Development and content validation of the Urethroplasty Training and Assessment Tool (UTAT) for dorsal onlay buccal mucosa graft urethroplasty

Abstract

ObjectivesTo develop and validate the Urethroplasty Training and Assessment Tool (UTAT) using Healthcare Failure Mode and Effect Analysis (HFMEA) for training and assessment of urology trainees learning this urethral reconstruction technique, as urethroplasty is the 'gold standard' treatment for long and recurrent urethral strictures and with a variety of techniques and a lack of standardised reconstructive curricula, there is a need for procedurespecific training tools to improve surgeon training and patient safety. Materials and MethodsThis international observational study was performed over an 11-month period. The HFMEA was used to identify and evaluate hazardous stages of urethroplasty to develop the UTAT. Hazard scores were calculated for the included steps of urethroplasty. Content validation was performed by 12 expert surgeons and multidisciplinary teams from international tertiary centres. ResultsThe HFMEA process resulted in an internationally validated UTAT. Hazard scores ≥4 and single point weaknesses were included to implement actions and outcome measures. Content validation was achieved by circulating the process map, hazard analysis table, and developed tools. Changes were implemented based on the feedback received from expert surgeons. The content validated dorsal onlay buccal mucosa graft bulbar UTAT contained five phases, 10 processes and 23 sub-processes. ConclusionsThe modular UTAT offers a comprehensive validated training tool developed via a detailed HFMEA protocol. This may be utilised to standardise the training and assessment of urology trainees.

Current Landscape of Surgical Assessment Models in Urology Residency Training

“…In 2019, Jasionowska et al published the UTAT (Urethroplasty Training and Assessment Tool), which utilized the HMFEA protocol to develop and validate this system. 36 The procedure is broken down into 5 phases, 10 processes, and 23 sub-processes, which are each given a difficulty score and rated on a Likert scale from 1-5. This safety checklist is specifically designed for training and evaluating urology residents while performing dorsal onlay buccal mucosa graft for bulbar urethroplasty.…”

Aligning Urology Residency Training With Real-World Workforce Needs

“… 4 Moreover, there is increasing work and interest in developing urologic training curricula with the use of simulation. 19 , 20 , 21 For example, the EAU Section of Robotics has developed a validated 12-week training program for robotic prostatectomy. 19 , 22 Implementation of similar curricula may help improve the competence of residents training at programs with decreased robotic/laparoscopic volume.…”