.1056/NEJMra054785 CrossRefPubMed

Iobst WF, Sherbino J, Cate OT, Richardson DL, Dath D, Swing SR, Harris P, Mungroo R, Holmboe ES, Frank JR (2010) Competency-based medical education in postgraduate medical education. Med Teach 32:651–656. doi:10.3109/0142159X.2010.500709 CrossRefPubMed

Yule S, Flin R, Paterson-Brown S, Maran N (2006) Non-technical skills for surgeons in the operating room: a review of the literature. Surgery 139:140–149CrossRefPubMed

Hull L, Arora S, Aggarwal R, Darzi A, Vincent C, Sevdalis N (2012) The impact of nontechnical skills on technical performance in surgery: a systematic review. J Am Coll Surg 214:214–230. doi:10.1016/j.jamcollsurg.2011.10.016 CrossRefPubMed

Schreuder HW, Wolswijk R, Zweemer RP, Schijven MP, Verheijen RH (2012) Training and learning robotic surgery, time for a more structured approach: a systematic review. BJOG 119:137–149. doi:10.1111/j.1471-0528.2011.03139.x CrossRefPubMed

10.

Ahmed K, Jawad M, Abboudi M, Gavazzi A, Darzi A, Athanasiou T, Vale J, Khan MS, Dasgupta P (2011) Effectiveness of procedural simulation in urology: a systematic review. J Urol 186:26–34. doi:10.1016/j.juro.2011.02.2684 CrossRefPubMed

11.

Schout BM, Hendrikx AJ, Scheele F, Bemelmans BL, Scherpbier AJ (2010) Validation and implementation of surgical simulators: a critical review of present, past, and future. Surg Endosc 24:536–546. doi:10.1007/s00464-009-0634-9 CrossRefPubMed

12.

Korndorffer JR Jr, Arora S, Sevdalis N, Paige J, McClusky DA III, Stefanidis D, PEGASUS Research Group (2013) The American College of Surgeons/Association of Program Directors in Surgery National Skills Curriculum: adoption rate, challenges and strategies for effective implementation into surgical residency programs. Surgery 154:13–20. doi:10.1016/j.surg.2013.04.061 CrossRefPubMed

13.

Aydin A, Ahmed K, Shafi AM, Khan MS, Dasgupta P (2015) The role of simulation in urological training—a quantitative study of practice and opinions. Surgeon. doi:10.1016/j.surge.2015.06.003 PubMed

14.

Shore EM, Grantcharov TP, Husslein H, Shirreff L, Dedy NJ, Mcdermott CD, Lefebvre GG (2016) Validating a standardized laparoscopy curriculum for gynecology residents: a randomized controlled trial. Am J Obstet Gynecol. doi:10.1016/j.ajog.2016.04.037 PubMed

15.

McDougall EM, Watters TJ, Clayman RV (2007) 4-year curriculum for urology residency training. J Urol 178:2540–2544. doi:10.1016/j.juro.2007.08.035 CrossRefPubMed

16.

Shamim Khan M, Ahmed K, Gavazzi A, Gohil R, Thomas L, Poulsen J, Ahmed M, Jaye P, Dasgupta P (2013) Development and implementation of centralized simulation training: evaluation of feasibility, acceptability and construct validity. BJU Int 111:518–523. doi:10.1111/j.1464-410X.2012.11204.x CrossRefPubMed

17.

Aghazadeh MA, Mercado MA, Pan MM, Miles BJ, Goh AC (2016) Performance of robotic simulated skills tasks is positively associated with clinical robotic surgical performance. BJU Int. doi:10.1111/bju.13511 PubMed

18.

de Vries AH, van Luijk SJ, Scherpbier AJ, Hendrikx AJ, Koldewijn EL, Wagner C, Schout BM (2015) High acceptability of a newly developed urological practical skills training program. BMC Urol 15:93. doi:10.1186/s12894-015-0084-8 CrossRefPubMedPubMedCentral

19.

Wiggins G, McTighe J (2001) Understanding by design. Prentice Hall, Upper Saddle River

20.

Zevin B, Levy JS, Satava RM, Grantcharov TP (2012) A consensus-based framework for design, validation, and implementation of simulation-based training curricula in surgery. J Am Coll Surg 215(580–586):e3. doi:10.1016/j.jamcollsurg.2012.05.035

21.

Schout BM, Hendrikx AJ, Scherpbier AJ, Bemelmans BL (2008) Update on training models in endourology: a qualitative systematic review of the literature between January 1980 and April 2008. Eur Urol 54:1247–1261. doi:10.1016/j.eururo.2008.06.036 CrossRefPubMed

22.

Chang L, Petros J, Hess DT, Rotondi C, Babineau TJ (2007) Integrating simulation into a surgical residency program: is voluntary participation effective? Surg Endosc 21:418–421. doi:10.1007/s00464-006-9051-5 CrossRefPubMed

23.

Spruit EN, Band GP, Hamming JF (2015) Increasing efficiency of surgical training: effects of spacing practice on skill acquisition and retention in laparoscopy training. Surg Endosc 29:2235–2243. doi:10.1007/s00464-014-3931-x CrossRefPubMed

24.

van Merrienboer JJG, Kirschner PA (2013) Ten steps to complex learning. A systematic approach to four-component instructional design. Routledge, New York, pp 78–111

25.

Ten Cate O, Durning S (2007) Peer teaching in medical education: twelve reasons to move from theory to practice. Med Teach 29:591–599. doi:10.1080/01421590701606799 CrossRefPubMed

26.

de Vries AH, Boute MC, Kuppen MC, van Merrienboer JJ, Koldewijn EL, Pelger RC, Schout BM, Wagner C (2015) Patient safety risks of basic urological procedures performed by junior and senior residents. J Surg Educ 72:918–926. doi:10.1016/j.jsurg.2015.04.014 CrossRefPubMed

27.

Ten Cate O (2013) Nuts and bolts of entrustable professional activities. J Grad Med Educ 5:157–158. doi:10.4300/JGME-D-12-00380.1 CrossRefPubMedPubMedCentral

28.

Abboudi H, Khan MS, Guru KA, Froghi S, de Win G, Van Poppel H, Dasgupta P, Ahmed K (2014) Learning curves for urological procedures: a systematic review. BJU Int 114:617–629. doi:10.1111/bju.12315 CrossRefPubMed

29.

Kern D, Thoam P, Hughes M (2009) Curriculum development for medical education: a six step approach. John Hopkins University Press, Baltimore

Title: High educational impact of a national simulation-based urological curriculum including technical and non-technical skills
Authors: Anna H. de Vries
Barbara M. A. Schout
Jeroen J. G. van Merriënboer
Rob C. M. Pelger
Evert L. Koldewijn
Arno M. M. Muijtjens
Cordula Wagner
Publication date: 01-02-2017
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 2/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-016-5060-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

High educational impact of a national simulation-based urological curriculum including technical and non-technical skills

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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