Affiliation:
1. Department of Surgery, Walter Reed National Military Medical Center/Uniformed Services University of the Health Sciences , Bethesda, MD 20889, USA
2. Department of Surgery, Naval Medical Center Portsmouth , Portsmouth, VA 23708, USA
3. Center for Health Professions Education, Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, MD 20814, USA
Abstract
ABSTRACT
Background
Military general surgeons commonly perform urologic procedures, yet, there are no required urologic procedural minimums during general surgery residency training. Additionally, urologists are not included in the composition of forward operating surgical units. Urologic Care Army/Air Force/Navy Provider Education was created to provide military general surgeons with training to diagnose and treat frequently encountered urologic emergencies when practicing in environments without a urologist present.
Study Design
A literature review and needs assessment were conducted to identify diagnoses and procedures to feature in the course. The course included a 1-hour didactic session and then a 2-hour hands-on simulated skills session using small, lightweight, cost-effective simulators. Using a pretest–posttest design, participants completed confidence and knowledge assessments before and after the course. The program was granted educational exemption by the institutional review board.
Results
Twenty-seven learners participated. They demonstrated statistically significant improvement on the knowledge assessment (45.4% [SD 0.15] to 83.6% [SD 0.10], P < .01). On the confidence assessment, there were statistically significant (P ≤ .001) improvements for identifying phimosis, paraphimosis, and testicular torsion, as well as identifying indications for suprapubic catheterization, retrograde urethrogram, and cystogram. There were also statistically significant (P < .001) improvements for performing: suprapubic catheterization, dorsal penile block, dorsal slit, scrotal exploration, orchiopexy, orchiectomy, retrograde urethrogram, and cystogram.
Conclusion
We created the first-ever urologic emergencies simulation curriculum for military general surgeons that has demonstrated efficacy in improving the diagnostic confidence, procedural confidence, and topic knowledge for the urologic emergencies commonly encountered by military general surgeons.
Publisher
Oxford University Press (OUP)
Subject
Public Health, Environmental and Occupational Health,General Medicine
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