A Simulation-based, cognitive assessment of resident decision making during complex urinary catheterization scenarios

Area of Science:

• Urology
• Surgical Education

Background:

• General surgery residents' decision-making abilities in complex urinary catheterization were assessed.
• Uncommon and challenging urinary catheter scenarios were utilized.

Purpose of the Study:

• To evaluate the decision-making skills of general surgery residents.
• To identify learning needs in managing complex urinary catheterization.

Main Methods:

• Forty residents were presented with two distinct clinical scenarios.
• Residents described their approach to patient workup, management, and catheterization decisions.
• Decision paths were documented and analyzed using Chi-square analysis.

Main Results:

• In traumatic urethral injury scenarios, many residents opted for Urology consultation or diagnostic tests.
• For complete urinary blockage, a minority attempted catheterization, with inconsistent techniques upon failure.
• No significant consensus was found among residents' decision-making processes.

Conclusions:

• General surgery residents require additional training in complex urinary catheterization decision-making.
• Decision trees derived from this study highlight specific learning gaps and needs.