Mp73-02 the Resident Holep Learning Curve: Creating a Standardized Curriculum for Learning Holep

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment (MP73)1 May 2024MP73-02 THE RESIDENT HOLEP LEARNING CURVE: CREATING A STANDARDIZED CURRICULUM FOR LEARNING HOLEP Christopher Manakas, Matthew D. Grimes, Emily C. Serrell, Ali Antar, Margaret Knoedler, and Daniel Gralnek Christopher ManakasChristopher Manakas , Matthew D. GrimesMatthew D. Grimes , Emily C. SerrellEmily C. Serrell , Ali AntarAli Antar , Margaret KnoedlerMargaret Knoedler , and Daniel GralnekDaniel Gralnek View All Author Informationhttps://doi.org/10.1097/01.JU.0001009564.26544.1c.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium Laser Enucleation of the Prostate (HOLEP) is a well-established treatment of benign prostatic hyperplasia (BPH) with advantages including use very large prostates, improved hemostasis, and lower re-treatment rates. Despite this, HOLEP accounts for only 3-6% of BPH procedures performed in the United States. Most studies attribute this to a steep learning curve, where attending physicians become proficient in 20-50 cases. However less is known about gaining proficiency in HOLEP as a resident. Therefore, we aim to define a resident HOLEP learning curve and create a structured approach to surgical teaching. METHODS: We developed and implemented a HOLEP Training Curriculum based on a structured, stepwise, approach to residents learning the two lobe HOLEP (Figure 1). We applied the Training Curriculum over consecutive cases performed in an academic year (June 2021 – June 2022). De-identified procedure information was prospectively collected including prostate size, imaging modality, total procedure duration, enucleation time, morcellation time, specimen weight, and intra-op/immediate post-op complications. Resident data including self-evaluation, PGY year, and case volume was collected then de-identified. Attendings evaluated residents in real-time to evaluate competency at each step. Our primary outcome was number of HOLEP training cases needed to independently complete prostate enucleation of <100g gland in less than 90 minutes. RESULTS: Over one year the HOLEP Training Curriculum was utilized in 302 HOLEP cases completed by two attendings and 14 trainees. Average pre-op prostate volume was 83.3g (27-160g). Number of HOLEP cases recorded by each PGY-level included: PGY-1 (1), PGY-2 (20), PGY-3 (11), PGY-4 (173), PGY-5 (48), and PGY-6 (49). All senior-level trainees (>PGY-3) reached the primary objective in a mean number of 31 HOLEP cases (range 19-44). Average trainee enucleation time was 47.5 minutes (23-78) at time of achieving proficiency. CONCLUSIONS: With consistent use of the HOLEP Training Curriculum in resident training, we identified an average learning curve of 31 HOLEP cases. This suggests that implementation of this Curriculum can occur and can help standardize resident training, particularly at high-volume centers, and remove a significant barrier to increased HOLEP utilization. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1181 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Christopher Manakas More articles by this author Matthew D. Grimes More articles by this author Emily C. Serrell More articles by this author Ali Antar More articles by this author Margaret Knoedler More articles by this author Daniel Gralnek More articles by this author Expand All Advertisement PDF downloadLoading ...