Residency Training Curriculum Research Articles

Telerehabilitation as a Teaching–Learning Tool in Physical Medicine and Rehabilitation Residency Training in the Philippines

Background:Prepandemic, Physical Medicine and Rehabilitation (PM&R) residency training curricula in the Philippines did not include telerehabilitation. The impact of virtual care on residents’ competencies during the pandemic has not been evaluated locally.Objective:The objective of the study is to determine residents’ ability to achieve PM&R competencies through telerehabilitation.Methods:This mixed-methods study included an original survey among residents and a focus group discussion with training/administrative staff.Findings:Residents reported professionalism, interpersonal/communication skills, and medical ethics/public health as the top three competencies facilitated by telerehabilitation, while procedural skills were the least facilitated. Training/administrative staff perceived telerehabilitation could be incorporated into PM&R training curricula.Conclusions:Telerehabilitation contributed to residents’ achievement of training competencies and learning of PM&R topics/skills.

Examination of the Knowledge Levels of Family Medicine Residents in Turkey about Oral and Dental Health.

To measure the general oral and dental health knowledge level of family medicine residents who are receiving full-time specialty training in Turkey. Primary care physicians can contribute to improving the oral and dental health of patients during general health services. The fundamentals of oral and dental health that the family medicine physicians should know about were determined, and questionnaire items on these fundamentals were prepared. The sample size was calculated as 296 individuals. The survey was conducted online. The collected data were analysed employing the following tests: chi-squared, Fisher, Kolmogorov-Smirnov, Spearman, ANOVA, Mann-Whitney U, Kruskal-Wallis, and Bonferroni. 302 family medicine residents in various clinics in Turkey participated in the study. The mean age of the participants was 29.6 ± 5.1. The mean knowledge scores of the resident physicians were calculated as 65.2 ± 10.9 (lowest: 27; highest: 92). The majority of resident physicians stated that they did not receive training on oral and dental health during their residency training, and that they agreed with the idea of integrating it into the residency training curriculum. The general knowledge level of family medicine residents in Turkey about oral and dental health was found to be moderate.

Development and evaluation of a surgical 3D simulation model on submental flap surgery training.

The purpose of the present study was to design and assess a 3D simulation model for submental flap surgery in training oral and maxillofacial surgery (OMFS) residents. This quasi-experimental study involved a total of 20 OMFS residents attending and was conducted from September 2023 to December 2023. A 3D submental flap surgical phantom was designed using Mimics V.21 software and printed using fused deposition modeling technology. Participants were first tested on their knowledge of submental flap surgery before being randomly assigned to experimental or control groups. The experimental group received a lecture and demonstration using the developed phantom, while the control group had traditional lecture education only. Afterward, the same test was administered to all participants post-training. Pre- and post-test scores were calculated and compared between the two groups. p-Value<0.05 was considered statistically significant. The average pre-intervention test scores in the control and experimental group, were 2.5±1.43 and 3±0.816, respectively (p=0.35). Post-intervention, the experimental group exhibited significantly higher exam scores compared to the group who had only received academic lecture training (6.9±0.87 vs. 4.9±0.99) (p<0.001). Irrespective of the applied teaching method, both groups showed a significant increase in exam scores after receiving submental flap training (p<0.001 for both groups, paired-sample t-test). The use of the developed submental flap phantom model significantly improved OMFS residents' test scores and knowledge of the surgical technique, suggesting its potential integration into the conventional resident training curriculum.

A structured curriculum for the acquisition of basic surgical endoscopic skills for surgical residents and quantification of skills improvement

IntroductionNew strategies and methods are needed to ensure that new generations can train and acquire surgical skills in a safe environment. Materials and methodsFrom January 2020 to October 2020, we performed a single centre, prospective observational cohort study. 19 participants (15 students, 4 residents) enrolled and 16 participants (13 students, 3 residents) successfully completed the curriculum. We performed a quantitative data analysis to evaluate its effectiveness in gaining and improving basic surgical endoscopic skills. ResultsThe time for single knot tying pre-, mid-, and post-training was reduced significantly, the average time (sec) decreased by 79.5 % (p < 0.001), the total linear distance (cm) by 74.5 % (p < 0.001) and the total angular distance (rad) by 71.7 % (p < 0.001). The average acceleration (mm/s2) increased by 20 % (p = 0.041). Additionally, the average speed increased by 23.5 % (p < 0.001), while motion smoothness (m/s3) increased by 20.4 % (p = 0.02). ConclusionThe obtained performance scores showed a significant increase in participants improving their basic surgical performance skills on the endoscopic simulator. This curriculum can be easily implemented in any surgical specialty as part of the residency training curriculum before first exposure in the operation room. All 16 participants recommended the implementation of such simulator training in their surgical training curriculum.

