de Vries Anna H, van Luijk Scheltus J, Scherpbier Albert J J A, Hendrikx Ad J M, Koldewijn Evert L, Wagner Cordula, Schout Barbara M A
Department of Urology, Catharina Hospital, Eindhoven, The Netherlands.
Academy of Post-graduate Education, Maastricht University Medical Centre, Maastricht, The Netherlands.
BMC Urol. 2015 Sep 4;15:93. doi: 10.1186/s12894-015-0084-8.
Benefits of simulation training are widely recognized, but its structural implementation into urological curricula remains challenging. This study aims to gain insight into current and ideal urological practical skills training and presents the outline of a newly developed skills training program, including an assessment of the design characteristics that may increase its acceptability.
A questionnaire was sent to the urology residents (n = 87) and program directors (n = 45) of all Dutch teaching hospitals. Open- and close-ended questions were used to determine the views on current and ideal skills training and the newly developed skills training program. Eight semi-structured interviews were conducted with 39 residents and 15 program directors. All interviews were audiotaped, fully transcribed, and thereafter analyzed.
Response was 87.4% for residents and 86.7% for program directors. Residents appeared to be still predominantly trained 'by doing'. Structured practical skills training in local hospitals takes place according to 12% of the residents versus 44% of the program directors (p < 0.001). Ideally, residents prefer to practice certain procedures on simulation models first, especially in endourology. The majority of residents (92%) and program directors (87%) approved of implementing the newly developed skills training program (p = 0.51). 'Structured scheduling', 'use of peer teaching' and 'high fidelity models' were indicated as design characteristics that increase its acceptability.
Current urological residency training consists of patient-related 'learning by doing', although more practice on simulation models is desired. The acceptability of implementing the presented skills-training program is high. Design characteristics that increase its acceptability are structured scheduling, the use of peer teaching and high fidelity models.
模拟培训的益处已得到广泛认可，但其在泌尿外科课程中的结构化实施仍具有挑战性。本研究旨在深入了解当前及理想的泌尿外科实践技能培训情况，并介绍一个新开发的技能培训项目大纲，包括对可能提高其可接受性的设计特征进行评估。
向荷兰所有教学医院的泌尿外科住院医师（n = 87）和项目主任（n = 45）发送了一份问卷。通过开放式和封闭式问题来确定对当前及理想技能培训以及新开发的技能培训项目的看法。对39名住院医师和15名项目主任进行了8次半结构化访谈。所有访谈均进行了录音、全文转录，随后进行分析。
住院医师的回复率为87.4%，项目主任的回复率为86.7%。住院医师似乎仍主要通过“实践”进行培训。12%的住院医师表示当地医院有结构化的实践技能培训，而项目主任的这一比例为44%（p < 0.001）。理想情况下，住院医师更倾向于先在模拟模型上练习某些操作，尤其是在腔内泌尿外科领域。大多数住院医师（92%）和项目主任（87%）赞成实施新开发的技能培训项目（p = 0.51）。“结构化安排”“同伴教学的使用”和“高保真模型”被认为是能提高其可接受性的设计特征。
当前泌尿外科住院医师培训以与患者相关的“边做边学”为主，尽管希望能在模拟模型上有更多练习。所提出的技能培训项目的实施可接受性较高。能提高其可接受性的设计特征包括结构化安排、同伴教学的使用和高保真模型。
