Urology Residency Program Directors Research Articles

(120) A Survey of Exposure to the Use of Xiaflex for the Treatment of Peyronie’s Disease Among United States Urology Residency Programs

Abstract Introduction Xiaflex (Collagenase Clostridium Histolyticum) is an FDA-approved treatment for patients with Peyronie’s Disease. However, despite its approval and widespread implementation in clinical practice, there is concern that urologists in training are offered minimal exposure to its use. Objective Thus, the purpose of this study was to evaluate the exposure of urology residents to Peyronie’s Disease and its management, particularly Xiaflex. Methods A six-question Google Forms survey regarding exposure of residents to Peyronie’s Disease and the Use of Xiaflex was created. The survey was disseminated through email to urology residency program directors, chief residents, or andrology-focused faculty. Results Overall, 47 institutional responses were received, eliciting a response rate of approximately 34%. At 45 institutions (96%), residents receive training in directly evaluating and caring for patients with Peyronie’s disease. Of these, in 36 institutions the training is led by an academic faculty who is fellowship trained in sexual medicine. At 46 institutions (98%), residents receive training in observing and/or performing surgical procedures such as plication, grafting, and penile implants for Peyronie’s disease. With regards to surgical treatment, residents are trained by an academic faculty who is fellowship trained in sexual medicine at 35 programs. Conversely, residents at only 31 institutions (66%) receive observational or procedural training for non-surgical management of Peyronie’s disease, specifically Xiaflex. Residents receive non-surgical training by an academic faculty who is fellowship trained in sexual medicine at 25 institutions and an academic faculty who is not trained in sexual medicine at 6 institutions. When categorizing based on AUA section: 3 out of 4 Mid-Atlantic programs (75%), 3 out of 4 New England programs (75%), 2 out of 8 New York programs (25%), the 1 Northeastern program (100%), all 11 North Central programs (100%), 5 out of 6 South Central programs (83.33%), 5 out of 6 Southeastern programs (83.33%), and 3 out of 6 Western programs (50%) reported residency exposure to the use of Xiaflex. Conclusions Urology residents receive broad exposure to the management of Peyronie’s Disease, particularly its surgical treatment. However, there exists a glaring disparity in residency exposure to Xiaflex, which represents the sole FDA-approved medical management for Peyronie’s Disease. To our knowledge, we present the first study evaluating resident exposure to Xiaflex in the treatment of PD. We believe it is important for United States residency programs to ensure that their trainees are educated on the use of this treatment option. A broader incorporation of training of Xiaflex among urology residents may increase the number of providers who are comfortable and competent with providing this level of care to a potentially vulnerable patient population. Further research is warranted to elucidate why this discrepancy exists and how programs can provide residents with further exposure to the use of Xiaflex in patients with Peyronie’s Disease. Disclosure No.

Current Utilization and Perceptions of Formal Education of Point-of-care Ultrasound in Urology

ObjectiveTo assess the extent of formal POCUS training, current utilization of POCUS, and contemporary perceptions of POCUS amongst urologists. MethodsA survey including questions regarding demographics, prior ultrasound education, current ultrasound utilization in practice/training, perceived optimal POCUS utilization, and the perception of formal ultrasound training was developed. The survey was disseminated to residency program directors (PDs) via the SAU and members of AUA sub-section organizations. Data was collected via Redcap. ResultsA total of 40 PDs and 159 other respondents completed the survey with approximately half (51%) in an academic practice and two-thirds (68%) with more than 10 years in practice. PD response rate was 28%, and general response rate was 2%. Among all respondents, 95% (186/196) and 82% (160/194) agreed/strongly agreed formal POCUS training would be worthwhile during and after residency. Among urology residency program directors, 93% (37/40) agreed/strongly agreed that formal POCUS training is worthwhile in residency. The majority of respondents used some form of ultrasound in practice (77%, 154/199). However, only 37% (72/199) of all respondents had prior formal POCUS training, and 19% (5/26) of program directors reported formal training in their programs. Of respondents without formal training, 63% (80/127) reported interest in pursuing formal training. ConclusionsPOCUS is widely utilized in many practices. Yet, most urologists have not participated in formal POCUS training and most programs do not have curricula. Urologists have favorable opinions of the utility, safety, and efficacy of POCUS and desire training.

