Exposure to paediatric urology during urology specialty training: a UK national trainee survey

Cleaveland, Paul; Jones, Cassandra; Thompson, A.; Liew, Matthew; Husain, J.

doi:10.1308/rcsbull.2017.332

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…Paediatric urology training forms part of the curriculum for higher urology surgical training in the UK, with scrotal exploration for testicular torsion being a specific competency. 15 Adult general surgical trainees are also required to be competent in the management of acute testicular torsion in childhood 16 and reducing the number of boys transferred to tertiary paediatric surgical centres should provide increased opportunities for adult trainees to achieve their indicative numbers for this procedure.…”

Section: Discussionmentioning

confidence: 99%

Does the source of referral affect outcomes for paediatric testicular torsion?

Peeraully

Jancauskaite

Dawes

et al. 2019

annals

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Introduction This single centre study retrospectively analysed the intraoperative findings relative to source of referral for emergency scrotal explorations performed in a tertiary level paediatric surgery department. Methods All patients who underwent emergency scrotal exploration under the care of paediatric surgeons in our unit between April 2008 and April 2016 were identified. Clinical data were obtained from contemporaneous records. Results Over the 8-year study period, 662 boys underwent emergency scrotal exploration: 6 (1%) were internal referrals, 294 (44%) attended our emergency department (ED) directly, 271 (41%) were referred from primary care and 91 (14%) were transferred from other hospitals. Excluding procedures in neonates, testicular torsion was present in 100 cases (15%). Testicular detorsion with bilateral 3-point testicular fixation was performed in 66 (66%) and orchidectomy with contralateral fixation in 34 (34%) where the torted testis was non-viable intraoperatively. The orchidectomy rate in the presence of torsion was 23% in ED referrals (12/52), 43% in primary care referrals (12/28) and 50% for transfers (10/20). The difference in rates between ED referrals and patients transferred from other hospitals was significant (p=0.026). There was no significant difference in median age between any of the groups (p=0.10). Conclusions Boys undergoing emergency scrotal exploration had a higher orchidectomy rate when transferred from other hospitals to our unit. This difference was statistically significant when compared with boys presenting directly to our ED. This supports advice from The Royal College of Surgeons of England for undertaking paediatric scrotal explorations in the presenting hospital when safe to do so rather than delaying the care of these patients by transferring them to a tertiary paediatric surgical unit.

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Section: Discussionmentioning

confidence: 99%

Does the source of referral affect outcomes for paediatric testicular torsion?

Peeraully

Jancauskaite

Dawes

et al. 2019

annals

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“…Furthermore, even in HST, the roughly 50 UK urology trainees selected annually are spread across regions and hospitals with variable urological services. This leads to discrepancies in trainees’ exposure to the urological subspecialties required to complete the Joint Committee on Surgical Training (JCST) Urology curriculum [ 4 – 7 ]. This challenge is not particular to the UK, with heterogeneity in urological training being identified across a number of European countries [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

How to Implement a Simulation-Based Education Programme: Lessons from the UK Urology Simulation Boot Camp

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Biyani

2021

Indian J Surg

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The operative and non-technical skills exposure of urology trainees has reduced due to a number of factors, including the European Working Time Directive, and the COVID-19 pandemic. Simulation-based education (SBE) is an innovative addition to clinical experience which can begin to address the skills-based learning deficiency in order to help trainees meet their curriculum requirements and optimise the exposure required for a trainee to become a competent general urology consultant. Surgical simulation is an effective training tool but has a complex implementation process, requiring considerable planning tailored to specific educational targets, to ensure it is sustainable and reproducible. Methodology from the field of implementation science offers an invaluable approach to design an effective simulation-based training adjunct, as exemplified by the example of the UK Urology Simulation Boot Camp (USBC), a comprehensive training course which incorporates core technical and non-technical skills based on the current Joint Committee on Surgical Training (JCST) urological training curriculum to equip newly appointed urology trainees to work as competent junior registrars. Delivered annually in Leeds since 2015, the course has had excellent feedback and results in improving the urological knowledge of trainees, as well as increases in trainees’ confidence. This paper will provide a summary of how the course was designed, delivered, reproduced, sustained and evaluated. Its success is demonstrated by its incorporation into the UK urology training programme, and since 2018, it is now recommended to all new urology residents in the UK. The course implementation model would be applicable to other surgical specialties.

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