To assess the training of medical students and their confidence in urethral catheter placement, given growing evidence of unnecessary urology consults and iatrogenic injury.
A third-year medical school class was queried regarding their attitudes and knowledge of catheter placement prior to and after the Clinical Biennium. The Clinical Biennium introduces hands on skills prior to clinical clerkships. Urethral catheterization is one of the skill stations that students rotate through, and urology residents provide a didactic session and supervised simulation. Confidence was self-rated regarding catheter technique, knowledge, troubleshooting, and comfort with placement in same and opposite gender. Factual questions were posed regarding proper insertion and malfunctioning catheters.
Ninety-two students participated in the initial survey, 41% female and 59% male. 87% of students had never placed a catheter. Students desired high confidence in catheter skills (4.4/5). There were no significant differences in responses for those with desire to pursue urology vs. other specialties, or procedural fields compared to non-procedural fields. Prior independent learning was reported by 38% of students and was a predictor for increased confidence across all domains (p<0.05). 16.7% of students initially identified proper male urethral insertion distance, which improved to 95.6% after the session. Student interest in urology modestly increased after the educational session (p=0.0282). At 3-6 month follow-up, students had median 4 (IQR 2-7) urethral catheter placements, and 74.2% of students rated training useful or extremely useful. Indeed, 54.8% desired more instruction. Knowledge assessment indicated 93% of students retained comprehension of proper male urethral insertion distance. Clinical foley training rarely contradicted instruction from the Clinical Biennium (6.5%). At all time points, medical student knowledge for troubleshooting catheters was low.
Medical students strive for high confidence in urethral catheter placement. Prior targeted education improves confidence and knowledge. Together with clinical experience, these effects are durable up to 6 months. This article is protected by copyright. All rights reserved.
BJU international. 2016 Apr 22 [Epub ahead of print]
Andrew Cohen, Charles Nottingham, Vignesh Packiam, Nora Jaskowiak, Mohan Gundeti
University of Chicago Medicine, Department of Surgery, Section of Urology., University of Chicago Medicine, Department of Surgery, Section of Urology., University of Chicago Medicine, Department of Surgery, Section of Urology., University of Chicago Medicine, Department of Surgery., University of Chicago Medicine, Department of Surgery, Section of Urology, Chief of Pediatric Surgery.