Effect of a Cadaveric Simulation–Based Teaching Model on Surgeon Comfort with Ureteral Reimplantation Procedures

Abstract

Objective:

The aim of this study was to evaluate the effect, with respect to surgeon comfort, of a cadaveric-simulation model for teaching ureteral-repair procedures.

Materials and Methods:

A novel didactic and simulation curriculum developed by the authors was proctored by Female Pelvic Medicine and Reconstructive Surgery (FPMRS) experts for teaching ureteroureterostomy, ureteroneocystostomy, and psoas hitch on a cadaveric model. Participants completed pre- and post-laboratory surveys, used to assess demographics; surgical experience; baseline and post-laboratory comfort with surgical steps and anatomy; and perceived likelihood of performing these procedures in the future.

Results:

Eleven FPMRS fellows from 4 different institutions plus 1 urology resident participated. Most had prior cadaver laboratory experience (75%). The majority reported never performing ureteroureterostomy, ureteroneocystostomy, or psoas hitch previously as primary surgeons (83.3%, 83.3%, and 91.7%, respectively). Baseline comfort with performing these procedures independently was low (16.7%, 16.7%, 8.3%, respectively). Post-laboratory–reported comfort with surgical steps increased (91.6%, 100%, 91.6%, respectively). The likelihood of being primary surgeons for these procedures in the future remained low (41.7%, 33.3%, 41.7%, respectively). Participants' comfort with surgical anatomy improved from 41.7% to 100%. All participants found this laboratory session helpful for learning the surgical steps and anatomy related to ureteral-repair procedures and would recommend this session to other physicians.

Conclusions:

A cadaveric-simulation model improves FPMRS trainee–reported comfort with the surgical steps and anatomy involved in ureteral-repair procedures. The self-reported likelihood of performing these procedures in the future, however, is low. (J GYNECOL SURG 38:127)