Assessment of robotic simulation by trainees in residency programs of the Southeastern Section of the American Urologic Association.

OBJECTIVES: To assess the Southeast Section of the American Urological Association (SESAUA) trainee exposure to and thoughts on robotic simulation. DESIGN: Questionnaire-based study of SESAUA residency trainees to determine their access to robotic simulation, live robotic experience to date, and opinion regarding the adequacy of current robotic training. SETTING: Three trainees from each SESAUA training program were invited to Orlando, Florida for a formal 2-day robotic training course. Day 1 was a 3-component didactic session. Day 2 involved faculty directing the trainees in set tasks on a live porcine model for 4 hours and another 4 hours on the Mimic dV-Trainer (Mimic Technologies, Inc, Seattle, WA) for directed exercises. PARTICIPANTS: Thirty-two trainees from 14 programs in the SESAUA participated in the course and filled out a 1-page, 8-item questionnaire following their simulator exposure. RESULTS: Seventeen (53.1%) trainees, including 5 urology year-3 trainees, reported never having had robotic console time. Of the trainees, 65.6% (21 of 32) had access to the Mimic dV-Trainer or Mimic "backpack" whereas 10 had no exposure to robotic simulation; 84.4% (27 of 32) felt that the simulator replicated real-life robotic console surgery and 90.6% (29 of 32) felt the simulator was helpful or would be helpful for training in their program. Trainees felt the "tubes 2" drill, which mimics a vesicourethral anastomosis, was the most difficult drill to perform. CONCLUSIONS: A majority of trainees in the SESAUA have had limited to no robotic console time. A high number of resident trainees in the SESAUA have exposure to virtual reality robotic simulation. Trainees believe that the simulator replicates real-life robotic console movements and almost all believe they would be benefit from having access to robotic simulation.

Electrocardiographic monitoring in the hospitalized patient: a diagnostic intervention of uncertain clinical impact.

Electrocardiographic monitoring, also known as telemetry monitoring or cardiac monitoring, focuses on the detection of clinically significant dysrhythmia. Although electrocardiographic monitoring has advantages and is undoubtedly invaluable in certain patients, significant overuse of cardiac telemetry monitoring does occur. The impact of this inappropriate use increases the cost of healthcare and can delay the admission process, an unpleasant burden which the hospital and its patients must bear. In addition, the liberal use of monitoring in unnecessary situations may give the hospital staff a false sense of security and/or desensitize them to alarms. In many instances, electrocardiographic monitoring may not be necessary. This article will review the literature regarding inpatient telemetry and its impact; furthermore, we will suggest high-yield criteria for its application among the inpatient population.