Who Is Shaping the Future of Academic Urology? A Descriptive Analysis of Residency Program Directors

To characterize the demographics, educational background, and scholarly characteristics of current urology residency program directors (PDs). Urology programs were identified by the listing on the "Accredited US Urology Programs" section of American Urological Association website as of October 2021. Demographics and academic data were collected via publicly available department website and Google search engine. Metrics obtained included years of service as PD from time of appointment, sex, medical school/residency/fellowship, all-time H-index, dual degrees obtained, and professorial ranking. One hundred and forty-seven accredited urological residencies were reviewed; every PD was included. The majority were male (78%) and fellowship trained (68%). Women represented only 22% of PDs. The median active time served as PD, as of 11/2021, was 4years (IQR: 2-7). Forty (28%) were faculty at the same program they completed their residency. The median all-time H-index was 12 (IQR: 7-19; range 1-61). Twelve PDs also served as chair of their department. The vast majority of PDs are male, fellowship trained, and have served for less than 5years. Future studies are necessary to follow the trends of representation in leaders of urology residency programs.

Understanding the Urology Program Directors Perspective on the Current Resident Selection Process: The Society of Academic Urologists National Survey of Urology Program Directors

The traditional residency selection process was altered dramatically by the SARS CoV-2 (COVID-19) pandemic. For the 2020-2021 application cycle in-person interviews were transitioned to the virtual format. What was thought to be a temporary transition has now become the new standard with continued endorsement from the Association of American Medical Colleges (AAMC) and the Society of Academic Urologists (SAU) for virtual interviews (VI). We sought to assess the perceived efficacy and satisfaction of the VI format from the urology residency program director's (PDs) perspective. A designated SAU Taskforce on "Optimizing the Applicant Experience in the Virtual Interview Era" developed and refined a survey composed of 69 questions on VI and was distributed to all urology program directors (PD) of member institutions of the SAU. The survey focused on candidate selection, faculty preparation, and interview day logistics. PDs were also asked to reflect on the impact of VI on their match results, recruitment of underrepresented minorities and female gender, and what their preference would be for future applications cycles. Urology residency PDs (84.7% response rate) between January 13, 2022 - February 10, 2022 were included in the study. Most programs interviewed a total of 36 to 50 applicants (80%), with an average of 10 to 20 applicants per interview day. The top 3 ranked criteria for interview selection reported by urology PDs surveyed included letters of recommendation, clerkship grades, and USMLE Step 1 score. The most common areas of formal training for faculty interviewers were diversity, equity and inclusion (55%), implicit bias (66%), and review of the SAU guidelines on illegal questions (83%). Over half (61.4%) of PDs believed that they were able to accurately represent their training program through the virtual platform, while 51% felt that VI did not afford similar assessments of applicant as in-person interviews. Two-thirds of PDs believed the VI platform improve access for all applicants to attend interviews. Focusing on the impact of the VI platform for recruitment of underrepresented minorities (URM) and female gender applicants, 15% and 24% reported improved visibility respectively for their program, and 24% and 11% reported increased ability to interview URM and female gender applicants respectively. Overall, in-person interviews were reported to be preferred by 42%, and 51% of PDs desired VIs to be included in future years. PDs opinion and role of the VIs into the future is variable. Despite uniform agreement of cost savings and belief that VI platform improves access for all, only half of PDs expressed interest of the VI format being continued in some form. PDs note limitation of VI in the ability to comprehensively assess applicants as well as the in-person format. Many programs have begun to incorporate vital training in the areas of diversity equity and inclusion bias, and illegal questions. There is a role for continued development and research on ways to optimize virtual interviews.

Is a "Urology Intern Boot Camp" Needed?

