scholarly journals Mapping a competency-based surgical curriculum in urology: Agreement (and discrepancies) in the Canadian national opinion

2016 ◽  
Vol 10 (5-6) ◽  
pp. 161
Author(s):  
Keith Francis Rourke ◽  
Andrew E. MacNeily
Keyword(s):  
Residency Training ◽  
Fellowship Training ◽  
Web Based ◽  
Boari Flap ◽  
Open Radical Prostatectomy ◽  
Urological Procedures ◽  
Significant Disagreement ◽  
Competency Based ◽  
Parametric Testing ◽  
Open Pyeloplasty

Introduction: Urology residency training in Canada is quickly evolving from a time-based to a competency-based model. We aim to better define core surgical competencies that would comprise a surgical curriculum and assess any discrepancies in opinion nationally.Methods: A web-based survey was validated and sent to the 536 practicing members of the Canadian Urological Association (CUA) in August and October 2014. The survey consisted of questions regarding practice demographics, fellowship training, and evaluated the 76 most common urological procedures (using a five-point Likert scale) in the context of the question, “After completion of residency training in Canada a urologist should be proficient in…” A core procedure was defined as one for which there was ≥75% agreement. Descriptive statistics and non-parametric testing were used to summarize the findings.Results: A total of 138 urologists completed the survey (25.7% response rate) with representation from all geographic regions. Respondents included 40.6% community and 59.4% academic urologists. The survey identified 16 procedures with 90‒100% agreement and a total of 30 core procedures with ≥75% agreement. When comparing community and academic urologists, there was statistically significant disagreement on 27 procedures, including 11 core procedures, most notably cystectomy (88.5% agreement vs. 67.1%; p=0.002), open pyeloplasty (84.6% vs. 65.8%; p=0.04), simple prostatectomy (78.9% vs. 69.7%; p=0.03), perineal urethrostomy (80.8% vs. 67.1%; p=0.02), open radical prostatectomy (96.1% vs. 80.3%; p=0.007), and Boari flap (90.4% vs. 76.3%; p=0.004). Regional discrepancies were also found, demonstrating eight procedures deemed uniquely core and three core procedures deemed less important regionally.Conclusions: This national survey has provided some consensus on 30 procedures that should comprise a core surgical curriculum in urology. However, there are some key differences of opinion (most notably between community and academic urologists) that must be considered.

scholarly journals Competence in pediatric urology upon graduation from residency: perceptions of residents, program directors and pediatric urologists

2013 ◽  
Vol 2 (3) ◽  
pp. 205 ◽  
Author(s):  
Jennifer J. Mickelson ◽  
Andrew E. MacNeily ◽  
Dinesh Samarasekera ◽  
Darren Beiko ◽  
Kourosh Afshar
Keyword(s):  
Training Programs ◽  
Study Groups ◽  
Program Directors ◽  
Fellowship Training ◽  
Pediatric Urology ◽  
Urological Procedures ◽  
Significant Disagreement ◽  
Moderate Complexity ◽  
Ongoing Assessment ◽  
Residency Program Directors

Objective: We aimed to clarify the scope of pediatric urological procedures that Canadian urology residents are perceived to be competent to perform upon graduation.Methods: We conducted a survey from April 2005 to June 2006 of urology residency program directors (UPDs), senior urology residents (SURs) and Pediatric Urologists of Canada (PUC) members from all 12 Canadian training programs. Questions focused on which of 23 pediatric urological procedures the 3 study groups perceived urology residents would be competent to perform upon completion of residency without further fellowship training. Procedures were based on the “A,” “B” and “C” lists of procedures (least complex to most complex) as outlined in the Royal College of Physicians and Surgeons of Canada Objectives of Training in Urology.Results: Response rates were 12/12 (100%), 41/53 (77%) and 17/23 (74%) for UPDs, SURs and PUC members, respectively. Average exposure to pediatric urology during residency was 5.4 (range 3–9) months and considered sufficient by 75% of UPDs and 69% of SURs, but only 41% of PUC members (p = 0.05). Overall, the 3 groups disagreed on the level of competence for performing level “A” and “B” procedures, with significant disagreement between PUC members and UPDs as well as SURs (p < 0.005).Conclusion: PUC members perceive Canadian urology residents’ exposure to pediatric urology as insufficient and their competence for procedures of low to moderate complexity as inadequate. Further investigation regarding exposure to and competence in other emerging subspecialty spheres of urology may be warranted. Ongoing assessment of the objectives for training in pediatric urology is required.

