title: CEVL e-learning teaches GUMS method to "score" hypospadias preoperatively and predict postoperative outcomes.
abstract: BACKGROUND
  Pediatric urological surgeons recognize the importance of formalizing the assessment of outcomes after hypospadias repair. To this end, surgical outcomes may be predicted by correlation with a summative score of objective assessments (Likert 1-4) of each: glans size, urethra plate appearance, meatus position, and extent of shaft chordee (GUMS). The best surgical outcome will be found in cases with the lowest score (GUMS = 4) and the worst surgical outcome in cases with the highest score (GUMS = 16).
  
  
  OBJECTIVE
  We aimed to determine if e-learning is suitable for training of the GUMS method. We did this by re-formatting the GUMS method of assessment of the hypospadias penis into an e-learning platform. Re-formatting was done using the CEVL (Computer Enhanced Visual Learning) context.
  
  
  METHODS
  A total of 49 cases provided content for the following content groups: learn basics (4 cases), scoring samples (16 cases), learn by examples (4 cases), practice scoring (15 cases), and self-test (10 cases). The content was formatted, edited (Adobe), and imported for interactive use (Articulate Storyline). Various frequently asked questions on how to score are also presented.
  
  
  RESULTS
  The survey respondents were pediatric urology attendings or fellows (60%) or urology residents (40%). E-learning GUMS scoring was done under 40 min before completion of the survey. Over 80% of respondents agreed/strongly agreed with the utility of the CEVL platform for learning the method. Respondents assigned GUMS scores to the survey cases and, on average, agreed on exactly the same scores for each component 63% of the time. The respondents chose the consensus score, or the next most common consensus score, 90% of the time.
  
  
  CONCLUSIONS
  We show that CEVL e-learning is an effective tool, which requires a minimal time investment, for teaching GUMS scoring. We believe that e-learning is a good platform to promote uniform clinical practices in outcomes research and for resident training.
authors.affiliation: Emory University & Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Elmore
authors.affiliation: Department of Urology, Lurie Children's Hospital, Northwestern University, Chicago, IL, USA. Electronic address: max.maizels@gmail.com.
authors.forename: Max
authors.initials: M
authors.lastname: Maizels
mesh_terms: D002648:Child; D003194:Computer-Assisted Instruction / Q000379:methods*; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D007396:Internship and Residency; D008297:Male; D010413:Penis / Q000601:surgery; D011184:Postoperative Period; D057234:Preoperative Period; D011379:Prognosis; D019651:Plastic Surgery Procedures / Q000193:education*; D011795:Surveys and Questionnaires; D014521:Urethra / Q000601:surgery; D014572:Urology / Q000193:education*
keywords: Hypospadias; Outcomes; Pediatrics; Surgery