Exploration of the Integration of Curriculum Ideology and Politics into the Educational Pathway of Standardized Training for General Practice Residents

In recent years, the national higher education reform has proposed the concept of curriculum ideological and political education as a major element. This integration into the standardized training of general practice residents (commonly referred to as general resident training) is an unavoidable trend in the teaching field. Based on the actual situation of our unit at The First Affiliated Hospital of Xi’an Medical University, this paper emphasizes the necessity of incorporating ideological and political education into the general resident training curriculum, despite the absence of pertinent practical experience in how to effectively incorporate such courses into comprehensive residential training. In our hospital, we must assess the ideological and political education in the curriculum of general resident training, proposing a scientific, reasonable ideological and political education concept system for general practice courses, integrating ideological and political education with general practice resident training, and strengthening the team of ideological and political education physicians to teach them to carry out such education, this would foster enthusiasm and initiative. Strengthening admission education and training for general practice resident training, as well as regularly hosting symposiums to share ideas and understand the mission of doctors can provide effective experience for ideological and political education in general resident training courses.

Educational concepts: A longitudinal interleaved curriculum for emergency medicine residency training.

Traditionally, emergency medicine (EM) residency programs teach non-adult emergency department activities (such as pediatric EM, point-of-care ultrasound [PoCUS], emergency medical services, and others) in a block format. In this way, a resident may have a 1-month pediatric EM rotation and then not have any further pediatric EM exposure until their next pediatric rotation 6‒9 months later. Furthermore, some rotations are only allotted for 1-month during the entire residency. A first-year EM resident may have their only formal PoCUS rotation early in the first year of training when their overall skills are developing, and their level of understanding and retention of information may not be optimal at that juncture of their residency training. This is far from ideal from an educational perspective. Learning scientists have now suggested that a longitudinal interleaved curriculum has substantial advantages over the traditional block format. This curriculum allows for a "spaced retrieval" practice that enhances retention of material and develops thinking processes that are important in clinical practice. The increased continuity of clinical experience has been shown to improve educational outcome and learner satisfaction. We developed a novel longitudinal interleaved curriculum for our EM resident trainees. This curriculum encompasses the entire 3 years of residency training and has the goals of increasing EM knowledge and clinical skills and being excellent preparation for board certification examinations. This concept has clear educational benefits. While adapting an existing medical training program would be challenging, a longitudinal curriculum could be phased in to replace a traditional EM curriculum.

A view from the top: A qualitative exploration of top-level health care leaders' perceptions on the implementation of simulation-based education in postgraduate medical education.

Although there is substantial evidence supporting the benefits of simulation-based education (SBE), its widespread and effective implementation remains challenging. The aim of this study was to explore the perceptions of top-level health care leaders regarding SBE and the barriers and facilitators that influence its wide implementation as part of the postgraduate surgical curricula in Denmark. We conducted semi-structured interviews with top-level health care leaders who were chosen based on their roles in ensuring high-quality patient care delivery and developing strategies to achieve the goals of the entire health care system. The interview transcripts were translated into English, and a thematic approach was used to code and inductively analyse the data. We used the Consolidated Framework for Implementation Research to identify and understand the determinants to a successful implementation of SBE. We interviewed 13 participants from different political and administrative levels. We found that the participants had limited knowledge about SBE, which highlighted a disconnection between these leaders and the educational environment. This was further compounded by a lack of effective communication and inadequate information dissemination between simulation centres and higher-level organisations. While participants recognised the benefits of SBE for doctors in training, they expressed concerns about the implementation given the already strained health care system and limited resources. The need for evidence, particularly in the context of patient safety, was emphasised to facilitate SBE implementation. Although participants supported the implementation of SBE, it was unclear who should initiate action. This study highlighted the perspectives of top-level health care leaders regarding SBE and identified the determinant factors for a successful implementation. Effective communication channels are crucial to enhance collaborations and reduce the disconnection between the different health care organisational levels. Strategic implementation processes, including the roles and responsibilities, should be defined and established. These will inform decisions regarding the implementation strategies to effectively integrate SBE into the residency training curricula.

