Benchmarking competency in paediatric groin surgery

Summary 

Introduction

A diminishing number of surgeons are performing paediatric groin surgery in large district general hospitals due to loss of expertise. The British Association of Urological Surgeons (BAUS) is currently engaged with the Royal College of Surgeons (RCS) to resolve this gradual loss of subspecialist expertise.

We have adopted a user-friendly approach to quantify training in this field.

Methods

In our centre we undertake approximately 150 paediatric groin cases per year with 3 specialist registrars (SpRs) rotating through the post every 4 months. Using existing Intercollegiate Surgical Curriculum Project (ISCP) tools, Direct Observation of Procedural Skill (DOPS) assessments were undertaken for each groin procedure performed by the SpR then scored by the trainer from 2 (unsatisfactory) to 6 (above expectations), with 4 being considered satisfactory/competent to perform the procedure. Three SpRs were assessed over a period of 4 months each.

Results

Competency was determined by 5 successive DOPS scores of 4. Case numbers over 4 months were 23–35 with a mean number of cases to achieve competency being 16 (range 10–18).

Conclusion

These results indicate that it is feasible and practical for a trainee to acquire adequate experience in DGH paediatric groin surgery and we suggest a minimum performance of 25 procedures.

Keywords: Paediatric urology, ISCP, DOPS, Competency, Logbook