The preparation of medical students for internship during medical school is variable, which can negatively affect the performance and confidence of new urology residents year 1. The primary objective is to assess the need for a workshop/curriculum to prepare medical students transitioning to urology residency. Our secondary objective is to identify the appropriate workshop/curriculum design and to identify the needed topics. A survey was developed to evaluate the utility of a Urology Intern Boot Camp for incoming first year urology residents utilizing 2 existing intern boot camp models from other surgical disciplines. Urology Intern Boot Camp content and format and programmatic structure were also considered. The survey was sent to all first- and second-year urology residents and urology residency program directors and chairs. A total of 730 surveys were sent, including 362 first- and second-year urology residents and 368 program directors/chairs. Responses were received from 63 residents and 80 program directors/chairs for an overall response rate of 20%. Only 9% of urology programs provide a Urology Intern Boot Camp. Interest in participating in Urology Intern Boot Camp was high with 92% of residents interested. Programmatic support for a Urology Intern Boot Camp was also high with 72% of program directors/chairs willing to allow time off and 51% willing to financially support intern participation. There is significant interest from urology residents and program directors/chairs in providing incoming urology interns a boot camp. The format of the Urology Intern Boot Camp preferred was a combination of didactics and hands-on skills, and a hybrid delivery model of virtual and in-person carried out in multiple sites around the country.

Scholarly Activity and Research Training in Urology Residency Programs: Assessment of Current Practice and Barriers

To identify factors associated with effective scholarly activity and identify barriers to research during urology residency. An online survey was sent to 134 urology residency program directors in the United States. The survey assessed program characteristics, available support, and barriers for scholarly activity. Logistic regression analysis was used to identify characteristics of programs in the top quintile for success in scholarly activity. There was a 40% response rate (n=40). The majority of programs (86%) were university affiliated. Nearly all programs (98%) require participation in scholarly activity as a requirement for graduation. There were 3 primary outcomes evaluated: participation in original research, published scholarly activity and presentation of scholarly activity. Factors significantly associated with participation in original research were required research time (P=0.06), lack of experienced faculty (P=0.006), statistical and IRB support (P=0.03, P=0.01), funding (P=0.02), and research curriculum (P=0.006). Factors significantly associated with publication in peer reviewed journals were lack of funding and experienced faculty (P=0.07, P=0.01). Factors significantly associated with presentation of scholarly activity included research director (P=0.05), chairman support (P=0.02), research training (P=0.03), protected time for faculty (P=0.07), and faculty /resident attitudes toward conducting scholarly activity (P=0.08, P=0.02) and resident promotion linked to scholarly activity (P=0.01). Training urology residents in research is essential. Current methods and available resources are variable. Programs should identify resources and barriers that have the greatest impact on resident success in scholarly activity, and may implement changes to improve productivity within their program.

A0097 - Who is shaping the future of urology? A descriptive analysis of current urology residency program directors

A0097 - Who is shaping the future of urology? A descriptive analysis of current urology residency program directors

MP12-07 A SURVEY OF UROLOGY RESIDENCY PROGRAM DIRECTORS ASSESSING CRITERIA TO INTERVIEW APPLICANTS DURING THE COVID-19 PANDEMIC

You have accessJournal of UrologyEducation Research II (MP12)1 Sep 2021MP12-07 A SURVEY OF UROLOGY RESIDENCY PROGRAM DIRECTORS ASSESSING CRITERIA TO INTERVIEW APPLICANTS DURING THE COVID-19 PANDEMIC Jamal Alamiri, Mohamed E. Ahmed, Vidhu Joshi, Boyd R. Viers, Candace F. Granberg, and R. Houston Thompson Jamal AlamiriJamal Alamiri More articles by this author , Mohamed E. AhmedMohamed E. Ahmed More articles by this author , Vidhu JoshiVidhu Joshi More articles by this author , Boyd R. ViersBoyd R. Viers More articles by this author , Candace F. GranbergCandace F. Granberg More articles by this author , and R. Houston ThompsonR. Houston Thompson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001985.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To determine criteria of interest to Urology residency program directors (PDs) when selecting applicants for residency interviews during the COVID-19 pandemic. METHODS: An anonymous survey was sent via email to all Urology residency PDs across the United States. PDs were asked to assign the degree of importance (1-5, with 5 being very important) of selected factors in deciding which applicants to interview. Surveys were distributed and study data was managed using REDCap. Descriptive statistical analyses were performed. RESULTS: In total, 130 urology residency PDs were contacted and 64 (49.3%) responded to the survey. Urology letter(s) of recommendation (LOR) based on non-virtual rotation(s), Urology clerkship grades, research experience, and Visa status of the applicant were cited as the most important factors in selecting applicants for interview with median importance ratings of 5, 4, 4, and 5, respectively. Urology LOR based on virtual rotation(s), virtual sub-internship(s), and participation in social media activities were the least important in selecting applicants for interviews with median importance ratings of 2 for each. Notably, Urology LOR(s) based on non-virtual rotation(s) and Visa status were consistently ranked as the most important factors by over 50% of PDs. CONCLUSIONS: Urology PDs value urology LOR(s) from non-virtual rotation(s), Urology clerkship grades, research experience, and applicant Visa status as the most important factors in selecting applicants for interviews during the COVID-19 pandemic. Virtual rotation(s) and social media activity were ranked the lowest among criteria that influence the selection process for interviews. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e190-e191 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jamal Alamiri More articles by this author Mohamed E. Ahmed More articles by this author Vidhu Joshi More articles by this author Boyd R. Viers More articles by this author Candace F. Granberg More articles by this author R. Houston Thompson More articles by this author Expand All Advertisement PDF downloadLoading ...

