Long-term impact of a robot assisted laparoscopic prostatectomy mini fellowship training program on postgraduate urological practice patterns.
OBJECTIVE
Robot assisted laparoscopic prostatectomy has stimulated a great deal of interest among urologists. We evaluated whether a mini fellowship for robot assisted laparoscopic prostatectomy would enable postgraduate urologists to incorporate this new procedure into clinical practice.


METHODS
From July 2003 to July 2006, 47 urologists participated in the robot assisted laparoscopic prostatectomy mini fellowship program. The 5-day course had a 1:2 faculty-to-attendee ratio. The curriculum included lectures, tutorials, surgical case observation, and inanimate, animate and cadaveric robotic skill training. Questionnaires assessing practice patterns 1, 2 and 3 years after the mini fellowship program were analyzed.


RESULTS
One, 2 and 3 years after the program the response rate to the questionnaires was 89% (42 of 47 participants), 91% (32 of 35) and 88% (21 of 24), respectively. The percent of participants performing robot assisted laparoscopic prostatectomy in years 1 to 3 after the mini fellowship was 78% (33 of 42), 78% (25 of 32) and 86% (18 of 21), respectively. Among the surgeons performing the procedure there was a progressive increase in the number of cases each year with increasing time since the mini fellowship training. In the 3 attendees not performing the procedure 3 years after the mini fellowship training the reasons were lack of a robot, other partners performing it and a feeling of insufficient training to incorporate the procedure into clinical practice in 1 each. One, 2 and 3 years following the mini fellowship training program 83%, 84% and 90% of partnered attendees were performing robot assisted laparoscopic prostatectomy, while only 67%, 56% and 78% of solo attendees, respectively, were performing it at the same followup years.


CONCLUSIONS
An intensive, dedicated 5-day educational course focused on learning robot assisted laparoscopic prostatectomy enabled most participants to successfully incorporate and maintain this procedure in clinical practice in the short term and long term.
Gamboa
Aldrin Joseph R
AJ
Department of Urology, University of California, Irvine, Orange, California 92868, USA.
Santos
Rosanne T
RT
Sargent
Eric R
ER
Louie
Michael K
MK
Box
Geoffrey N
GN
Sohn
Kevin H
KH
Truong
Hung
H
Lin
Rachelle
R
Khosravi
Amanda
A
Santos
Ricardo
R
Ornstein
David K
DK
Ahlering
Thomas E
TE
Tyson
Darren R
DR
Clayman
Ralph V
RV
McDougall
Elspeth M
EM
D000328:Adult; D002983:Clinical Competence; D003479:Curriculum; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D005257:Fellowships and Scholarships / Q000458:organization & administration; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D010535:Laparoscopy / Q000379:methods; D008297:Male; D010818:Practice Patterns, Physicians'; D015397:Program Evaluation; D011468:Prostatectomy / Q000193:education* / Q000295:instrumentation; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014572:Urology / Q000193:education