Advertisement

Current status of urology surgical training in Europe: an ESRU–ESU–ESUT collaborative study

  • Diego M. CarrionEmail author
  • Moises E. Rodriguez-Socarrás
  • Guglielmo Mantica
  • Francesco Esperto
  • Angelika Cebulla
  • Diederick Duijvesz
  • Giulio Patruno
  • Juan L. Vásquez
  • Domenico Veneziano
  • Jesús Díez-Sebastian
  • Ali S. Gozen
  • Joan Palou
  • Juan Gómez Rivas
Original Article

Abstract

Purpose

To determine the current status of surgical training amongst European Urology Residents, including their satisfaction with training and their confidence in performing procedures.

Methods

A 23-item survey was distributed to the 15th European Urology Residents Education Programme (EUREP) 2017 participants. An analysis of demographics, workload, training resources, surgical exposure, surgical caseload, satisfaction and confidence in performing each procedure was performed.

Results

A total of 152/350 participants completed the survey (response rate 43%), of which 14% think they perform enough surgeries during their training, and 83% would like to continue training with a fellowship. Confidence in performing procedures without supervision and satisfaction with training was associated with higher surgical caseloads. Confidence in all laparoscopic/robotic procedures (except for laparoscopic/robotic partial nephrectomy) was associated with laparoscopic and robotics training, participation in practical courses and having training resources in hospitals. Satisfaction with surgical training was statistically associated with working ≤  50 h per week, laparoscopic training and having laparoscopic training boxes.

Conclusions

Surgical exposure of European Urology residents for major/minimally invasive procedures, confidence in performing these procedures, and overall satisfaction with training is low. A higher volume of cases, as well as resources for training are associated with higher individual confidence and satisfaction with training.

Keywords

Confidence Education Europe Residency Satisfaction Simulation Surgical training Urology 

Notes

Acknowledgements

We would like to thank Dr. Karl H. Pang, MBChB, BSc, MSc, PhD, MRCS (Eng), from the Academic Urology Unit, University of Sheffield, UK, and board member of the European Society of Residents in Urology for his contribution with editing of the manuscript.

Author contributions

Protocol development: GP, JGR, JLV; Project development: JGR, MER; Data collection: CA, DD FE; Data analysis: JDS, DC; Manuscript writing: DC, GM; Manuscript editing: JGR, KP, DV, ASG, JP.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

345_2019_2763_MOESM1_ESM.tiff (8.3 mb)
Training resources in relation to confidence in laparoscopic and robotic procedures. Associations of training, participation in practical courses, and resources for training with major laparoscopic/robotic procedures in residents who report confidence in performing each surgery. (TIFF 8490 kb)
345_2019_2763_MOESM2_ESM.docx (20 kb)
Supplementary file2 (DOCX 19 kb)
345_2019_2763_MOESM3_ESM.docx (385 kb)
Urology resident training survey distributed to the 15th EUREP 2017 participants. (DOCX 384 kb)

