Mp25-15 international experts consensus on performance metrics for a transurethral resection of bladder

You have accessJournal of UrologyCME1 Apr 2023MP25-15 INTERNATIONAL EXPERTS CONSENSUS ON PERFORMANCE METRICS FOR A TRANSURETHRAL RESECTION OF BLADDER Marco Paciotti, Pietro Diana, Pieve Emanuele, Andrea Gaglioli, Ruben De Groote, RUI FARINHA, Vincenzo Ficarra, Richard Gaston, Paolo Gontero, Rodolfo Hurle Rozzano, Luis Martínez-Piñeiro, Andrea Minervini, Vito Pansadoro, Ben Van Cleynenbreugel, Peter Wiklund, Paolo Casale Rozzano, Giovanni Lughezzani, Stefano Mancon, Alessandro Uleri, Pieve Emanuele, Alexandre Mottrie, Joan palou, Anthony G. Gallagher, Alberto Breda, Nicolò Buffi, and Pieve Emanuele Marco PaciottiMarco Paciotti More articles by this author , Pietro DianaPietro Diana More articles by this author , Pieve EmanuelePieve Emanuele More articles by this author , Andrea GaglioliAndrea Gaglioli More articles by this author , Ruben De GrooteRuben De Groote More articles by this author , RUI FARINHARUI FARINHA More articles by this author , Vincenzo FicarraVincenzo Ficarra More articles by this author , Richard GastonRichard Gaston More articles by this author , Paolo GonteroPaolo Gontero More articles by this author , Rodolfo Hurle RozzanoRodolfo Hurle Rozzano More articles by this author , Luis Martínez-PiñeiroLuis Martínez-Piñeiro More articles by this author , Andrea MinerviniAndrea Minervini More articles by this author , Vito PansadoroVito Pansadoro More articles by this author , Ben Van CleynenbreugelBen Van Cleynenbreugel More articles by this author , Peter WiklundPeter Wiklund More articles by this author , Paolo Casale RozzanoPaolo Casale Rozzano More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Stefano ManconStefano Mancon More articles by this author , Alessandro UleriAlessandro Uleri More articles by this author , Pieve EmanuelePieve Emanuele More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Joan palouJoan palou More articles by this author , Anthony G. GallagherAnthony G. Gallagher More articles by this author , Alberto BredaAlberto Breda More articles by this author , Nicolò BuffiNicolò Buffi More articles by this author , and Pieve EmanuelePieve Emanuele More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003253.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transurethral resection of bladder (TURB) is a common procedure and should be mastered by every urologist. Recent surveys reported worrying data about residents’ capacity and confidence to perform a TURB safely. There is an imperative to standardize and improve TURB training programs. We are working to establish the first Proficiency-Based Progression (PBP) structured training curriculum for a TURB procedure. As a first step, we aimed to develop the metrics which characterized a reference approach to a TURB procedure, and to obtain expert consensus on the metrics in a modified Delphi meeting. METHODS: A reference approach to piecemeal TURB was developed according to the PBP methodology. A core team of three TURB experts and a senior behavioral scientist deconstructed the procedure, characterizing procedure Phases, Steps, Errors, and Critical Errors of a piecemeal TURB. The identified performance metrics constitute an optimal approach for training purposes. Urological societies guidelines, published peer-review papers and clinical experience guided the metric development. Unedited videos of TURB were used for verification and refinement of the metrics. The metrics were then presented to an international group of procedure experts to evaluate the face and content validity of the metrics through a modified Delphi format. RESULTS: The core team deconstructed the procedure identifying 6 procedure phases, 60 procedure steps, 43 errors, and 40 critical errors. The procedure metrics were presented in a 3 hours Delphi meeting where 15 experts from 6 Countries were included. Through a modified Delphi process, a reference case was identified as a standard elective TURB on a male patient, diagnosed after full diagnostic work-up with ≤4 bladder lesions, the largest one ≤3 cm. The international experts panel added 3 steps, 4 errors, 1 critical error. Fourteen steps, 5 errors and 3 critical errors were edited. At the end of the Delphi, 6 procedure phases, 63 procedure steps, 49 errors, and 38 critical errors were identified. A panel consensus of 100% on the resulting metrics was obtained. CONCLUSIONS: A core metrics team performed a detailed task deconstruction of a piecemeal TURB. The performance metrics were presented, edited, and approved by an international panel of experts. These metrics represent a common system to train and objectively assess trainee capacity to perform TURB. They will be used to develop the first PBP-based training curriculum for TURB. The metrics represent a milestone of change in the training paradigm for one of the most commonly performed urological procedures. Source of Funding: . © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e348 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Paciotti More articles by this author Pietro Diana More articles by this author Pieve Emanuele More articles by this author Andrea Gaglioli More articles by this author Ruben De Groote More articles by this author RUI FARINHA More articles by this author Vincenzo Ficarra More articles by this author Richard Gaston More articles by this author Paolo Gontero More articles by this author Rodolfo Hurle Rozzano More articles by this author Luis Martínez-Piñeiro More articles by this author Andrea Minervini More articles by this author Vito Pansadoro More articles by this author Ben Van Cleynenbreugel More articles by this author Peter Wiklund More articles by this author Paolo Casale Rozzano More articles by this author Giovanni Lughezzani More articles by this author Stefano Mancon More articles by this author Alessandro Uleri More articles by this author Pieve Emanuele More articles by this author Alexandre Mottrie More articles by this author Joan palou More articles by this author Anthony G. Gallagher More articles by this author Alberto Breda More articles by this author Nicolò Buffi More articles by this author Pieve Emanuele More articles by this author Expand All Advertisement PDF downloadLoading ...