Study design, materials and methods
OBGYN and Urology residents and medical students voluntarily participated in a 2-hour simulation and didactic session including a pre and post-didactic survey. Two simulations were done on a model using cystoscopy and included placement of a unilateral ureteral catheter with oversight of the urogynecology fellows. The primary outcome was to assess the confidence and knowledge of OBGYN and urology trainees with didactics and simulation. Confidence was measured on a 5-level ordinal scale. Knowledge was assessed by a series of questions on the pre and post-intervention surveys. Secondary outcomes include demographic information, previous exposure to ureteral catheterization and time between each simulation. McNemar’s test and Wilcoxon signed ranks test were used to analyze data. Demographic data collected included gender, residency specialty and current trainee year and was analyzed using descriptive statistics.
Results
In total, 25 trainees participated in the didactic simulation, 36% male and 64% female. Sixteen subjects were OBGYN residents, 2 subjects were urology residents, 4 were urology students and 3 were OBGYN students. Of all the trainees, 88% reported never inserting ureteral catheters and of the OBGYN residents, 5 subjects have spent less than 1 week on the urogynecology service. Eighty eight percent of trainees had a strong interest in learning ureteral catheterization defined as 3 or greater on the nominal scale of 1 to 5. For the combined group (all trainees), knowledge increased (p=0.033), confidence increased (p<0.001), and time improved (p<0.001) from pre-didactic simulation to post-didactic simulation. Ninety two percent of trainees found the simulation and didactic session helpful in improving their ability to performing ureteral catheterization.
Interpretation of results
The trainees who participated in the simulation improved in all categories assessed.