References

  1. 1.
    Carrion DM, Rivas JG, Esperto F, Patruno G, Vasquez JL (2018) Current status of urological training in Europe. Arch Esp Urol 71:11–17Google Scholar
  2. 2.
    van der Vleuten C, Verhoeven B (2013) In-training assessment developments in postgraduate education in Europe. ANZ J Surg 83:454–459.  https://doi.org/10.1111/ans.12190 CrossRefGoogle Scholar
  3. 3.
    Rivas JG, Cabello-Benavente R, Bueno-Serrano G, Rodríguez MS, Esteban MF (2018) Current status of urological education in Spain. Arch Esp Urol 71:4–10Google Scholar
  4. 4.
    Somani BK, Van Cleynenbreugel B, Gozen A, Palou J, Barmoshe S, Biyani S et al (2018) The European Urology residents education programme hands-on training format: 4 years of hands-on training improvements from the European School of Urology. Eur Urol Focus.  https://doi.org/10.1016/j.euf.2018.03.002 Google Scholar
  5. 5.
    Domínguez Escrig JL (2018) Homogeneity of the European training program. The role of the European Board of Urology. Arch Esp Urol 71:129–133Google Scholar
  6. 6.
    Bucholz EM, Sue GR, Yeo H, Roman SA, Bell RH, Sosa JA (2011) Our trainees’ confidence: results from a national survey of 4136 US general surgery residents. Arch Surg 146:907–914.  https://doi.org/10.1001/archsurg.2011.178 CrossRefGoogle Scholar
  7. 7.
    Cocci A, Patruno G, Gandaglia G, Rizzo M, Esperto F, Parnanzini D et al (2018) Urology residency training in Italy: results of the first national survey. Eur Urol Focus 4:280–287.  https://doi.org/10.1016/j.euf.2016.06.006 CrossRefGoogle Scholar
  8. 8.
    Schatz A, Kogan B, Feustel P (2014) Assessing resident surgical competency in urology using a global rating scale. J Surg Educ 71:790–797.  https://doi.org/10.1016/j.jsurg.2014.03.012 CrossRefGoogle Scholar
  9. 9.
    Parker DC, Kocher N, Mydlo JH, Simhan J (2016) Trends in urology residents’ exposure to operative urotrauma: a survey of residency program directors. Urology 87:18–24.  https://doi.org/10.1016/j.urology.2015.08.032 CrossRefGoogle Scholar
  10. 10.
    Furriel FTG, Laguna MP, Figueiredo AJC, Nunes PTC, Rassweiler JJ (2013) Training of European urology residents in laparoscopy: results of a pan-European survey. BJU Int 112:1223–1228.  https://doi.org/10.1111/bju.12410 CrossRefGoogle Scholar
  11. 11.
    Rodríguez-Socarrás ME, Rivas JG, García-Sanz M, Pesquera L, Tortolero-Blanco L, Ciappara M et al (2017) Medical-surgical activity and the current state of training of urology residents in Spain: results of a national survey. Actas Urol Esp 41:391–399.  https://doi.org/10.1016/j.acuro.2016.11.003 CrossRefGoogle Scholar
  12. 12.
    Borgmann H, Arnold HK, Meyer CP, Bründl J, König J, Nestler T et al (2018) Training, research, and working conditions for urology residents in Germany: a contemporary survey. Eur Urol Focus 4:455–460.  https://doi.org/10.1016/j.euf.2016.12.001 CrossRefGoogle Scholar
  13. 13.
    Eysenbach G (2004) Improving the quality of web surveys: the checklist for reporting results of internet E-Surveys (CHERRIES). J Med Internet Res 6:e34.  https://doi.org/10.2196/jmir.6.3.e34 CrossRefGoogle Scholar
  14. 14.
    Fonseca AL, Reddy V, Longo WE, Gusberg RJ (2014) Graduating general surgery resident operative confidence: perspective from a national survey. J Surg Res 190:419–428.  https://doi.org/10.1016/j.jss.2014.05.014 CrossRefGoogle Scholar
  15. 15.
    Okhunov Z, Safiullah S, Patel R, Juncal S, Garland H, Khajeh NR et al (2019) Evaluation of urology residency training and perceived resident abilities in the United States. J Surg Educ.  https://doi.org/10.1016/j.jsurg.2019.02.002 Google Scholar
  16. 16.
    Abdollah F, Jindal T, Menon M (2017) Surgical training in the robotic surgery era: the importance of structured programs. Eur Urol Focus 3:117–118.  https://doi.org/10.1016/j.euf.2016.05.007 CrossRefGoogle Scholar
  17. 17.
    Cadish LA, Fung V, Lane FL, Campbell EG (2016) Surgical case logging habits and attitudes: a multispecialty survey of residents. J Surg Educ 73:474–481.  https://doi.org/10.1016/j.jsurg.2015.09.007 CrossRefGoogle Scholar
  18. 18.
    Veneziano D, Cacciamani G, Shekhar CB (2018) Simulation and training in Urology—in collaboration with ESU/ESUT. Arch Esp Urol 71:55–62Google Scholar
  19. 19.
    Mattar SG, Alseidi AA, Jones DB, Jeyarajah DR, Swanstrom LL, Aye RW et al (2013) General surgery residency inadequately prepares trainees for fellowship: results of a survey of fellowship program directors. Ann Surg 258:440–449.  https://doi.org/10.1097/SLA.0b013e3182a191ca CrossRefGoogle Scholar