Anesthesia residency training in regional anesthesiology and acute pain medicine: a competency-based model curriculum

2020 ◽  
Vol 45 (8) ◽  
pp. 660-667
Author(s):  
Glenn Woodworth ◽  
Robert B Maniker ◽  
Christina M Spofford ◽  
Ryan Ivie ◽  
Nathalie I Lunden ◽  
...  
Keyword(s):  
Medical Education ◽  
Residency Training ◽  
Acute Pain ◽  
Mobile Application ◽  
Practical Implementation ◽  
Pain Medicine ◽  
Web Based ◽  
Competency Based Medical Education ◽  
Educational Framework ◽  
Competency Based

The Accreditation Council for Graduate Medical Education has shifted to competency-based medical education. This educational framework requires the description of educational outcomes based on the knowledge, skills and behaviors expected of competent trainees. It also requires an assessment program to provide formative feedback to trainees as they progress to competency in each outcome. Critical to the success of a curriculum is its practical implementation. This article describes the development of model curricula for anesthesiology residency training in regional anesthesia and acute pain medicine (core and advanced) using a competency-based framework. We further describe how the curricula were distributed through a shared web-based platform and mobile application.

A Web-Based Tutor for Java? Evidence of Meaningful Learning

2011 ◽  
pp. 207-229
Author(s):  
Henry H. Emurian
Keyword(s):  
Self Efficacy ◽  
Instructional System ◽  
Meaningful Learning ◽  
Individual Student ◽  
Web Based ◽  
Java Applet ◽  
Before And After ◽  
Competency Based ◽  
Level Of Understanding ◽  
The Individual

Students in a graduate class and an undergraduate class in Information Systems completed a Web-based programmed instruction tutor that taught a simple Java applet as the first technical training exercise in a computer programming course. The tutor is a competency-based instructional system for individualized distance learning. When a student completes the tutor, the student has achieved a targeted level of understanding the code and has written the code correctly from memory. Before and after using the tutor in the present study, students completed a software self-efficacy questionnaire and a test of the application of general Java principles (far transfer of learning). After completing the tutor, students in both classes showed increases in software self-efficacy and in correct answers on the test of general principles. These findings contribute to the stream of formative evaluations of the tutoring system. They show the capacity of the Web-based tutor to generate meaningful learning (i.e., understanding of concepts) at the level of the individual student.

Impact of Laparoscopy on Training: Are Open Appendectomy and Cholecystectomy on the Brink of Extinction?

2019 ◽  
Vol 85 (7) ◽  
pp. 761-763 ◽  
Author(s):  
Patrick D. Melmer ◽  
Christen Chaconas ◽  
Ryan Taylor ◽  
Elizabeth Verrico ◽  
April Cockcroft ◽  
...  
Keyword(s):  
Residency Training ◽  
Surgical Intervention ◽  
Open Appendectomy ◽  
Surgical Residency ◽  
Acs Nsqip ◽  
Surgical Residents ◽  
Hands On ◽  
Competency Based ◽  
Operative Experience ◽  
Acs Nsqip Database

