The image part with relationship ID rId3 was not found in the file.

Author: Yuding Wang, Jen Hoogenes, Kevin Kim, Udi Blankstein, Kelly Dore, Edward Matsumoto McMaster University

Date: Saturday October 20th, 2018

Development, Implementation, and Evaluation of Urology Bootcamp For

Training First-year Urology Residents

The image part with relationship ID rId3 was not found in the file.

The image part with relationship ID rId3 was not found in the file.

I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization.

Je n’ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d’appareils médicaux ou un cabinet de communication.

2

Why Bootcamp? • Transition to residency can be a time of

significant stress and anxiety1

• Lead to burnout,2,3 mental health problems,4 and poor patient care5

• Residency PDs identified a lack of medical knowledge and skill as one common struggle for new residents6

3

1) Radcliff et al 2003 2) Thomas et al. 2004 3) Dabrow et al. 2006 4) Jorm et al. 2005 5) Shanafelt et al 2002 6) Lyss-Leman et al 2009

Why Bootcamp?

• “early preparatory course or orientation sessions for learners undergoing a transition in medical education”7

• Bootcamp adopted in many contexts and specialties

during periods of transition to alleviate resident stress and anxiety, improve resident performance, and confidence.8-13

4 7) Blackmore et al 2017

8) Chu et al. 2017 9) Jambhekar et al. 2014

Purpose and objectives Purpose:

• Develop & implement an intensive urology bootcamp curriculum

• facilitating transition of incoming urology interns

Objectives:

• To assess acquisition of clinical knowledge and skills • To assess urology bootcamp’s utility in improving

confidence • To assess the acceptability and feasibility of the joint

bootcamp across 2 universities 5

Course development

• Needs assessment • current residents & staff urologist

• Backward design for course

development “getting incoming residents the

knowledge and skills to survive their first few nights of call”

6

Bowen R. Understanding by Design (2017)

Course Development

• Survey PGY 2-5 urology residents & staff across both sites • ID topics perceived essential to urology interns

• Results were reviewed by PDs at Western and McMaster

• Results were matched to new urology EPA’s and Milestones

Objectives matched to CanMEDS 2015

7

Bootcamp Curriculum • 2 day curriculum

• Comprising of 17-hour didactic and

hands-on learning

• Days were divided: • Primarily didactic lectures in the

morning • Hands-on teaching in the afternoon

8

Models

9

Participants

• First year urology residents from McMaster and Western (n=6)

• Second year urology residents as historical controls

10

Assessment • Knowledge

• Pre/post MCQ • End of bootcamp OSCE

• Clinical skills • End of bootcamp OSCE

• Acceptability and course evaluation • Survey • Semi-structured group interviews

11

Results (MCQ) Knowledge & Surgical Skills acquisition (MCQ)

• Still present at Retention

12

0

20

40

60

80

100

Pre-bootcamp Post-bootcamp Post-bootcamp newquestions

Perc

enta

ge

Timing of multiple choice exam administration

Comparing Pre/Post Bootcamp MCQ Results

0

20

40

60

80

100

PGY1 PGY2Pe

rcen

tage

Level of Training

Post bootcamp MCQ

*p=0.003

*p=0.005

**p=0.005

Results (OSCE) Knowledge and Surgical Skills acquisition

13

1

2

3

4

5

Flexible cysto Grosshematuria

Informedconsent

Patientpositioning

Scopeassembly

SP catheterinsertion

Entr

ustm

ent S

core

OSCE Station

Mean Entrustment Score on OSCE per Station

PGY 1 PGY 2

0

10

20

30

40

50

60

70

80

90

100

Flexible cysto Grosshematuria

Informedconsent

Patientpositioning

Scopeassembly

SP catheterinsertion

Perc

enta

ge

OSCE Stations

Mean Overall Performance Score on OSCE per Station

PGY 1 PGY 2

1) Requires complete supervision/guidance 3) Requires some supervision/prompting 5) Requires no supervision, ready for independent practice

0

1

2

3

4

Mea

n

Confidence

Prebootcamp

Postbootcamp

Results

14

*

**

Results • Acceptability

Post bootcamp survey all 6 participants found bootcamp very helpful » “Very useful. So fantastic! I gained a lot of knowledge + comfort” » “Yes, help with anxiety related to procedures not formally taught, but expected (i.e. SP

catheter)” » “Yes. Very useful, good to build confidence and comradery”

All participant indicated they would recommend urology bootcamp new interns

• Feasibility • Cost approximately 400 dollars in materials and supplies to run • Printing cost for our urology manual • Webhosting for our urology bootcamp webportal: (www.urologybootcamp.com)

15

Conclusion

• Bootcamp demonstrated the feasibility, acceptability and educational value of urology bootcamp to help in the transition to urology residency

• Retention test demonstrated maintenance of knowledge

16

Thank You

yuding.wang@medportal.ca

@MacUrology

17

• Download the ICRE App,

• Go to: www.royalcollege.ca /icre-evaluations to complete the session evaluation.

Help us improve. Your input matters.

• Téléchargez l’application de la CIFR

• Visitez le www.collegeroyal.ca /evaluationscifr afin de remplir une évaluation de la séance.

Aidez-nous à nous améliorer. Votre opinion compte!

You could be entered to win complimentary registration for ICRE 2019. Vous pourriez gagner une inscription gratuite à la CIFR 2019.

18