Training of tunisian future urologists: how to improve it ?

##plugins.themes.academic_pro.article.main##

Sahbi Naouar
Mohamed Yassine Binous
Salem Braiek
Rafik El Kamel

Abstract

Aim: The lack of continuous evaluation of training tools in medicine, especially in developing countries, represents a brake to the development of the latter. The aim of this study is to establish an inventory of the training facilities available to residents in urology in Tunisia, to assess their satisfaction and their expectations, and to propose solutions to improve residents training.
Methods:An anonymous questionnaire was sent by E-mail in 2015 to all residents in urology in Tunisia. The questionnaire addressed demographic characteristics, educational resources used and desired, the current medical and university curriculum and evaluation of the training. Results:Among 33 residents, 66.6% responded to the survey. Medical staff, courses organized by the national college of urology, reading french-language articles and daily activity in operating room were the most used pedagogic resources. Training was judged unsatisfactory by 59.1% of respondents because of a lack of theoretical training in 18.1% of cases, a lack of practical training in 13.6% of cases and both of them in 27.2% of cases. Training on animals and simulator, creation of an educational booklet, use of online course materials, and the institution of a mentoring process during residency were rated favorable by the majority of respondents.
Conclusion: The majority of residents in urology in Tunisia believe their training is unsatisfactory. The E-learning, improved access to surgical training in animals and simulator, better information on existing resources and strengthening of companionship through tutoring should enhance satisfaction.

Keywords:

Pedagogy - evaluation - resident - urology - training.

##plugins.themes.academic_pro.article.details##

References

  1. Norman G. Defining competence: A methodological review. In Neufeld V. and Norman G. editors. Assessing clinical competence, New-York : Springer, 1985.
  2. Sibert L, Grand'Maison P, Charlin B, Grise P. Développement d'un Examen Clinique Objectif Structuré pour évaluer les compétences des internes en urologie. Pédag Méd 2000;1:33-9.
  3. Piessen G, Chau A, Mariette C, Bouillot JL, Veyrie N. Evaluation of training of residents and chief-residents in visceral and digestive surgery in France: result of a national survey. J Visc Surg 2013;150:297-305.
  4. Grewal SG, Yeung LS, Brandes SB. Predictors of success in a urology residency program. J Surg Educ 2013;70:138-43
  5. Ponsot Y, Droupy S. La formation des urologues au Canada. Prog Urol (FMC) 2006;16:14-16.
  6. Miernik A, Sevcenco S, Kuehhas FE, et al. Bringing excellence into urology: How to improve the future training of residents? Arab J Urol 2014;12:15-20.
  7. Présentation du cahier de l'interne. Disponible à partir de URL: http://www.urofrance.org/congres-et-formations/formation-initiale/cahierinterne/ presentation-du-cahier-de-linterne.html.
  8. Ruffion A, Arnouil N, Tamarelle B, et al. T-Res : le futur de l'évaluation des internes en urologie? Prog Urol 2014;24:836.
  9. E-learning. Guide de conception de formation ouverte et à distance dans le monde de la santé. Rapport: HAS, 2015-06, 101 p.
  10. Horstmann M, Renninger M, Hennenlotter J, Horstmann CC, Stenzl A. Blended E-learning in a Web-based virtual hospital: a useful tool for undergraduate education in urology. Educ Health 2009;22:30.
  11. Marks A, Maizels M, Mickelson J, et al. Effectiveness of the computer enhanced visual learning method in teaching the society for fetal urology hydronephrosis grading system for urology trainees. J Pediatr Urol 2011;7:113-7.
  12. Maizels M, Yerkes EB, Macejko A, et al. A new computer enhanced visual learning method to train urology residents in pediatric orchiopexy: a prototype for Accreditation Council for Graduate Medical Education documentation. J Urol 2008;180:1814-8.
  13. Necknig U, von Ostau N, Schone S. ‘Urology schedule'- the urological mentoring program. Urologe A 2012;51:254-6.
  14. Daelmans HE, Hoogenboom RJ, Donker AJ, Scherpbier AJ, Stehouwer CD, van der Vleuten CP. Effectiveness of clinical rotations as a learning environment for achieving competences. Med Teach 2004;26:305-12.
  15. Remmen R, Denekens J, Scherpbier A, et al. An evaluation study of the didactic quality of clerkships. Med Educ 2000;34:460-4.
  16. Resch KD. Post-mortem inspection for neurosurgery: a training model for endoscopic dissection technique. Neurosurg Rev 2002;25:79-88.
  17. Lin E, Szomstein S, Addasi T, Galati-Burke L, Turner JW, Tiszenkel HI. Model for teaching laparoscopic colectomy to surgical residents. Am J Surg 2003;186:45-8.
  18. Ward M, MacRae H, Schlachta C, et al. Resident self-assessment of operative performance. Am J Surg 2003;185:521-4.
  19. Bréauda J, Chevalliera D, Benizri E, et al. Intégration de la simulation dans la formation des internes en chirurgie. Programme pédagogique du centre de simulation médicale de la faculté de médecine de Nice. J Chir Visc 2012;149:55-63.
  20. Sibert L, Charlin B, Gagnon R, Corcos J, Khalaf A, Grise P. Evaluation du raisonnement clinique en urologie : l'apport du Test de Concordance de Script. Prog Urol 2001;11:1213-19.
  21. Tranchart H, Aurégan JC, Gaillard M, Giocanti-Aurégan A. Évaluation des compétences techniques des internes de chirurgie ophtalmologique, orthopédique et digestive français: état actuel et perspectives. J Fr Ophtalmol 2015;38:679-88.