Effectiveness of direct observation of procedural skills (DOPs) in postgraduate training in urology at Institute of Kidney Diseases, Peshawar

Abstract

Objective: To determine the effectiveness of direct observation of procedural skills (DOPS) in the assessment and improving operative skills of postgraduate residents in urology. Study Design: Comparative study. Place and Duration of Study: Department of Urology, Institute of Kidney Diseases (IKD), Hayatabad Medical Complex, Peshawar, from March till December 2016. Methodology: Twenty postgraduate residents in urology were assessed for three commonly performed procedures in urology with structured proforma, specially designed for DOPS, using Likert scale from 1 to 5. Formative feedback was given to all the residents highlighting their strengths and weaknesses. During second phase, all the three procedures were performed by four consultants respectively with residents as learner in the second phase of DOPS. During the third phase, a repeat assessment of e-residents was performed to study the overall improvement in operative skills, respectively. Results: In pre-DOPS assessment, only 7 (35%) out of 20 residents, passed in skill of cystoscopy, 6 (30%) residents passed in transurethral resection of prostate (TURP), while 3 (15%) residents passed in skills of uretero-renoscopy (URS). The mean score of overall ability to perform procedure during first phase of DOPS were 2.7 ±1.3 for cystoscopy, 2.1 ±0.97 for TURP, and 2.5 ±1.1 for ureterorenoscopy. Significant improvement (p 0.04) in passing was observed in third phase with 17 (85%), 14 (70%), and 14 (70%) residents were declared passed in cystoscopy, TURP and URS, respectively. The mean score of overall ability to perform procedure during the third phase was 4.7 ±0.7 for cystoscopy, 4.5 ±0.94 for TURP, and 4.7 ±0.94 for ureteroscopy. Conclusion: DOPS is effective tool for assessing and improving the skills of postgraduate residents in urology.