  20. 20.
    Coleman JJ, Esposito TJ, Rozycki GS, Feliciano DV (2013) Early subspecialization and perceived competence in surgical training: are residents ready? J Am Coll Surg 216:764–771.  https://doi.org/10.1016/j.jamcollsurg.2012.12.045 (discussion 771–3) CrossRefGoogle Scholar
  21. 21.
    Kempenich JW, Willis RE, Blue RJ, Al Fayyadh MJ, Cromer RM, Schenarts PJ et al (2016) The effect of patient education on the perceptions of resident participation in surgical care. J Surg Educ 73:e111–e117.  https://doi.org/10.1016/j.jsurg.2016.05.005 CrossRefGoogle Scholar
  22. 22.
    Veneziano D, Ploumidis A, Proietti S, Tokas T, Kamphuis G, Tripepi G et al (2018) Evolution and uptake of the endoscopic stone treatment step 1 (EST-s1) protocol: establishment, validation, and assessment in a collaboration by the European School of Urology and the Uro-Technology and Urolithiasis Sections. Eur Urol 74:401–402.  https://doi.org/10.1016/j.eururo.2018.05.012 CrossRefGoogle Scholar
  23. 23.
    Gas J, Bart S, Michel P, Peyronnet B, Bergerat S, Olivier J et al (2019) Prevalence of and predictive factors for burnout among French urologists in training. Eur Urol 75:702–703.  https://doi.org/10.1016/j.eururo.2018.12.037 CrossRefGoogle Scholar
  24. 24.
    Badash I, Burtt K, Solorzano CA, Carey JN (2016) Innovations in surgery simulation: a review of past, current and future techniques. Ann Transl Med 4:453.  https://doi.org/10.21037/atm.2016.12.24 CrossRefGoogle Scholar
  25. 25.
    Raison N, Ahmed K, Dasgupta P (2016) The role of simulation in surgical training. Eur Urol Focus 2:63–64.  https://doi.org/10.1016/j.euf.2015.07.004 CrossRefGoogle Scholar
  26. 26.
    Aydin A, Shafi AMA, Khan MS, Dasgupta P, Ahmed K (2016) Current status of simulation and training models in urological surgery: a systematic review. J Urol 196:312–320.  https://doi.org/10.1016/j.juro.2016.01.131 CrossRefGoogle Scholar
  27. 27.
    Aydin A, Ahmed K, Shafi AMA, Khan MS, Dasgupta P (2016) The role of simulation in urological training—a quantitative study of practice and opinions. Surgeon 14:301–307.  https://doi.org/10.1016/j.surge.2015.06.003 CrossRefGoogle Scholar
  28. 28.
    Agha RA, Fowler AJ (2015) The role and validity of surgical simulation. Int Surg 100:350–357.  https://doi.org/10.9738/INTSURG-D-14-00004.1 CrossRefGoogle Scholar
  29. 29.
    Veneziano D, Smith A, Reihsen T, Speich J, Sweet RM (2015) The SimPORTAL fluoro-less C-arm trainer: an innovative device for percutaneous kidney access. J Endourol 29:240–245.  https://doi.org/10.1089/end.2014.0401 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Diego M. Carrion
    • 1
    • 2
    • 3
    Email author
  • Moises E. Rodriguez-Socarrás
    • 3
    • 4
  • Guglielmo Mantica
    • 3
    • 4
  • Francesco Esperto
    • 3
    • 5
  • Angelika Cebulla
    • 3
    • 6
  • Diederick Duijvesz
    • 3
    • 7
  • Giulio Patruno
    • 8
  • Juan L. Vásquez
    • 3
    • 9
  • Domenico Veneziano
    • 10
    • 11
    • 12
    • 13
  • Jesús Díez-Sebastian
    • 2
    • 14
  • Ali S. Gozen
    • 13
    • 15
  • Joan Palou
    • 16
    • 17
    • 18
  • Juan Gómez Rivas
    • 1
    • 2
    • 3
    • 13
    • 18
  1. 1.Department of UrologyLa Paz University HospitalMadridSpain
  2. 2.Autonomous University of MadridMadridSpain
  3. 3.European Society of Residents in Urology (ESRU)ArnhemThe Netherlands
  4. 4.Department of UrologySan Raffaele-Turro Hospital, San Raffaele UniversityMilanItaly
  5. 5.Department of UrologyHumanitas GavazzeniBergamoItaly
  6. 6.Department of UrologyUniversity Hospital UlmUlmGermany
  7. 7.Department of UrologyCanisius Wilhemina HospitalNijmegenThe Netherlands
  8. 8.Department of UrologyOspedale San Giovanni AddolorataRomeItaly
  9. 9.Department of UrologyHerlev and Gentofte HospitalHerlevDenmark
  10. 10.Department of Urology and Kidney TransplantGrande Ospedale MetropolitanoReggio CalabriaItaly
  11. 11.School of MedicineHofstra UniversityNew YorkUSA
  12. 12.Life and Health Sciences Research Institute (ICVS), School of MedicineUniversity of MinhoBragaPortugal
  13. 13.European Society of Uro-Technology (ESUT)ArnhemThe Netherlands
  14. 14.Department of BiostatisticsLa Paz University HospitalMadridSpain
  15. 15.Department of UrologySLK-Kliniken, University of HeidelbergHeilbronnGermany
  16. 16.Department of UrologyFundacio PuigvertBarcelonaSpain
  17. 17.Autonomous University of BarcelonaBarcelonaSpain
  18. 18.European School of Urology (ESU)ArnhemThe Netherlands

Personalised recommendations