Operative dictations in surgical trainees: an underutilized educational resource?

Accurate operative notes are imperative to patient care and are used for communication, billing, quality assurance, and medical-legal conflicts. However, operative note quality often varies and many lack critical details. Unfortunately, no standardized training exists in operative dictations for surgical trainees. This pilot study sought to determine resident ability to dictate a comprehensive operative note and to determine a need for a formal operative dictation curriculum. Thirty-eight surgical residents between post-graduate years (PGY) one to four participated in a ventral hernia repair simulation. One senior (PGY3/4) resident coached two junior residents (PGY1/2). Residents completed an informal needs assessment regarding operative dictations. Post-simulation, residents completed an operative dictation. Notes were graded using a modified validated rubric. Thirty-five residents completed the needs assessment, and 38 residents submitted an operative note. Eighty-two percent of this group have completed ≤ 25 operative dictations in training and 77% have received minimal feedback on operative dictations. Out of 33 total points, mean overall score was 18.9 ± 5.4 (Junior resident: 17.9 ± 5.4; Senior resident: 20.9 ± 4.8) Total mean scores did not significantly differ between junior and senior residents (p = 0.10). Senior and junior residents scored similarly on the procedural details component (p = 0.29). Senior residents scored higher on relevant patient history and operative note headers (p = 0.04). Standard surgical training may not provide enough teaching and feedback to residents on operative note dictations. A formal residency training curriculum may bolster trainee ability to learn the components of an effective operative note.

Peering Into the Future: A First Look at the CBME Transition to Practice Stage in Diagnostic Radiology

Queen's University (Kingston, ON, Canada) adopted a competency-based medical education (CBME) curriculum for Diagnostic Radiology residency training in an accelerated manner in 2017, with the curriculum comprised of four stages of training. This article focuses on the final stage (Transition to Practice), during which assessment methods of the new national curriculum (implemented in July 2022) were piloted. This study aims to highlight the challenges and opportunities associated with the implementation of CBME in Diagnostic Radiology training and specific considerations for programs undergoing this curricular transition. Ethics approval was provided by the affiliated hospital Research Ethics Board. All relevant electronic assessments pertaining to all trainees who had completed the Transition to Practice stage (n=3) were collated, deidentified, analyzed, and presented in tabulated format. A total of 39 evaluations completed by 13 assessors were assessed, with an average time of 3minutes and 6seconds to complete an assessment form. Also, 95% of evaluations were rated as entrustments. However, no residents met the minimum number of required entrustments for all five stage-specific Entrustable Professional Activities. These 39 evaluations included 219 milestone rating scores, with 86% rated as "achieved." Following review by the residency program Competence Committee, all three residents were promoted from the Transition to Practice stage. Challenges in CBME implementation include the number and quality of resident assessments. Strategies for success may include providing clear guidelines and training for both faculty and residents, early identification and intervention, and adopting a holistic evaluation strategy. CBME has the potential to enhance medical education quality by emphasizing learner progress toward competency and providing personalized feedback and support.

Status quo of urological residency training in Germany-a strengths, weaknesses, opportunities, and threats (SWOT) analysis

Urological residency training is adecisive step on the urological career path. The aim of this review is to develop strategies and approaches to actively shape, improve and further develop urological residency training. With the help of astrengths, weaknesses, opportunities, and threats (SWOT) analysis, the status quo of urological residency training in Germany is analyzed in astructured manner. Strengths of urological residency training incorporate the attractiveness of the specialty itself, and the residency training curriculum in urology ("Weiterbildungscurriculum Urologie", WECU), including the networking of inpatient and outpatient training and accompanying internal and external further training. The German Society of Residents in Urology (GeSRU) also provides anetworking platform for residents. Weaknesses include country-specific differences and alack of checkpoints during residency training. Opportunities for urological continuing education arise from freelance work, digitalization, and technical and medical progress. In contrast, the aftermath of the coronavirus disease 2019 (COVID19) pandemic, with still limited staff and surgical capacities, an increased psychosocial workload, and the rising number of outpatient treatments in urology pose threats for urological residency programs. With the help of aSWOT analysis, factors for the further development of urological residency training can be identified. In order to provide high-quality residency training in the future, strengths and opportunities should be consolidated and weaknesses and threats should be addressed at an early stage.

