Laparoscopic practice patterns among North American urologists 5 years after formal training
P M Colegrove1, H N Winfield, J F Donovan
1Department of Urology, University of Iowa, Iowa City, USA.
The Journal of Urology
|February 18, 1999
Summary
Urologist laparoscopy use significantly declined five years post-training, with most practitioners performing fewer procedures than expected. This indicates a challenge in maintaining surgical skills and practice in urological laparoscopy.
Area of Science:
- Urology
- Surgical Education
- Minimally Invasive Surgery
Background:
- Postgraduate training courses aim to equip urologists with laparoscopic surgical skills.
- Assessing long-term practice patterns is crucial for understanding the impact of such training.
Purpose of the Study:
- To evaluate urologist laparoscopy practice patterns five years after completing a postgraduate surgical training course.
- To compare current practice with data collected at 3 and 12 months post-training.
Main Methods:
- A survey was distributed in 1997 to 322 North American urologists who attended 11 training programs between 1991 and 1992.
- The survey assessed current laparoscopic procedure volume, perceived skill maintenance, and reasons for practice changes.
Main Results:
- Only 53.6% of respondents performed laparoscopic procedures in the year prior to the 5-year survey, a decrease from 84% at 1 year post-training.
- A significant drop was observed in perceived skill sufficiency, with 37% feeling competent at 5 years versus 66% at 1 year.
- Key reasons for decreased use included fewer indications, increased costs, patient factors, higher complications, and reduced institutional support.
Conclusions:
- Urological laparoscopy practice diminishes significantly in the years following postgraduate training.
- Maintaining surgical skills acquired in training courses is a challenge for many urologists.
- The decline in laparoscopic use is multifactorial, influenced by clinical, economic, and institutional factors.
