TY  - EJOU
AU  - Haddad, Joseph 
AU  - Anderson, Christopher 
AU  - Heinlen, Jonathan 
AU  - Stratton, Kelly 
AU  - Mellis, Adamantios 
AU  - Herr, Harry 
AU  - Cookson, Michael 
AU  - Patel, Sanjay 

TI  - Improving the quality of operative reports  for transurethral resection of bladder tumor surgery in resident education
T2  - Canadian Journal of Urology

PY  - 2017
VL  - 24
IS  - 5
SN  - 1488-5581

AB  - <b>Introduction:</b> To assess the quality of resident dictations for transurethral resection of bladder tumor (TURBT). One indicator of surgical quality is the completeness of the operative report. Surprisingly, there is a paucity of standardized operative templates for TURBT and little formalized instruction for learners. The quality of TURBT dictations was assessed and areas of improvement were determined after implementation of a 10 item TURBT checklist.<br/>

<b>Materials and methods:</b> A retrospective review of the last 50 TURBT operative reports dictated by residents was performed. A "TURBT checklist" was used assessing 10 key factors in documentation. A formal training session regarding TURBT dictations was given with TURBT checklists handed out to each trainee. Fifty TURBT dictations were subsequently analyzed.<br/>

<b>Results:</b> TURBT dictations improved across the board following checklist implementation. Total number of checklist items dictated increased to 7.0 from 2.6 prior (p<0.05). When stratified by resident experience, TURBT dictations improved across different resident years (p<0.05). Junior resident dictations statistically improved in every checklist item (p < 0.05). Senior resident dictations improved in almost every category but only two reached statistical significance. A regression model demonstrated checklist implantation to be a significant predictor of improvement in mean number of checklist items dictated independent of PGY level.<br/>

<b>Conclusions:</b> Our study demonstrates that prior to implementation, TURBT operative dictations performed by residents lacked many of the critical components required for a quality TURBT. However, once properly instructed, a relatively simple "checklist" can be easily implemented and serve as a teaching tool for residents in training to ensure critical procedural elements are documented.
KW  - resident education
KW  -  bladder cancer
KW  -  transurethral resection of bladder tumor
KW  -  surgical quality

DO  -