Sex-specific differences in surgical confidence: results of the Endo Workshop of the German Society of Residents in Urology 2022

Abstract

Simulation-based training is gaining importance in urologic residents training. This prospective study evaluated the influence of the Endo Workshop of the German Society of Residents in Urology e. V. (GeSRU) on surgical confidence. GeSRU Endo Workshop 2022 included 1 h simulation-based training sessions on stone removal using ureteroscopy (URS) and transurethral resection of the bladder (TURB). Using an online questionnaire, surgical confidence was assessed before and after the workshop. Surgical assessment relied on the global rating scale (GRS). Overall, 40residents participated: 25(62.5%) men and 15(37.5%) women. In URS assessment, men vs. women achieved an average of 26.6 vs.26.1/35points on the GRS (p = 0.7) and completed the task in 8.1 ± 1.9 vs.9.9 ± 0.4 min (p < 0.001). In TURB assessment, men vs. women achieved an average of 26.0 vs.27.3/35points on the GRS (p = 0.3) and required 7.6 ± 1.9 vs.7.7 ± 2.2 min (p = 0.9), respectively. Among participants who answered the baseline survey and the evaluation (n = 33), 16(80%) men vs.3 (23%) women had surgical confidence to perform URS before (p = 0.01), and 19(95%) men vs.7 (54%) women after the workshop (p = 0.03). Regarding the performance of TURB, 10(50%) men vs.7 (54%) women reported surgical confidence before (p = 0.1), and 15(75%) men vs.10 (77%) women after the workshop (p = 1.0). An increase in surgical confidence to perform URS and TURB was reported by 9(45%) and 10(50%) men and 9(69%) and 8(62%) women, respectively. Endourologic simulation-based training increases surgical confidence of both female and male residents. Despite comparable surgical outcomes, women approach URS with lower surgical confidence compared to their male counterparts.