Resident-run urology clinics: A tool for use in competency-based medical education for teaching and assessing transition-to-practice skills.

INTRODUCTION: In a competency-based approach to resident education, a component of training should focus on skills needed for the transition from residency to independent practice. The ability to run an outpatient clinic represents one such skill. Resident-run clinics (RRC) have been implemented in family medicine programs to allow residents to practice this skill, and have enhanced learning while providing excellent patient satisfaction. To date, there has been little experience with RRCs in surgical residency programs. We describe a urology RRC and report assessments of both resident performance and patient satisfaction.

METHODS: The RRC was run independently by a senior urology resident. All cases were reviewed with faculty at the end of the day, and an evaluation form assessing resident performance was completed. Residents also completed a brief self-assessment. All patients completed an anonymous survey to assess aspects of patient satisfaction.

RESULTS: Overall, resident performance was excellent, with changes to the management plan in 6% (3/47) of cases after faculty review. All clinics finished within 30 minutes of planned end time. Residents reported confidence in their ability to manage the clinic (8.25/10). Forty-three patient surveys were completed. On a five-point scale, patient ratings of wait time, clinic environment, and appointment duration were 3.91, 4.23, and 4.12, respectively. Patient ratings of resident skills (communication, sensitivity, treatment options, and answering questions) were 4.30, 4.35, 4.40, and 4.42, respectively. Overall, confidence in residents was 9.07/10 and 100% of patients would recommend the RRC.

CONCLUSIONS: Based on our ongoing experience, RRCs provide well-received, safe patient care and serve as a learning tool for residents as they prepare for independent practice. Given these results, residency programs could consider inclusion of a RRC as a component of the transition- to-practice training within a competency-based curriculum.