Resident performance in complex simulated urinary catheter scenarios.

Area of Science:

• Urology
• Medical Education
• Surgical Training

Background:

• Urinary catheterization is a frequent hospital procedure with risks of infection and trauma if performed improperly.
• Guidelines exist for catheter insertion, but resident decision-making in complex scenarios requires evaluation.
• Increasing nursing responsibility highlights the need for residents to master advanced catheterization skills.

Purpose of the Study:

• To assess the clinical decision-making skills of surgical residents during simulated urinary catheterization.
• To investigate consistency in catheter choices and clinical presentations among residents.
• To identify potential training deficiencies in urinary catheter selection.

Main Methods:

• Forty-five general surgery residents (postgraduate years 2-4) participated in simulated urinary catheterization scenarios.
• Residents were presented with 3-4 scenarios of varying difficulty and had 15 minutes to choose from five catheter types.
• Chi-square tests analyzed the relationship between initial and subsequent catheter choices for decision-making consistency.

Main Results:

• The 16 French Foley catheter was the most common initial choice for scenarios A-C, while the 16 French Coude was preferred for scenario D.
• Residents achieved the highest success rate in initial catheterization attempts.
• No significant relationship was found between residents' initial and subsequent catheter choices within each scenario (P > 0.05).

Conclusions:

• Initial urinary catheter choices appeared deliberate, influenced by patient background (e.g., scenario D).
• Subsequent catheter choices within scenarios revealed significant inconsistency, suggesting potential deficits in clinical decision-making.
• Findings indicate a possible lack of competence or inadequate training in urinary catheter selection among surgical residents.