The operative experience of present-day surgical residency training has evolved as a result of the contributions of laparoscopic surgery. Some traditional open procedures are now more descriptive and less of a familiarity to many general surgery residents (GSRs). The aim of this study was to investigate how open operative experience compares with laparoscopy for GSRs. A retrospective, multicenter, consecutive cohort study of all patients undergoing surgical intervention involving the appendix and gallbladder identified from the ACS-NSQIP database over a 2.5-year period. All GSR postgraduate year-level operative experience was recorded. Of 777 procedures, 13 laparoscopic appendectomy conversions to open (4.3%) by Rocky-Davis (15%) or lower midline (84.6%) incisions were performed versus 285 that remained laparoscopic (95.6%). Fifty (10.4%) open cholecystectomies (38 open + 10 conversions + 2 common bile duct (CBD) exploration), 27 (5.6%) laparoscopic cholecystectomies with cholangiogram, and 402 (83.9%) laparoscopic cholecystectomies were performed. Twenty-nine different GSRs participated in procedures. Eighty-five (10.9%) operations were performed with multi–postgraduate year levels. Surgical residents have an unequal operative experience for case-specific open procedures. A competency-based system to demonstrate a resident's hands-on surgical skills is fundamental to residency training and should be considered for specific types of low-volume open surgical cases.

scholarly journals Designing and Implementing a Competency-Based Training Program for Anesthesiology Residents at the University of Ottawa

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Emma J. Stodel ◽  
Anna Wyand ◽  
Simone Crooks ◽  
Stéphane Moffett ◽  
Michelle Chiu ◽  
...  
Keyword(s):  
Medical Education ◽  
Training Program ◽  
Residency Training ◽  
Residency Training Program ◽  
Neck Surgery ◽  
Current Time ◽  
Competency Based Medical Education ◽  
Competency Based ◽  
Specialty Practice ◽  
The University

Competency-based medical education is gaining traction as a solution to address the challenges associated with the current time-based models of physician training. Competency-based medical education is an outcomes-based approach that involves identifying the abilities required of physicians and then designing the curriculum to support the achievement and assessment of these competencies. This paradigm defies the assumption that competence is achieved based on time spent on rotations and instead requires residents to demonstrate competence. The Royal College of Physicians and Surgeons of Canada (RCPSC) has launched Competence by Design (CBD), a competency-based approach for residency training and specialty practice. The first residents to be trained within this model will be those in medical oncology and otolaryngology-head and neck surgery in July, 2016. However, with approval from the RCPSC, the Department of Anesthesiology, University of Ottawa, launched an innovative competency-based residency training program July 1, 2015. The purpose of this paper is to provide an overview of the program and offer a blueprint for other programs planning similar curricular reform. The program is structured according to the RCPSC CBD stages and addresses all CanMEDS roles. While our program retains some aspects of the traditional design, we have made many transformational changes.

scholarly journals Competency-based Residency Training

2000 ◽  
Vol 75 (12) ◽  
pp. 1178-1183 ◽  
Author(s):  
Donlin M. Long
Keyword(s):  
Residency Training ◽  
Competency Based

scholarly journals Increasing Trends in Orthopedic Fellowships Are Not due to Inadequate Residency Training

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
K. A. Almansoori ◽  
M. Clark
Keyword(s):  
Residency Training ◽  
Fellowship Training ◽  
Exploratory Research ◽  
Participation Rates ◽  
Surgical Skill ◽  
Research Survey ◽  
Perceptions And Attitudes ◽  
Motivating Factor ◽  
Medical Specialities ◽  
Increasing Trends

Orthopedic residents have one of the highest fellowship participation rates among medical specialities and there are growing concerns that inadequate residency training may be contributing to this trend. Therefore, a mixed-exploratory research survey was distributed to all 148 graduating Canadian orthopedic residents to investigate their perceptions and attitudes for pursuing fellowships. A response rate of 33% (n=49) was obtained with the majority of residents undertaking one (27%) or two (60%) fellowships. Surgical-skill development was reported as the most common motivating factor, followed by employment and marketability; malpractice protection and financial reasons were the least relevant. The overwhelming majority of residents (94%,n=46) felt adequately prepared by their residency training for independent general practice, and 84% (n=41) of respondents did not feel that current fellowship trends were due to poor residency training. Three common themes were expressed in their comments: the growing perceived expectation by healthcare professionals and employers to be fellowship-certified, the integration of fellowship training into the surgical education hierarchy, and the failure of residency training curriculums to accommodate for this trend. In conclusion, Canadian orthopedic residents are confident of their residency training and are increasingly pursuing fellowships to primarily develop their surgical skills and expertise.

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