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[手术信心的性别差异:2022年德国泌尿外科住院医师学会内镜研讨会的结果]

[Sex-specific differences in surgical confidence: results of the Endo Workshop of the German Society of Residents in Urology 2022].

作者信息

Siech Carolin, Kluth Luis A, Konopka Mareen, Reimann Maximilian, Plage Henning, Lichy Isabel, Gerdes Benedikt, Kasperek Jan, Humke Clara, Marks Phillip, Fisch Margit, Karakiewicz Pierre I, Chun Felix K H, Schäfer Timm, Meyer Christian P, Kaulfuss Julia C

机构信息

Goethe-Universität Frankfurt, Universitätsklinikum, Klinik für Urologie, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Kanada.

出版信息

Urologie. 2024 Nov;63(11):1122-1128. doi: 10.1007/s00120-024-02429-w. Epub 2024 Aug 27.

Abstract

BACKGROUND

Simulation-based training is gaining importance in urologic residents training.

OBJECTIVES

This prospective study evaluated the influence of the Endo Workshop of the German Society of Residents in Urology e. V. (GeSRU) on surgical confidence.

MATERIALS AND METHODS

GeSRU Endo Workshop 2022 included 1 h simulation-based training sessions on stone removal using ureteroscopy (URS) and transurethral resection of the bladder (TURB). Using an online questionnaire, surgical confidence was assessed before and after the workshop. Surgical assessment relied on the global rating scale (GRS).

RESULTS

Overall, 40 residents participated: 25 (62.5%) men and 15 (37.5%) women. In URS assessment, men vs. women achieved an average of 26.6 vs. 26.1/35 points on the GRS (p = 0.7) and completed the task in 8.1 ± 1.9 vs. 9.9 ± 0.4 min (p < 0.001). In TURB assessment, men vs. women achieved an average of 26.0 vs. 27.3/35 points on the GRS (p = 0.3) and required 7.6 ± 1.9 vs. 7.7 ± 2.2 min (p = 0.9), respectively. Among participants who answered the baseline survey and the evaluation (n = 33), 16 (80%) men vs. 3 (23%) women had surgical confidence to perform URS before (p = 0.01), and 19 (95%) men vs. 7 (54%) women after the workshop (p = 0.03). Regarding the performance of TURB, 10 (50%) men vs. 7 (54%) women reported surgical confidence before (p = 0.1), and 15 (75%) men vs. 10 (77%) women after the workshop (p = 1.0). An increase in surgical confidence to perform URS and TURB was reported by 9 (45%) and 10 (50%) men and 9 (69%) and 8 (62%) women, respectively.

CONCLUSIONS

Endourologic simulation-based training increases surgical confidence of both female and male residents. Despite comparable surgical outcomes, women approach URS with lower surgical confidence compared to their male counterparts.

摘要

背景

基于模拟的培训在泌尿外科住院医师培训中日益重要。

目的

这项前瞻性研究评估了德国泌尿外科住院医师协会(GeSRU)的内镜研讨会对手术信心的影响。

材料与方法

2022年GeSRU内镜研讨会包括1小时基于模拟的输尿管镜取石术(URS)和经尿道膀胱肿瘤切除术(TURB)培训课程。通过在线问卷在研讨会前后评估手术信心。手术评估采用整体评分量表(GRS)。

结果

共有40名住院医师参与:25名(62.5%)男性和15名(37.5%)女性。在URS评估中,男性和女性在GRS上的平均得分分别为26.6分和26.1分(满分35分,p = 0.7),完成任务的时间分别为8.1±1.9分钟和9.9±0.4分钟(p < 0.001)。在TURB评估中,男性和女性在GRS上的平均得分分别为26.0分和27.3分(满分35分,p = 0.3),所需时间分别为7.6±1.9分钟和7.7±2.2分钟(p = 0.9)。在回答了基线调查和评估的参与者中(n = 33),16名(80%)男性和3名(23%)女性在研讨会前对进行URS有手术信心(p = 0.01),研讨会后19名(95%)男性和7名(54%)女性有手术信心(p = 0.03)。关于TURB的表现,10名(50%)男性和7名(54%)女性在研讨会前报告有手术信心(p = 0.1),研讨会后15名(75%)男性和10名(77%)女性有手术信心(p = 1.0)。分别有9名(45%)男性、10名(50%)男性、9名(69%)女性和8名(62%)女性报告进行URS和TURB的手术信心有所增加。

结论

基于腔内泌尿外科模拟的培训提高了男女住院医师的手术信心。尽管手术结果相当,但女性进行URS时的手术信心低于男性同行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9ba/11549232/f20c715a1fd4/120_2024_2429_Fig1_HTML.jpg

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