PD33-03 NATIONAL IMPLEMENTATION OF A VIRTUAL SUBINTERNSHIP IN UROLOGY

INTRODUCTION AND OBJECTIVE: In-person subinternships for visiting medical students were discouraged during the COVID-19 pandemic. The Society of Academic Urologists (SAU) endorsed virtual subinternships in urology (vSIU) and provided all institutions with a standardized vSIU Guidebook containing a structured curriculum and curated resources. We sought to evaluate the successes and limitations of the vSIU at a national level. METHODS: In December 2020, we sent anonymous surveys via email to all medical students who submitted applications to the urology residency match and to all urology residency program directors (PDs) and associate PDs on the SAU email list. Surveys evaluated goals, curriculum composition, satisfaction, and future reusability. Outcomes were evaluated on a 5-point Likert scale. RESULTS: A total of 162 students (30%) and 78 PDs (48%) completed the survey, including 76 students (47%) and 32 PDs (41%) who participated in vSIU at 29 institutions. Of these electives, 66% were 1-2 weeks in duration, 48% were full-time, and 76% utilized the SAU guidebook. Electives consisted of a wide range of curricular elements (Figure). The most important goals for both students and PDs were experiencing/demonstrating program culture and evaluating whether the program/student are a good fit (≥ 50% rated “extremely important”). These goals were achieved by > 80% of students and PDs. Overall, 79% of students and 78% of PDs rated the vSIU “excellent” or “very good.” On multivariable ordinal logistic regression, duration ≥ 3 weeks and class size ≤ 4 students were associated with higher student ratings (p <0.05). Full-time electives, class size ≤ 4 students, and utilization of the SAU guidebook were associated with higher PD ratings (p <0.05). Although the majority of respondents found the vSIU less effective overall than in-person subinternships, 46% of students and 66% of PDs recommended incorporating virtual components into future electives. CONCLUSIONS: Amid a global pandemic, the vSIU was a successful nationwide initiative to provide virtual urological education to medical students. Though the vSIU should not replace in-person subinternships, the electives were highly rated and achieved the most important goals for students and PDs. The most successful courses were full-time, longer, had smaller class sizes and utilized the SAU Guidebook.

A Survey of Urology Residency Program Directors Assessing Criteria to Interview Applicants during the COVID-19 Pandemic.

