[Urological training: contemporary challenges and new approaches]

Area of Science:

• Medical Education
• Surgical Training
• Urology

Background:

• Traditional apprenticeship-based surgical training is insufficient for current demands.
• Competency-Based Postgraduate Medical Education (CBME) and Entrustable Professional Activities (EPAs) offer structured competency assessment frameworks.
• Implementing these models in urology is crucial for modernizing surgical education.

Purpose of the Study:

• To review the effectiveness of CBME and EPAs in surgical training.
• To examine the implementation and validation of EPAs specifically within urology.
• To identify challenges and facilitators for adopting these advanced training models.

Main Methods:

• Literature review of international data on CBME and EPAs in surgical training.
• Analysis of validated EPA frameworks developed for urology.
• Evaluation of a pilot study on EPA implementation in Switzerland.

Main Results:

• International data support EPAs for standardized progression of surgical competencies.
• Validated urology EPA frameworks range from 16 to 32 activities.
• A Swiss pilot study confirmed the feasibility of implementing EPAs in urology.

Conclusions:

• EPAs offer a standardized approach to assessing and progressing surgical competencies in urology.
• Successful implementation requires addressing the balance of technical and non-technical skills and adapting frameworks to local contexts.
• Training supervisors and identifying motivated leaders are key to successful adoption.