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errors or complications experienced during the skills practice are the hallmarks of
simulation. Of critical importance, the simulated learning is completely learner-
focused rather than a patient-centered encounter where the learner is of secondary
importance to the naturally clinical demands of a patient. Also, it appears that pro-
viding a preoperative surgical warm-up with instructor feedback can improve oper-
ative performance compared to either a warm-up or feedback alone [ 15 ].
One of the key objectives of any curriculum is to foster or promote the learner to
become committed to self-directed learning. However, training the learner in the
skills relevant to self-directed learning is critical and sometimes difficult. This can
be achieved through self-assessment, information searching, critical appraisal, and
clinical decision-making. Surgeons are notoriously poor at self-assessment so this
process of learning self-directed learning must be overseen by educators providing
concrete feedback in the information searching, critical appraisal, and clinical
decision- making processes [ 11 ]. Independent learning projects and personal learn-
ing plans or contracts can also be useful strategies to promote self-directed learning.
Through this process, trainees can eventually formulate and answer their own ques-
tions which is the definition of self-directed learning. Once again role modeling, as
provided by educators and faculty, is an additional method by which the next gen-
eration of urologists will understand the importance of self-directed learning.
The clinical work in urology is dependent on effective teamwork as it pertains to
the operating room and multidisciplinary delivery of comprehensive care to com-
plex urologic patients such as those with oncologic diseases. As such, it is important
that the curriculum focuses on educational strategies for promoting teamwork.
These strategies can include collaborative learning experiences as experienced in
team- based learning, creating work environments that model effective teamwork,
regular review and assessment of team function in which the trainee is included, and
dedicated simulated training in team skills and functions [ 16 ]. Several researchers
have demonstrated that team-simulated practice of communication and technical
skills significantly improve these parameters in all team members and makes team-
work more efficient and effective. This type of training can be performed in situ
thereby assisting in the identification of institutional or environmental factors that
may directly impact on the effectiveness of the team.
Implementation
While the challenging initial work of creating a curriculum determines the learner
needs and establishes the learning objectives and teaching strategies, it is equally
important to plan an efficient and calculated implementation of the curriculum. To
accomplish this step of curriculum development, it is important to clearly identify
the resources that will be required to introduce and maintain the curriculum. These
resources include personnel, time, facilities, and funding costs. Personnel factors
will encompass not only educators and faculty but secretarial and administrative
support for the maintenance and evaluation of the curriculum. It is also important to
consider patients within this personnel support and how they will be impacted as
E.M. McDougall and B. Schwartz