Ophthalmic Education: The Top 100 Cited Articles in Ophthalmology Journals.

Purpose To identify the top 100 (T100) cited articles on ophthalmic education and examine trends and areas of focus in ophthalmic education. Methods A literature search was conducted for articles published between 2011 and 2021 related to ophthalmic education within ophthalmology journals using the ISI Web of Science Core Collection database. The search was performed in June 2022 and was conducted using the search phrase ([educat* OR teach* OR instruct* OR train* OR "medical student*" OR residen* OR fellow* OR undergrad* OR postgrad* OR "faculty" OR "attending"] AND *ophthalm*). Results were analyzed using VOSviewer v.1.6.18 and statistical analysis was performed using Microsoft Excel. Results The majority of articles were published in the Journal of Cataract & Refractive Surgery (19%), followed by Ophthalmology (12%), and Eye (12%). Articles were most often published in the year 2013 (15%), followed by 2014 (12%) and 2012 (12%). Articles most commonly originated from English-speaking countries, including the United States (43%), England (14%), Canada (8%), and India (8%). Topics most often examined in ophthalmic education were resident education (51%), medical school education (21%), and surgical training (21%). The most common study types were cohort studies (22%), case series (21%), and prospective trials (16%). There were 16 institutions that produced more than one article in the T100 articles list. Conclusion The T100 articles on ophthalmic education were primarily U.S. based and focused on resident education, surgical training, and medical school ophthalmic curriculum. Further research into ophthalmic education is warranted to establish evidence-based curricula guidelines.

Gynaecology, general surgery and urology residents' perspective and exposure to endoscopy training and practice: a cross-sectional study of resident doctors in four residency training centres in Abuja, Nigeria from June to August, 2020.

the use of endoscopy in the surgical management of a wide range of ailments has revolutionised the practice of surgery. Endoscopy however has been underutilised in developing nations. Optimal training exposure during the residency training program is considered as very crucial to the improvement of endoscopy practice in this region. The objective of this study was to evaluate the perception and endoscopy training exposure of resident doctors in gynaecology, general surgery and urology in four residency training centres in Abuja. this was an analytical cross-sectional study of endoscopy exposure of gynaecology, general surgery and urology resident doctors in four residency training centres in Abuja from June through August 2020. Using a structured questionnaire, information was obtained on demography, perception of endoscopy, exposure to and expectations for endoscopy training and practice. Data were analysed with SPSS version 25 (IBM Corp., Armonk, NY, USA). a total of 125 questionnaires were distributed with a 92% response rate. The mean age of the respondents was 36.17±4.62 years with a mean duration of training of 53.91±28.02 months. Eighteen (15.8%) were satisfied with endoscopy practice in their centre and only five respondents (4.4%) had attained competence in operative endoscopy. Twelve trainees (10.5%) reported that they had received formal training in endoscopy outside their workplace and 109 (95.6%) desired to have post-fellowship training. Competence was statistically significantly higher among the senior registrars compared to registrars (Fisher 51.81, P=< 0.001). Lack of funding was the most reported limiting factor to endoscopy training (66.7%) while most (85.1%) desired the incorporation of structured endoscopy training into the residency training curriculum. this study showed poor endoscopy training exposure, a high level of dissatisfaction with the state of endoscopy practice and high expectations of the trainees for improved training facilities and human capacity.

Robotic simulation: validation and qualitative assessment of a general surgery resident training curriculum.

