MP08-20 IMPROVING SURGICAL TRAINING: SHIFTING THE CULTURE FROM “APPRENTICESHIP” TO “PATIENT-CENTERED” LEARNING

Abstract

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety II1 Apr 2016MP08-20 IMPROVING SURGICAL TRAINING: SHIFTING THE CULTURE FROM “APPRENTICESHIP” TO “PATIENT-CENTERED” LEARNING Ming-Hsien Wang and Timothy Baumgartner Ming-Hsien WangMing-Hsien Wang More articles by this author and Timothy BaumgartnerTimothy Baumgartner More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2265AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The apprenticeship model of ′see one, do one, teach one′ has been the cornerstone of surgical training since Sir William Halsted introduced the concept of residency in 1889. Traditionally, the trainees would determine how to maximize learning during time spent with appointed mentors. With our evolving educational milieu combined with the constraint of work hours, it is important to have specific curricular elements to facilitate achievement of ACGME milestones. Pediatric urology patients often present with complex, congenital diagnosis. Multi-disciplinary conferences are a standard of care for oncology patients, but are not currently the standard for pediatric urology patients. We propose that a ″patient-centered″ pre-operative multidisciplinary conference is valuable to pediatric patients as well as surgical trainees. METHODS 1) Establish a working group of faculty and trainees who are invested in safety and education. 2) Design and define educational outcomes based on ACGME milestones. 3) Track key teaching elements from pediatric urologic cases. 4) Implement conference series and track participation, learning, and outcomes. 5) Residents′ in-service scores (ISE) and monthly morbidity/ mortality rates would be used as initial surrogates to assess outcomes. RESULTS A weekly, fellow and resident organized ″patient centered, preoperative multidisciplinary conference″ was established in 2012 incorporating pediatric specialists: radiology, nephrology, nursing, and urology. Participants were notified of the patients/ topics to be discussed one week prior. Senior trainees supervise junior residents in preparation of the cases. Participation from 2012-2015 is 90% from urology and radiology faculty, trainees. The average ISE score improved by 12% since the implementation of the conference. There is no significant difference in the rate of reported surgical morbidities. CONCLUSIONS Our initial study shows an educational benefit without detrimental effect on surgical outcomes. We plan to formally document in the medical record, the recommendations and treatment plan after each conference. The record will be accessible to all providers, including outside referring physicians. Moving forward, we plan to track key cases for residents learning. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e92 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ming-Hsien Wang More articles by this author Timothy Baumgartner More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...