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2017 SUPS/SMS Surgical Lab for Residents Educational Assessment

posted: December 13, 2017

Penile prosthesis surgery remains an important and effective treatment option for male erectile dysfunction that does not respond to other less invasive approaches or when these approaches are contraindicated or not acceptable to the patient.

Traditionally, surgical technical skills have been acquired by observing and then performing surgical tasks in a “see one… do one …teach one” model solely within the operating room. Although operative experience is paramount, the lack of formal teaching and testing of surgical skills in a safe practice environment remains a longstanding educational shortcoming of this traditional paradigm.

Unfortunately, constraints on surgical resident training, including work hour mandates, shorter training programs, costs, and public expectations, are limiting the acquisition of surgical skills in the operating room. As a result, more limited regional and national simulation training courses are being conducted to augment the resident experience.

In prosthetic urology, the educational effect of these simulation and skills courses has not been reported. In particular, whether relatively short simulation experiences are of educational benefit, even in the short-term, is of interest.

At the 2017 SMSNA fall meeting in San Antonio, we set out to assess the educational effect of the SUPS/SMS Surgical lab for Residents. This is an intensive half-day lab open to resident trainees from around the country. SUPS and SMS members provide both didactic and hands on training for residents interested in prosthetic Urology.

Before and immediately after course participation, participants completed a 15-question multiple choice assessment of procedural knowledge that tested knowledge pertaining to penile implant surgery. Questions were based on recommendations from the International Consultation on Sexual Medicine (J Sex Med 2016; 13:489-518). The pre-course assessment was completed via an online REDCap survey two months before the course.

Before the course and immediately after course participation, participants also completed a self-assessment of their own procedural confidence from a surgical task list for penile prosthesis surgery. Participants were asked to rate their own confidence on a 5-point Likert scale (1=not at all confident, 2=minimally confident, 3=average confidence, 4=above average confidence, 5=very confident).

The study has three primary goals:

  1. Determine the effect of the intensive SUPS/SMS surgical lab on trainee knowledge and self-rated procedural confidence
  2. Determine whether the effect of the course was different based on post-graduate year
  3. Determine whether the effect of the course was different based on prior implant experience

Once the final statistical analysis is complete, we hope this project demonstrates that an intensive simulation and surgical skills course can improve procedural knowledge and self-rated procedural confidence across all levels of training and for residents with different exposure to prosthetic surgery.

Although it is impossible to determine whether participation in the SUPS/SMS lab translates into improved performance in the OR and better patients outcomes, we believe these opportunities are essential for surgical education. In our view, simulation training is not meant to supplant a trainee’s actual operative experience but rather prepare the trainee to maximize the benefit from every experience in the operating room.

We expect the statistical analysis to be complete in early 2018 and I look forward to presenting our data and publishing our findings in the future.

Please accept my best wishes for the holiday season.

Aaron C. Lentz, MD, FACS
Associate Professor of Surgery
Duke University Division of Urologic Surgery