We aimed to determine criteria of interest to urology residency program directors when selecting applicants for residency interviews during the COVID-19 pandemic. An anonymous survey was sent via email to all urology residency program directors across the United States. Program directors were asked to assign the degree of importance (1-5, with 5 being very important) of selected factors in deciding which applicants to interview. Surveys were distributed and study data were managed using REDCap. Descriptive statistical analyses were performed. In total, 130 urology residency program directors were contacted and 64 (49.3%) responded to the survey. Urology letter(s) of recommendation based on nonvirtual rotation(s), urology clerkship grades, research experience, and visa status of the applicant were cited as the most important factors in selecting applicants for interview with median importance ratings of 5, 4, 4, and 5, respectively. Urology letter(s) of recommendation based on virtual rotation(s), virtual sub-internship(s), and participation in social media activities were the least important in selecting applicants for interviews with median importance ratings of 2 for each. Notably, urology letter(s) of recommendation based on nonvirtual rotation(s) and visa status were consistently ranked as the most important factors by more than 50% of program directors. Urology program directors value urology letter(s) of recommendation from nonvirtual rotation(s), urology clerkship grades, research experience, and applicant visa status as the most important factors in selecting applicants for interviews during the COVID-19 pandemic. Virtual rotation(s) and social media activity were ranked the lowest among criteria that influence the selection process for interviews.

Widely Variable Parental Leave Practices for Urology Residency Programs in the United States

To query a cohort of program directors to better understand the contemporary landscape of parental leave for urology trainees. The American Board of Urology mandates that a resident must work 46 weeks annually in order to not extend residency. We hypothesize that formal parental leave policies may vary by institution and may not be easily accessible. A 22 question survey designed to assess parental leave policies was distributed to 144 American College of Graduate Medical Education accredited Urology residency program directors in the United States via e-mail. Results were collected anonymously. A total of 65 program directors completed the survey for a response rate of 43%. The median age of program directors was 49 and 78% were male. Only 12% reported no formal maternity leave policy, while 21% reported no formal paternity leave policy. Maternity leave duration varied greatly with 6 (49%) and 12 weeks (27%) as the most common duration, while paternity leave was most commonly reported as 2 (39%), 6 (18%) and 12 weeks (19%) in length. Most parental leave policies were available via an institutional website (81%), with only 39% available on a public website. While most leave policies covered compensation, few addressed call expectations or procedural safety precautions. Parental leave policies across Urology training programs in the United States are variable, and may not cover critical components of pregnancy or leave. An opportunity exists to create a comprehensive, standardized parental leave policy.

Effect of COVID-19 on Urology Residency Training: A Nationwide Survey of Program Directors by the Society of Academic Urologists.

Coronavirus disease (COVID-19) has profoundly impacted residency training and education. To date, there has not been any broad assessment of urological surgery residency changes and concerns during the COVID-19 pandemic. The Society of Academic Urologists distributed a questionnaire to urology residency program directors on March 30, 2020 exploring residency program changes related to the COVID-19 pandemic. Descriptive statistics are presented. A qualitative analysis of free response questions was undertaken. A post hoc analysis of differences related to local COVID-19 incidence is described. The survey was distributed to 144 residency programs with 65 responses for a 45% response rate. Reserve staffing had started in 80% of programs. Patient contact time had decreased significantly from 4.7 to 2.1 days per week (p <0.001). Redeployment was reported by 26% of programs. Sixty percent of programs reported concern that residents will not meet case minimums due to COVID-19. Wellness activities centered on increased communication. All programs had begun to use videoconferencing and the majority planned to continue. Programs in states with a higher incidence of COVID-19 were more likely to report resident redeployment (48% vs 11%, p=0.002) and exposure to COVID-19 positive patients (70% vs 40%, p=0.03), and were less likely to report concerns regarding exposure (78% vs 97%, p=0.02) and personal protective equipment availability (62% vs 89%, p=0.02). As of April 1, 2020 the COVID-19 pandemic had resulted in significant changes in urology residency programs. These findings inform a rapidly changing landscape and aid in the development of best practices.

Vasectomy: A Survey of Urologist’s Opinions on Training Family Planning Providers [37I

