The success and evolution of a urological "Boot Camp" for newly appointed UK urology registrars: Incorporating simulation, nontechnical skills and assessment

Young, M, Kailavasan, M., Taylor, J., Cornford, P., Colquhoun, A., Rochester, M., Hanchanale, V., Somani, B., Nabi, G., Garthwaite, M., Gowda, R., Reeves, F., Rai, B., Doherty, R., Gkentzis, A., Athanasiadis, G., Patterson, J., Wilkinson, B., Myatt, A., Biyani, C.S. and Jain, S (2019) The success and evolution of a urological "Boot Camp" for newly appointed UK urology registrars: Incorporating simulation, nontechnical skills and assessment. Journal of Surgical Education. (doi:10.1016/j.jsurg.2019.04.005).

Abstract

BACKGROUND: Urological training has dramatically changed in recent years. Training durations are shorter and a drive toward consultant led care has reduced trainees experience. Within the UK, approximately 50 registrars annually embark on a 5-year Urology training programme, with variable levels of basic urological experience.

OBJECTIVE: To describe a simulation programme aimed at delivering the knowledge and skills necessary to safely and effectively start working as a registrar in Urology by intensive training with a 1:1 faculty to delegate ratio.

DESIGN, SETTING, AND PARTICIPANTS: Our course content mirrors the UK training syllabus for junior Urology registrars. We delivered 8 modules over a 4-day programme with a fifth day of assessments. Delegates level of urological knowledge, operative competency and confidence pre-, immediately post-training and at 3-months postcourse were assessed. Objective delegate and faculty feedback was also collected. Technical skills modules include; inguinoscrotal surgery, ureteroscopy, transurethral resection, urodynamics, and Botox administration as well as basic reconstructive and laparoscopic operative skills. "Nontechnical" skills included simulated ward round, out-patient, and emergency scenarios.

RESULTS: Feedback from delegates and faculty members has been overwhelmingly positive. We have used this feedback to tailor the content of the course for following years. An increased knowledge level (based on mean examination scores [precourse 55.5%, postcourse 70.1%]) and operative competency was observed in all skills assessed (transurethral resection of the prostate, transurethral resection of bladder tumor, Ureteroscopy, laparoscopic skills, and instrument assembly). Operative confidence was increased immediately and at 3-months postcourse.

CONCLUSIONS: Our "boot camp" course provides a realistic introduction and foundation to begin Urological practice. Being delivered at the beginning of the training scheme, prior to intensive patient exposure, registrars are in an optimum position to develop their newly acquired knowledge and skills to enhance training and intends to improve patient safety and satisfaction.

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