ORLANDO, FL USA (UroToday.com) - Medical education has long had to strike a balance when providing adequate training to novices and young doctors. The question arises: how do you train them effectively, and does their involvement in patient care affect outcomes? In this study, Lee and colleagues offer an answer in the case of fellow and chief-resident participation during robot-assisted radical prostatectomy (RARP).
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They evaluated perioperative outcomes of three scenarios depending on who was present at the surgical console: attending only (n=91), attending and fellow (n=152), and attending and chief resident (n=145). The measures included patient characteristics (ranging from demographics to disease-specific measures including Sexual Health Inventory for Men, AUA Symptom Score, Gleason score, etc) as well as perioperative outcomes (including estimated blood loss, length of stay, surgical margins, operative time, etc.).
Their results demonstrated that although fellow and chief-resident involvement is associated with increased operative times (89.3 versus 125.4 minutes when compared to attending-only group), it is not associated with worsened oncologic or functional outcomes up to 1 year, postoperatively.
This work reinforces the concept that although time-intensive, training can be safe and does not compromise efficacy when performed under adequate supervision.
Presented by Ziho Lee at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
University of Pennsylvania, Philadelphia, PA USA
Written by Martin Hofmann, MD, University of California (Irvine), and medical writer for UroToday.com