Illuminating Gaps in Laser Education in Urology Residency Programs

Purpose: Urologists utilize numerous laser technologies. The American Urological Association (AUA) has an online laser education module, but no standardized program curriculum is required. We sought to understand gaps in knowledge surrounding laser technologies in the AUA New England (NE) Section to inform decisions around the annual Residents Skills Course and overall resident education. Methods: An anonymous questionnaire assessing basic laser information and attitudes was created. All academic urology training programs in NE (n = 12) were invited. Responders were encouraged to give their best guess rather than confer or look up answers. Results: A total of 62% of residents (n = 72) and 62 attendings from the 12 NE programs participated. The most common laser technology uses were nephrolithiasis, urothelial cancer, prostate, strictures, and skin. Faculty varied as regards which diseases residents should apply lasers, be trained in, and show competence. Residents felt less confident in their baseline knowledge as compared with attendings, but most in both groups rated their knowledge lower after completing the questionnaire. Knowledge of the nominal optical hazard distance for each wavelength was negligible. Some respondents could not differentiate between laser wavelength, depth of penetration, Joules, Hertz, or Watts; and very few could explain the difference between standard holmium and Moses, and thulium (solid state) vs thulium fiber. Conclusions: Gaps in knowledge surrounding laser technologies are significant. Urologists acknowledge deficiencies, yet only 25% to 32% are very likely to seek information on their own. Standardized laser education that is frequently updated and delivered will improve overall knowledge and reduce the risk for patient harm.