The da Vinci skills simulation curriculum has been validated in the literature. The updated simulator, SimNow, features restructured exercises that have not been formally validated. The purpose of this study is to validate the SimNow resident robotic basic simulation curriculum. This study also consists of a qualitative assessment that gives greater insight into the learner's experience completing the robotic curriculum. There were 18 participants in this study: 6 novices, 6 competent surgeons, and 6 expert surgeons. The curriculum comprised 5 exercises; participants completed three consecutive scored trials. Computer-derived performance metrics were recorded. The NASA Task Load Index survey was used to assess subjective mental workload. Subjects were asked a series of open-ended questions regarding their experience that were recorded and transcribed. Codes were identified using an inductive method, and themes were generated. Performance metrics were significantly different between novice versus competent and expert surgeons. There was no significant difference in any score metric between competent and expert surgeons. On average, overall score percentages for competent and expert surgeons were between 90.4 and 92.8% versus 70.5% for novices (p = 0.02 and p = 0.01). Expert surgeons perceived a higher level of performance completing the exercises than novice surgeons (15.8 vs. 45.8, p = 0.02). Participants noted a similar robotic experience, utilizing efficiency of motion and visual field skills. Participants agreed on exercise strengths, exercise weaknesses, and software limitations. Competent and expert surgeons were better able to assess the exercises' clinical application. The SimNow curriculum is a valid simulation training as part of a general surgery resident robotic curriculum. The curriculum distinguishes between novices compared to competent and expert surgeons, but not between competent and expert surgeons. Clinical training level does not affect the experience and mental workload using the robotic simulator, except for competent and expert surgeons' ability to better assess clinical application.

Evaluation of Pathology Residency Training Curriculum and Practice in the Hubei Province of China.

The pathology residency program began in China in 2014. There has been no competency assessment on training programs in the Hubei province of China. To evaluate the current residency training curriculum and resident performance in Hubei Province. A 37-question online questionnaire was designed to cover general demographic information, diagnostic competency, expectations of ideal caseload for gross and preview, teaching patterns, examinations, research activities, weak points, and other topics in pathology practice. A total of 166 participants, including 62 postgraduate year (PGY) 2, 49 PGY3, and 55 new practicing pathologists, responded to the survey. PGY3 residents were found to be more competent than PGY2 in diagnostic competency. Forty-five of 55 new practicing pathologists (81.8%) reported that they could sign out cases independently, whereas 10 of 55 (18.2%) were found to still need transitional time for learning before working independently. Some residents could sign out cytopathology cases and gained knowledge in immunohistochemistry and histochemical staining, while some residents did not receive adequate training in molecular pathology. The ideal caseloads for gross and preview during residency were greater than 5000 and 7000, respectively. Nonneoplastic diseases, neuropathology, dermatopathology, hematopathology, and soft tissue pathology were considered difficult subspecialties in pathology practice. While residents trained in Hubei Province have met the basic requirements for qualified pathologists, more efforts need to be made in many areas, such as well-structured training curriculum and better-designed proficiency examinations. The findings of this study are of great importance to prioritizing training in the future.

A national needs assessment to identify technical procedures in plastic surgery for simulation-based training

Medical simulation is not developed and integrated into plastic surgery unlike other surgical specialties despite the procedures being complex and require practice. First step in enhancing simulation in plastic surgery is to clarify the need among peers. The objective of the study was to identify and prioritize the technical procedures that should be included in a simulation-based curriculum for residency training in plastic surgery. A panel of participants with key roles in the Danish plastic surgery specialist training program was appointed. Participation was voluntary. A national need assessment study was performed using a three-round Delphi process to collect information from the participants. In round 1, participants reported all the procedures that a newly qualified specialist in plastic surgery should be able to perform. In round 2, participants replied to a survey exploring the frequency of the procedures, the number of surgeons performing the procedure, the risk or discomfort for patients treated by an inexperienced surgeon and the feasibility of training the procedure in simulation, resulting in a preliminary ranking of procedures. In round 3, participants eliminated and reprioritized the identified procedures according to importance. Thirty-five of 37 agreed to enter the expert panel. The response rate was 97%, 86% and 86% for rounds 1, 2 and 3, respectively. Twenty-nine of 136 procedures identified in round 1 reached the final prioritized list of procedures relevant for simulation training in plastic surgery.

Does length of time between cases affect resident operative time for tonsillectomy and adenoidectomy?

