Current State of Pediatric Urology Training: Resident Competency Expectations vs. Perceived Ability

Area of Science:

• Pediatric Urology
• Surgical Education
• Resident Training

Background:

• Chief resident autonomy in pediatric urology is crucial for developing surgical skills.
• Understanding the expectations of program directors (PDs) and pediatric urologists is key to assessing resident preparedness.
• Assessing the gap between expected and observed resident performance is vital for improving surgical education.

Purpose of the Study:

• To evaluate program directors' (PDs) and pediatric urologists' expectations for chief resident autonomy in pediatric urology procedures.
• To compare these expectations with observed resident performance.
• To identify discrepancies in expected versus actual resident proficiency.

Main Methods:

• Two national surveys were distributed to pediatric urologists via the Society of Pediatric Urology (SPU) and to U.S. urology PDs.
• The validated Zwisch scale was used to assess expectations for chief resident performance in pediatric urology cases.
• SPU surveys additionally collected data on observed resident performance.

Main Results:

• Response rates were 32% for SPU and 33% for PDs.
• PDs reported higher expectations for chief resident autonomy than pediatric urologists across all case types.
• Observed resident proficiency consistently fell below the expectations of both PDs and pediatric urologists, particularly for complex procedures.

Conclusions:

• A significant gap exists between expected and actual chief resident proficiency in pediatric urology, despite structured training.
• Discrepancies in expectations between PDs and pediatric urologists may stem from sub-specialization and varied exposure.
• Recommendations include enhancing pediatric training, adjusting expectations, and aligning residency goals with future practice needs.