IMPACT OF A ONE-DAY URODYNAMIC COURSE ON KNOWLEDGE, PERCEPTIONS AND ATTITUDES OF UROLOGY RESIDENTS
INTRODUCTION: Urodynamic (UDN) training is very heterogeneous throughout the world. Practical aspects are taught through supervision by experienced practitioners, informal internships or short-term courses. According to the International Continence Society (ICS), trainees should attend a theoretical course with at least 18 hours of instruction.
OBJECTIVES: Evaluate the impact of a short-lasting UDN course in knowledge, perceptions and attitudes of urology residents. METHODS: The subjects of this study consisted of PGY4 and PGY5 urology residents. The educational intervention consisted of a course following the ICS guidelines, except that ours is a 12-hour course, consisting of a combination of lectures, instruction and case discussions including anatomy and physiology, UDN techniques, interpretation of studies and artifacts. Residents completed a 20-question multiple-choice test to assess knowledge before the course (T0), after one week (T1) and after 4 months (T2). They also completed a survey to evaluate their perceptions and attitudes towards UDN at T1 and T2.
RESULTS: 29 residents (13 PGY4 and 16 PGY5) attended the course and completed the baseline evaluation (T0), 23 (79.3%) completed T1 and 17 (58.6%) completed the T2 evaluation. No improvement of UDN knowledge was observed (52.2% correct answers vs 61.4% vs 56.7%; at T0, T1 and T2, respectively; p = 0.535). Most residents became more confident in various competencies, including the indications for UDN tests, patient preparation, terminology, preparation of UDN reports and impact of UDN for patient management both at T1 and T2. At T1, 20 (87.0%) subjects became more restrictive in the indication of UDN and 3 (13.0%) did not change their indication criteria; at T2, 8 (66.7%) residents became more restrictive, 3 (25.0%) did not change and 1 (8.3%) became more liberal. At T2, 6 (50%) residents were performing a more comprehensive pre-UDN patient evaluation, 5 (41.7%) were more judicious in patient counselling and 1 (8.3%) was unchanged. Most participants (n= 19; 86.4%) rated the course as very useful, and 3 (13.6%) as useful at T1 while at T2 the rates were 58.3% and 41.7%, respectively.
CONCLUSIONS: Our study demonstrates that a 12-hour urodynamic course can improve attitudes and self-rated urodynamic competence for urology residents.
Urodynamics; urgency; incontinence
Uroneurologia / Disfunção Miccionais / Urodinâmica
Hospital das Clínicas da Faculdade de medicina da USP - Sao Paulo - Brasil, Universidade de Ottawa - - Canadá
Cristiano Mendes Gomes, José de Bessa Junior, Ricardo Vita Nunes, José Antonio Penedo Prezotti, João Victor Teixeira Henriques, Luccas Soares Laferreira, Homero Bruschini, Marcio Gomes