ObjectiveTo evaluate the effect of prolonged time intervals between tonsillectomy and adenoidectomy (TA) on resident operative time and complications. Study designRetrospective cohort. SettingTertiary academic hospital. MethodsThis retrospective study covers a five-year period from 2015 to 2020. Time intervals between isolated pediatric TA cases performed by eight otolaryngology residents were reviewed to assess effect on operative time (defined as prolonged if ≥ 30 min and non-prolonged if < 30 min). Intervals including a procedure involving either a tonsillectomy or adenoidectomy that was a non-isolated TA were excluded. ResultsA total of 309 isolated TAs were identified with 67.3% of procedures performed under 30 min. The mean surgical time interval between procedures was 5.83 ± 10.02 days (range 0.02–69.82). Most TAs were performed on patients aged 7 years or younger. Surgical time interval between TA was not a significant factor in determining prolonged operative time on univariable logistic regression, OR 1.01 (CI: 0.98 to 1.03) (p = 0.63). Patient age at surgery, adenoid grade, tonsil size and total number of TAs performed to date were significant factors in determining prolonged operative time in both univariable and multivariable logistic regression models. Prolonged operative time did not have a significant effect on readmission, reoperation, or post-operative bleeding. ConclusionExtended time interval (up to 3 months) between routine TA does not affect operative time. Expansion of our methodology to more complex cases would be beneficial in designing resident training curriculum.

Amisulpride: A Useful Second-Generation Antipsychotic Omitted From the US Residency Training Curriculum.

In this report, the author discusses the second-generation antipsychotic amisulpride, which is used around the world for treatment of schizophrenia but is not approved for any mental health indication in the US.

Implementation of competence by design in Canadian neurosurgery residency programs*

Objective The Royal College of Physicians and Surgeons of Canada (RCPSC) recently redesigned the Canadian neurosurgery residency training curriculum by implementing a competency-based model of training known as Competence by Design (CBD) centered around the assessment of Entrustable Professional Activities (EPAs). This sequential explanatory mixed-methods study evaluated potential benefits and pitfalls of CBD in Canadian neurosurgery residency education. Methods Two four-month interval surveys were distributed to all Canadian neurosurgery residents participating in CBD. The surveys assessed important educational components: CBD knowledge of key stakeholders, potential system barriers, and educational/psychological impacts on residents. Paired t-tests were done to assess changes over time. Based on longitudinal survey responses, semi-structured interviews were conducted to investigate in-depth residents’ experience with CBD in neurosurgery. The qualitative analysis followed an explanatory approach, and a thematic analysis was performed. Results Surveys had 82% average response rate (n = 25). Over time, most residents self-reported that they retrospectively understood concepts around CBD intentions (p = 0.02). Perceived benefits included faculty evaluations with more feedback that was clearer and more objective (53% and 51%). Pitfalls included the amount of time needed to navigate through EPAs (90%) and residents forgetting to initiate EPA forms (71%). There was no significant change over time. During interviews, five key themes were found. Potential solutions identified by residents to enhance their experience included learning analytics data availability, mobile app refinement, and dedicated time to integrate EPAs in the workflow. Conclusion This study was the first to assess resident-perceived benefits and pitfalls of the neurosurgery CBD training program in an educational framework context. In general, residents believed that theoretical principles behind CBD were valuable, but that technological ability and having enough time to request EPA assessments were significant barriers to success. Long-term studies are required to determine the definitive outcomes of CBD on residents’ performance and ultimately, on patient care.

