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Training Community Gynecologists to Perform Intraoperative Cystoscopy: A Competency-Based Training Experience

Nihira, Mikio A. MD, MPH*†; Quiroz, Lieschen H. MD*; Hardré, Patricia PhD*; Allen, Arielle DO; Shobeiri, Seyed Abbas MD*

Female Pelvic Medicine & Reconstructive Surgery: March/April 2014 - Volume 20 - Issue 2 - p 76–82
doi: 10.1097/SPV.0000000000000056
Original Articles

Objective: This study aimed to pilot a cystoscopy training program for community gynecologists that is validated by posttraining examination.

Methods: Twenty-eight gynecologists were trained to perform cystoscopy using a competency-based training approach. Baseline information included years in practice and number of incontinence procedures and/or cystoscopies performed per month. Three 5-hour workshops were administered that included applied practice. After learners individually trained until they felt comfortable with their skills on a model, they were individually tested on a cadaver. Performance was evaluated with 2 instruments, namely, a task-specific checklist and a global rating scale based on the objective structured assessment of technical skill model. Failure was defined as inability to independently complete elements of the task-specific checklist for cystoscopic examination. Likert-type self-report scales were used during pretesting and posttesting, assessing confidence to perform component tasks for diagnostic cystoscopy.

Results: Twenty-four of 28 trainees successfully performed a systematic cadaveric bladder examination during the primary posttest. After debriefing, the 4 trainees who initially failed successfully performed cystoscopy during a second trial. Median age was 51 years and median time in practice was 19.5 years. All participants reported high confidence in identifying ureteral injury at the course’s conclusion.

Conclusions: A task-specific training program can successfully improve the confidence and skill of community gynecologists to perform intraoperative diagnostic cystoscopy. Professionals may not be able to define when they have received enough instruction in terms of hands-on training with models, before acquisition of technical skills. Formal evaluation of technical skills is recommended after training to ensure competence.

Formal evaluation of technical skills is recommended after training to ensure competence.

From the *Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City; †Jeannine Rainbolt College of Education, University of Oklahoma, Norman; and ‡INTEGRIS Urogynecology, Oklahoma City, OK.

Reprints: Mikio A. Nihira, MD, MPH, Section of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Blvd, (PO Box 26901), WP2410, Oklahoma City, OK 73190. E-mail: Mikio-Nihira@ouhsc.edu.

The authors have declared they have no conflicts of interest.

Reprints: not available.

Presented at the American Urogynecologic Society Meeting, Long Beach, CA, September 28-October 2, 2010.

© 2014 by Lippincott Williams & Wilkins