INTRODUCTION: Vasectomy is one of the only forms of male-controlled contraception, yet it is the only form of contraception not generally performed by traditional family planning providers: family medicine physicians and obstetricians/gynecologists (OB/GYNs). Our study aims to assess the willingness of urologists to train family planning providers on this procedure. METHODS: For this IRB approved/exempt study, electronic surveys were sent to all American urology residency program directors via REDCap. In addition, in person surveys were conducted at the American Urology Association (AUA) 2019 Conference. Statistical analyses were performed using Student t-tests for continuous data and Pearson chi-squared tests for categorical data. RESULTS: Forty-nine AUA conference responses and 26 residency program director responses were collected. Most urologists surveyed were willing to train other urologists (85.1%), while they were less willing to train non-urologists: general surgeons (20.3%), family medicine physicians (20.3%), and OB/GYNs (10.8%). While more urologists were willing to train family medicine physicians versus OB/GYNs (P&lt;.01), more urologists believed it would be more difficult for family medicine practitioners to learn vasectomy (P&lt;.01). Urologists were worried about competition, that training others would decrease cases for urologists, and family planning providers would have insufficient volume. In addition, urologists were concerned that family medicine physicians had a lack of surgical skills and OB/GYNs would be unfamiliar with anatomy. CONCLUSION: Overall, urologists show an unwillingness to train family planning providers. In order to provide comprehensive care, family planning providers should find allies to help learn the procedure or partner with vasectomy providers.

Predictors and Barriers to Faculty Scholarly Activity in United States Urology Residency Programs

ObjectiveTo determine factors and barriers associated with scholarly activity among faculty members at urology residency programs in the United States. MethodsAn online survey was sent to all 134 urology residency program directors. The survey assessed program characteristics including size, location and definition of scholarly activity. It assessed available support for and barriers to resident scholarly activity, faculty participation in scholarly activity and mentorship of residents. Linear regression analysis was used. ResultsWe had a 40% response rate (N = 40). Faculty attitudes toward conducting scholarly activity (P < .001) and lack of a research curriculum (P = .05) were barriers to the outcome ‘participation in scholarly activity’. Faculty attitudes toward conducting scholarly activity was also a barrier to the outcomes ‘mentorship of residents’ (P = .004) and ‘publication of at least 1 paper’ (P = .004). Available statistician was positively associated with the outcomes ‘publications’ (P = .062) and ‘presentations’ (P = .032). A minimum requirement of a local presentation (P=0.04) and chairman support (P = .015) were positively associated with the outcome ‘presentation at a conference.’ ConclusionTraining residents in research matters for the resident, the institution and future generations of surgeon scientists. Higher levels of faculty scholarly activity were associated with a minimum requirement for residents to submit a manuscript for publication, strong chairman support for resident research, and the availability of a statistician. A common barrier to faculty scholarly activity, publications, and resident mentorship was faculty attitudes toward resident scholarly activity. Urology residency programs seeking to prioritize scholarly activity among faculty should consider these factors.

Urology Residency Directors' Awareness of Association between α-Adrenergic Antagonists and Floppy Iris Syndrome and Practice Patterns Regarding Prophylactic α-Adrenergic Antagonists

Purpose The use of prophylactic α-adrenergic receptor antagonists prior to surgery is associated with reduced postoperative urinary retention. However, α-adrenergic receptor antagonists have been associated with intraoperative floppy iris syndrome (IFIS). Studies have shown that IFIS is correlated with higher rates of cataract surgery complications. The purpose of this study is to investigate United States urology residency program directors' (1) awareness of the association between α-adrenergic receptor antagonists and IFIS and (2) practice patterns regarding the use of prophylactic α-adrenergic receptor antagonists prior to surgery. Materials and Methods An anonymous, online survey was sent to the program director of each of the 138 urology residency programs accredited by the Accreditation Council for Graduate Medical Education. The survey assessed program directors' knowledge regarding the association between α-adrenergic receptor antagonists and IFIS, and practice patterns regarding the use of prophylactic α-adrenergic receptor antagonists prior to surgery. Results Sixty-nine of the 138 (50%) residency directors responded. Forty percent of respondents believe that tamsulosin (Flomax) does not increase the risk of IFIS. Fifty-two percent of respondents prescribe or consider prescribing prophylactic α-adrenergic blockers prior to surgery, with tamsulosin being the most preferred α-adrenergic blocking agent. Of the prescribing urologists, only 58% counsel most of their patients regarding the association between the prescribed drug and IFIS, 28% never ask patients whether they have had cataract surgery, and 56% would change the drug or dosage used if they learned that a patient had not yet had cataract surgery. Conclusion The results of this study demonstrate the potential to decrease the risk of IFIS through education of urologists regarding the association of α-adrenergic antagonists with IFIS.