V14-01 DESIGN AND DEVELOPMENT OF A HIGH-FIDELITY TRANSRECTAL ULTRASOUND (TRUS) SIMULATION MODEL FOR RESIDENT EDUCATION

You have accessJournal of UrologyProstate Oncology II & Testis Oncology & Misc. Oncology (V14)1 Sep 2021V14-01 DESIGN AND DEVELOPMENT OF A HIGH-FIDELITY TRANSRECTAL ULTRASOUND (TRUS) SIMULATION MODEL FOR RESIDENT EDUCATION Patrick Saba, Rachel Melnyk, Kit Yuen, Alexis Steinmetz, Alexander Cranwell, Karen Doersch, Elizabeth Ellis, Mahmoud Khalil, Scott Quarrier, Rajat Jain, Jeanne O'Brien, Gareth Warren, Thomas Frye, Hani Rashid, and Ahmed Ghazi Patrick SabaPatrick Saba More articles by this author , Rachel MelnykRachel Melnyk More articles by this author , Kit YuenKit Yuen More articles by this author , Alexis SteinmetzAlexis Steinmetz More articles by this author , Alexander CranwellAlexander Cranwell More articles by this author , Karen DoerschKaren Doersch More articles by this author , Elizabeth EllisElizabeth Ellis More articles by this author , Mahmoud KhalilMahmoud Khalil More articles by this author , Scott QuarrierScott Quarrier More articles by this author , Rajat JainRajat Jain More articles by this author , Jeanne O'BrienJeanne O'Brien More articles by this author , Gareth WarrenGareth Warren More articles by this author , Thomas FryeThomas Frye More articles by this author , Hani RashidHani Rashid More articles by this author , and Ahmed GhaziAhmed Ghazi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002111.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transrectal ultrasound (TRUS) biopsy teaches the basics of ultrasound guided techniques while also providing a basis for more advanced prostate oncology diagnosis methods. TRUS can cause discomfort to patients and requires skills in three-dimensional orientation and interpretation of findings. Currently there is a lack of TRUS biopsy training methods that are accessible and provide realistic feedback outside of live patients. We sought to design a high-fidelity simulation model for resident education which can be used to further TRUS training techniques. METHODS: A hydrogel model was developed containing a prostate with 6 colored zones (left/right, base, mid, and apex) for targeted biopsy, rectum, hollow seminal vesicles, and urethra. 6 experts (median cases completed = 550) and 6 residents completed ≥2 biopsies of each zone. Time to complete each biopsy, length of the most accurate core obtained from each region, and attempts to obtain a biopsy from the correct zone were collected along with feedback (free response and 5-point Likert scale questions) on the usefulness as a teaching/assessment tool and procedural/anatomical accuracy. RESULTS: When asked how the model replicates the relevant human anatomy for the procedure, experts and novices rated the model 3.75/5 and 4.5/5 respectively. Additionally, both rated the model >4 when asked if the overall simulated tissue accurately resembles the appearance of live human tissue. Furthermore, both groups rated the model highly (≥4) for the procedural realism. When asked about teaching using the model, experts and novices rated the model highly (≥4) agreeing that the model is useful for improving technical skills, teaching the procedure, and assessing the user’s ability to perform the procedure. Experts took significantly less attempts and time per biopsy region, less time per attempt, and reported significantly lower difficulty than novices (2.4 v 3.7, p=0.001; 59.8 v 123.9, p<0.001; 23.3 v 31.3, p=0.001; 3.0 v 4.8, p=0.001, respectively). However, both groups best core accuracy in each region was similar for all attempts (88% v 92%, p=0.31). CONCLUSIONS: This TRUS biopsy model incorporates essential components for inclusion in resident training curriculum as a teaching and assessment tool by providing instantaneous feedback and procedural metrics while displaying high anatomical and procedural realism ratings. Ultimately this model can also serve as the basis for virtual learning, utilizing its portable and non-biohazardous properties in combination with merged reality software. Source of Funding: n/a © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1165-e1165 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick Saba More articles by this author Rachel Melnyk More articles by this author Kit Yuen More articles by this author Alexis Steinmetz More articles by this author Alexander Cranwell More articles by this author Karen Doersch More articles by this author Elizabeth Ellis More articles by this author Mahmoud Khalil More articles by this author Scott Quarrier More articles by this author Rajat Jain More articles by this author Jeanne O'Brien More articles by this author Gareth Warren More articles by this author Thomas Frye More articles by this author Hani Rashid More articles by this author Ahmed Ghazi More articles by this author Expand All Advertisement Loading ...

Update and Progress in Pediatric Sleep Disorders

Sleep is of utmost importance for the adequate growth, physical, and cognitive development, and health of children. The field of pediatric sleep medicine, which is not a component of many residency training curricula, has grown significantly in recent years with newly described disorders, updated diagnostic methods, and new treatment options. Sleep transcends all disciplines; hence, having a fundamental awareness of suboptimal sleep in a child is paramount for the general pediatrician, and also any subspecialist.