eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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6/2019
vol. 11
 
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abstract:
Original paper

Prostate brachytherapy procedural training: incorporation of related procedures in resident training and competency assessment

Jennifer Bachand
1
,
Samuel R. Schroeder
2
,
Neil B. Desai
2
,
Michael R. Folkert
2

1.
UT Southwestern Medical School, Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center, Dallas, TX USA
2.
Department of Radiation Oncology, Simmons Comprehensive Cancer Center at the University of Texas Southwestern Medical Center, Dallas, TX USA
J Contemp Brachytherapy 2019; 11, 6: 601–606
Online publish date: 2019/12/16
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Purpose
Inadequate procedural training is of increasing concern in resident training, especially in prostate brachytherapy (PB). Transperineal rectal spacer placement (TRSP) requires many of the same proficiencies as PB. This work describes the assessment of teaching techniques focusing on developing critical competencies for PB using related clinical procedures (TRSP).

Material and methods
For PB and TRSP, key competencies were identified: 9 for PB and 7 for TRSP; 4 are shared between PB and TRSP. “Comfort level” with these procedures was assessed prior to and following participation in TRSP.

Results
8 of 12 trainees at our institution participated in TRSP procedures. 2 of these trainees had prior experience with PB or related procedures and were excluded. Trainees self-reported “comfort levels” between 0 and 3 for four competency domains. Initial median comfort (MC) level for competency domains relevant to PB included: patient positioning (median 1, range 0-2), transrectal ultrasound imaging (median 1, range 0-1), fiducial placement (median 1, range 0-1), and hydrodissection (median 0, range 0-1). Median number of TRSP procedures performed by assessed trainees during the analysis period was 4 (range 1-6). Following TRSP procedure training, MC level increased: 2 points for patient positioning (median 3, range 1-3; p < 0.01), 1.5 points for transrectal ultrasound imaging (median 2.5, range 1.3, p < 0.001); 1 point for fiducial placement (median score 2, range 1-3; p < 0.001); and 1.5 points for hydrodissection (median score 2, range 1-3; p < 0.001).

Conclusions
Increasing trainee involvement in related procedures to develop core competencies may help facilitate increased comfort with common skills critical to the independent performance of PB.

keywords:

prostate brachytherapy, rectal spacer, resident education, simulation

 
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