Educational Resources for Resident Training in Quality Improvement: A National Survey of Urology Residency Program Directors

IntroductionA key physician competency outlined in the Urology Milestone Project is engagement in quality improvement. Despite this mandate little is known about the attitudes of urology residency program directors regarding the relative importance of quality improvement education. Therefore, we performed a national survey of program directors. MethodsA 25-item survey was developed to investigate program director knowledge and training in quality improvement methodology, participation in quality improvement related activities, curriculum support for resident quality improvement educational activities, and attitudes regarding the relative importance of quality improvement education. The survey was sent via e-mail (November 1, 2016) to all program directors affiliated with the Society of Academic Urologists (sample size 116 of 134, 87% of Accreditation Council for Graduate Medical Education programs). ResultsA total of 36 program directors returned a completed survey for a response rate of 31%. Only 22% (8) of program directors reported receiving formal education or training in quality improvement methodology. Overall 44% (16) of program directors reported that their program offers formal education or a curriculum in quality improvement methodology for their trainees. Program directors expressed a strong desire for residents to learn quality improvement methodology (positive response 32 of 36, 89%) and understand how to apply it to conduct a quality improvement project (positive response 30 of 35, 86%). Program directors strongly believe that a urology oriented quality improvement curriculum would be a valuable resource (positive response 31 of 36, 86%) with a need for support from our professional society (positive response 29 of 36, 81%). ConclusionsA minority of programs have quality improvement education available for residents. However, program directors agree that quality improvement is an integral part of residency training that should be promoted by our profession.

PD58-10 QUALITY IMPROVEMENT EDUCATION AND PARTICIPATION IN UROLOGY RESIDENCY PROGRAMS: PRELIMINARY SURVEY RESULTS OF PROGRAM DIRECTORS

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Quality Improvement & Patient Safety I1 Apr 2017PD58-10 QUALITY IMPROVEMENT EDUCATION AND PARTICIPATION IN UROLOGY RESIDENCY PROGRAMS: PRELIMINARY SURVEY RESULTS OF PROGRAM DIRECTORS Justin Ziemba, Brian Matlaga, and Christopher Tessier Justin ZiembaJustin Ziemba More articles by this author , Brian MatlagaBrian Matlaga More articles by this author , and Christopher TessierChristopher Tessier More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2625AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES One of the key physician competencies outlined in the Urology Milestone project is engagement in quality improvement (QI). Despite this mandate, little is known about how QI education and participation by residents is integrated into their training. Therefore, we performed a national survey of urology residency program directors (PD) in partnership with the Society of Academic Urologists (SAU). METHODS A 37-item electronic survey was developed to assess QI education, mentorship, and participation within a urology residency program. The survey was tested by an assistant program director and revised based on the feedback received. The survey was sent via email (11/1/2016) to all PD affiliated with the SAU (n=116; 94% of ACGME programs). Included in this analysis are only the completed responses received from the initial survey invitation at 1 week (censor date 11/7/2016). RESULTS A total of 22 respondents returned a completed survey for a response rate of 19% (22/116). Table 1 outlines program characteristics. All PD reported they participate in direct patient care, but 36% (8/22) also listed QI leader and educator as an additional role. Only 27% (6/22) of PD have received formal training in QI methodology, but 59% (13/22), 55% (12/22), and 32% (7/22) are directly involved in QI education, serve on a QI committee, and lead a QI team, respectively. Only 45% (10/22) of programs have a formal curriculum for teaching QI to residents with 90% (9/10) using didactic sessions focusing on Six Sigma (5/10; 50%) and root cause analysis (5/10; 50%) methodology. Table 2 lists PD attitudes towards QI education and participation for residents. The majority of PD (19/22; 86%) would like to see the American Urological Association develop a urology-oriented QI curriculum. CONCLUSIONS A minority of programs have QI education available for residents. However, PD agree that QI is an integral part of residency training, which should be promoted by our profession. Responses from additional PD will allow us to validate these initial trends. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1131 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Justin Ziemba More articles by this author Brian Matlaga More articles by this author Christopher Tessier More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Program Directors' Criteria for Selection Into Urology Residency

