The computer enhanced visual learning tutorial for orchiopexy consisted of customized computer visuals
that demonstrate 11 steps or skills involved in routine inguinal orchiopexy, eg ligate hernia. The attending urologist rated resident competence with each skill using a 5-point Likert scale and provided specific feedback to the resident suggesting ways to improve performance. These ratings were weighted by case difficulty. The computer enhanced visual learning weighted score at entry into the clinical rotation was compared to the best performance during the rotation in each resident.
Results: Seven attending surgeons and 24 urology residents (resident training postgraduate years 1 to 8) performed a total of 166 orchiopexies. Overall the residents at each postgraduate see more year performed an average of 7 cases each with complexity ratings that were not significantly different among postgraduate year groups (average GSK-3 inhibitor 2.4, 1-way ANOVA p not significant). The 7 attending surgeons did not differ significantly in assessment of skill performance or case difficulty (1-way ANOVA p not significant). Of the 24 residents 23 (96%) showed improvement in computer enhanced visual learning score/skill performance. In the entire group the average computer enhanced visual learning weighted score increased more than 50% from entry to best performance (137 to 234 orchiopexy units, paired t test p < 0.0001).
Conclusions: Computer enhanced
visual learning is a novel method that enhances resident learning by breaking a core procedure into discrete steps and providing a platform for constructive feedback. Computer enhanced visual learning, which is a checklist Selleckchem CHIR-99021 tool, complies with Accreditation Council for Graduate Medical
Education documentation requirements. Computer enhanced visual learning has wide applicability among surgical specialties.”
“Purpose: Two accepted open surgical techniques exist for lower urinary tract reconstruction for ureteroceles, that is complete excision/enucleation and marsupialization/partial excision. To our knowledge it is currently unknown whether 1 method offers better clinical outcomes. We sought to answer this question.
Materials and Methods: We retrospectively reviewed the records of patients who underwent open surgical repair for ureterocele at 3 academic institutions. The 2 groups (complete excision vs marsupialization) were compared for each clinical outcome, including ongoing vesicoureteral reflux, new bladder diverticulum, hydronephrosis, continence, urinary tract infection and voiding dysfunction. Each clinical outcome was analyzed for independence from the surgical method.
Results: A total of 33 cases of complete excision and 24 of marsupialization were collected. The excision and marsupialization groups were similar with respect to patient age at surgery, gender and average followup (55 and 38 months, respectively).