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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
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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.
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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
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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”
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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
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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
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Models
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Participants
• First year urology residents from McMaster and Western (n=6)
• Second year urology residents as historical controls
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Assessment • Knowledge
• Pre/post MCQ • End of bootcamp OSCE
• Clinical skills • End of bootcamp OSCE
• Acceptability and course evaluation • Survey • Semi-structured group interviews
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Results (MCQ) Knowledge & Surgical Skills acquisition (MCQ)
• Still present at Retention
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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
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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
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*
**
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)
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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
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• 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.
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