Page 4 - CUA2018 Abstracts - Miscellaneous/Other

2018 CUA AbstrACts

Poster Session 2: Education/Practice Management

June 25, 2018; 0800–0930

MP–2.1 Methods: Six first–year residents from two Canadian centres participated
Development and validation of a 3D–printed bladder model to in the two–day boot camp, which included 11 didactic lectures (first–
simulate the laparoscopic urethrovesical anastomosis for radical year medical and surgical topics) and simulation sessions that allowed for
prostatectomy training deliberate practice with feedback. Participants completed an entrance and
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Yanbo Guo , Jen Hoogenes , Nathan Wong , Kevin Kim , Bobby Shayegan , exit survey and an identical pre– and post–boot camp 31–item multiple–
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Edward Matsumoto 1 choice questionnaire (MCQ). At the end of Day 2, participants completed
1 Department of Surgery, Division of Urology, McMaster University, a six–station objective structured clinical exam (OSCE) followed by a semi–
Hamilton, ON, Canada structured group feedback discussion. Three second–year urology residents
Introduction: The laparoscopic approach of performing a radical prostatec- served as historical controls and completed the identical MCQ and OSCE.
tomy (RP) is associated with a steep learning curve, especially during the Results: The six participants had a mean age of 26.8±2 years, three were
urethrovesical anastomosis (UVA). In an attempt to decrease the learning male, and represented five medical schools. Most prior urology experience
curve for performing a UVA, we developed a 3D printed bladder model for was as an observer or second assist. Participants markedly improved on the
simulated UVA training. Our objective was to validate this model. pre– and post– MCQs (62%±11 and 91%±9, respectively), whereas the his-
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Methods: The final bladder model was produced using a LulzBot TAZ 6 torical controls scored 66%±8. Participants scored marginally higher than
3D printer. The dimensions mimic the anatomical structures of a human the controls on four of the six OSCE stations. Post–boot camp, participants
bladder and urethra, and the polymer allows for realistic incising and suture reported overall higher confidence levels and felt the curriculum was an
pull–through. Urology residents, fellows, and staff completed a laparoscopic excellent preparation for residency.
training course during which they performed a simulated UVA on the Conclusions: Our inaugural urology boot camp demonstrated feasibility and
model. Laparoscopic video trainers were used with the model affixed inside utility. The knowledge and technical skills uptake was established via the
a simulated torso (Fig. 1; available at https://cua.guide/), and each UVA MCQ and OSCE results, with participants’ performance at or even above the
was videotaped for construct validation purposes. Participants completed level of the second–year resident controls. We aim to further develop our
an exit questionnaire using five–point Likert scales within six domains. boot camp and provide a framework for other urology residency programs.
Results: Junior and senior residents, fellows, and staff from seven urology
programs completed the course (n=24). Mean age was 29.8 years (±4.6), MP–2.3
and 21 were male. For face validity, participants scored the following means The difficulty of a clinical OSCE start station does not impact
(out of 5): 3.6 for anatomical realism; 3.8 for overall task–based usefulness; final OSCE mark
4.1 for the UVA task itself; and 4.4 for suturing, knot tying, and cutting. For Avril Lusty , Naji Touma , Michael Leveridge 1
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content validity, participants rated overall usefulness as a training tool 4.3 1 Department of Urology, Queen’s University, Kingston, ON, Canada
and improving operative technique 4.4. Overall reaction scored a mean Introduction: Examinees in clinical objective structured clinical examina-
of 4.2 over the six domains. A mean of 4.1 was scored for transferability tions (OSCEs) may be concerned that the difficulty (or ease) of their start
of skills to the operating room, and a mean of 4.3 was indicated for “the station may undermine (or bolster) their confidence and subsequent per-
model should be incorporated into urology training curricula.” formance. We sought to determine if starting at the easiest or most difficult
Conclusions: We established that this low–cost bladder model ($14 CAD/ station impacts overall outcome.
model) has face and content validity for laparoscopic UVA training within Methods: Results of all Canadian PGY–5 candidates writing the Queen’s
this sample, and skills acquired using the model can prepare learners for University Examination of Skills Training (QUEST) examination between
live laparoscopic UVAs. The videos are currently being evaluated by three 2003 and 2013 were queried, and selected stations (the easiest, most diffi-
expert raters to assess the model’s construct validity. cult, and most difficult manned) were determined for each year. Independent
sample t–tests and regression analysis were used to determine if there was a
MP–2.2 significant difference in final OSCE scores between participants who began
Development, implementation, and evaluation of a competency– on the selected stations vs. the participants who did not.
based boot camp for first–year urology residents Results: Three hundred twenty–six residents participated over the study
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Yuding (Ding) Wang , Jen Hoogenes , Udi Blankstein , Kevin Kim , Roderick period. Mean station score was 74.3% (standard deviation [SD] 6.0%).
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Clark , Ali Al–Hashimi , Bobby Shayegan , Edward Matsumoto 1 There was no significant difference noted in overall final OSCE scores
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1 Department of Surgery, Division of Urology, McMaster University, between the participants who began on the easiest (73.7% vs. 74.6%;
Hamilton, ON, Canada; Department of Surgery, Division of Urology, p=0.524), the most difficult (74.1% vs. 74.3%; p=0.868), or the most dif-
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Western University, London, ON, Canada ficult manned (73.6% vs. 74.4%; p=0.459) stations and those participants
Study Groups: McMaster University Surgical Associates. who did not. On regression analysis, the easiest, most difficult, and most
Introduction: The integration of competency–based education into surgical difficult manned stations each resulted in non–significant decreases in mean
residency programs, such as the Competence by Design (CBD) initiative in score (–0.9%, –0.3%, and –1.4%, respectively).
Canada, presents challenges for curricula design to ensure residents achieve Conclusions: The difficulty level of the starting station on an OSCE examina-
competence as they progress. Surgical boot camps have been used to tion does not appear to benefit, nor harm subsequent overall performance
improve the learning process by orienting and preparing new residents. We on the examination.
developed, implemented, and evaluated an intensive didactic and simula-
tion–focused boot camp for first–year urology residents.
CUAJ • June 2018 • Volume 12(6Suppl2) S73
© 2018 Canadian Urological Association