To investigate urology residency program directors' criteria for resident selection. In 2014, the urology residency program directors were surveyed using an email questionnaire. The generated questionnaire included the following 3 components: (1) assessing the factors used in selecting applicants for interviewing and matching, (2) rating the factors resulting in a negative decision for applicants for interviewing and matching, and (3) investigating the factors that gave applicants special attention or consideration from program directors. Analysis of variance testing and post hoc Student t tests were used to assess for differences in the mean importance score of the factors. Urology reference letters and United States Medical Licensing Examination (USMLE) scores were ranked as the most important factors for applicant selection. A USMLE Step 1 score≤220 and a USMLE Step 2 score≤220 were the most deleterious factors to applicants, with a previous match failure being no less deleterious to an applicant than a USMLE Step 1 or 2 score≤220. Program directors gave special attention or consideration to gender (25%), minority status (36.8%), being from the same medical school as the program director (61.8%), completing an away rotation at the program director's institution (86.8%), being a child of an academic urologist (47.4%), and being a child of an academic nonurologic physician (15.8%). Although program directors consider a variety of factors during the residency selection process, USMLE performance, urology references, and completing an away rotation at the program directors' institution appear to be the most important factors to program directors during the residency selection process.

Pediatric Resident Exposure to Urology: Identifying a Need

We evaluated current trends of pediatric urology exposure during the 3-year pediatric residency period nationwide. We also evaluated the opinions of urology and pediatric residency program directors regarding the need for additional exposure to pediatric urology. From February to October 2011 we administered 2 concurrent electronic surveys. One set was sent to urology residency program directors and the other was sent to pediatric residency program directors. The surveys consisted of 6 and 12 questions, respectively. The questions were created to best evaluate exposure to pediatric urology from the perspective of each cohort. Response data were analyzed using the chi-square test and case-control methods. Of the 117 accredited urology residency program directors and 190 pediatric residency program directors 51 (43.5%) and 78 (41.1%), respectively, completed the survey. Urology program directors answered favorably by a margin of 66% toward increased involvement with pediatric residents, while 84.6% of pediatric residency directors would like increased exposure to pediatric urology. Furthermore, 87% of pediatric residency directors reported that they do not require residents to have a formal pediatric urology rotation. However, in 65% of pediatric programs residents received some form of didactic education. These results show the desire on the part of urology and pediatric residency program directors for pediatric residents to have greater exposure to pediatric urology, particularly didactic and bedside teaching in the management of pediatric urological disorders. Increasing pediatric resident exposure to pediatric urological pathology and treatment during training would have a positive impact on the subsequent diagnosis and care of pediatric urological conditions.

Competence in pediatric urology upon graduation from residency: perceptions of residents, program directors and pediatric urologists

We aimed to clarify the scope of pediatric urological procedures that Canadian urology residents are perceived to be competent to perform upon graduation. We conducted a survey from April 2005 to June 2006 of urology residency program directors (UPDs), senior urology residents (SURs) and Pediatric Urologists of Canada (PUC) members from all 12 Canadian training programs. Questions focused on which of 23 pediatric urological procedures the 3 study groups perceived urology residents would be competent to perform upon completion of residency without further fellowship training. Procedures were based on the "A," "B" and "C" lists of procedures (least complex to most complex) as outlined in the Royal College of Physicians and Surgeons of Canada Objectives of Training in Urology. Response rates were 12/12 (100%), 41/53 (77%) and 17/23 (74%) for UPDs, SURs and PUC members, respectively. Average exposure to pediatric urology during residency was 5.4 (range 3-9) months and considered sufficient by 75% of UPDs and 69% of SURs, but only 41% of PUC members (p = 0.05). Overall, the 3 groups disagreed on the level of competence for performing level "A" and "B" procedures, with significant disagreement between PUC members and UPDs as well as SURs (p < 0.005). PUC members perceive Canadian urology residents' exposure to pediatric urology as insufficient and their competence for procedures of low to moderate complexity as inadequate. Further investigation regarding exposure to and competence in other emerging subspecialty spheres of urology may be warranted. Ongoing assessment of the objectives for training in pediatric urology is required.