Short-term impact of a robot-assisted laparoscopic prostatectomy 'mini-residency' experience on postgraduate urologists' practice patterns.
BACKGROUND
To assist practising urologists acquire and incorporate robot-assisted laparoscopic prostatectomy (RALP) into their practice, a 5 day mini-residency (M-R) programme with a mentor, preceptor and potential proctor experience was established at the University of California, Irvine, Yamanouchi Center for Urological Education. The follow-up results from the initial 21 RALP M-R participants are presented.


METHODS
Between September 2003 and September 2004, 21 urologists from six states and four countries underwent a RALP M-R. Each participant underwent 1:2 teacher:attendee instruction over a 5 day period, which included inanimate model skills training, animal/cadaver laboratory skills training and operating room observation experience. Participants were also offered a proctoring experience at their hospital if they so desired. A questionnaire survey was mailed 1-14 months (mean 7.2 months) following completion of the mini-residency and these results were tabulated and reviewed.


RESULTS
A 100% response rate was achieved from the mailed questionnaires. The mean M-R participant age was 43 years (range 33-55 years). One-third of the M-R participants were practising in an academic environment. Most of the participants (55%) had no fellowship training. Of those with fellowship training (45%), three (15%) were in laparoscopy and three (15%) were in oncology; 25% of the participants were in large (>6 physicians), 25% in small (2-6 physicians) and 15% in solo practices; 70% of the participants were located in an urban setting. The majority of the participants (80%) had laparoscopic experience during residency training and had performed 20-60 laparoscopic cases prior to attending the M-R programme. Within 7.2 months after M-R (range 1-14 months), 95% of the participants were practising robot-assisted laparoscopic prostatectomy and 25% of the RALP M-R participants had also performed robotic-assisted laparoscopic pyeloplasty. Of the M-R participants, 38% availed themselves of the preceptor/proctor component of the programme; among these, 100% reported that they were performing RALP vs. only 92% of the MR participants who did not have a proctor experience. The 5 day length of the M-R was considered to be of satisfactory duration by 90% of the participants, while 1 participant considered it too brief and 1 considered it too long. All but one of the participants rated the M-R as a very or extremely valuable experience. All the M-R participants indicated that they would recommend this training programme to a colleague.


CONCLUSIONS
A 5 day intensive RALP M-R course seems to encourage postgraduate urologists, already familiar with laparoscopy, to successfully incorporate robotic surgery into their practice. The take rate, or the percentage of participants performing robotic-assisted surgery within 14 months after M-R, was 95%. Continued follow-up will ultimately determine the long-term effectiveness of this 1 week intensive training programme for postgraduate urologists.
McDougall
Elspeth M
EM
Department of Urology, University of California at Irvine, Orange, CA 92868, USA. cshell@uci.edu
Corica
Federico A
FA
Chou
David S
DS
Abdelshehid
Corollos S
CS
Uribe
Carlos A
CA
Stoliar
Gabriella
G
Sala
Leandro G
LG
Khonsari
Sepi S
SS
Eichel
Louis
L
Boker
John R
JR
Ahlering
Thomas E
TE
Clayman
Ralph V
RV
D000328:Adult; D004502:Education, Medical, Continuing; D006801:Humans; D007396:Internship and Residency; D010535:Laparoscopy; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011468:Prostatectomy / Q000193:education* / Q000379:methods*; D012371:Robotics; D013997:Time Factors; D014572:Urology / Q000193:education*