Introduction:Exposure to prenatal consultations and opportunities for counseling in fellowship vary greatly. Many graduating fellows do not feel comfortable providing prenatal consultation, and there is a paucity of educational resources available to guide them during training. We sought to summarize available educational opportunities and make recommendations for a curriculum to guide fetal urology education during fellowship training. Methods: Separate surveys were created for program directors (PDs) and current pediatric urology fellows and distributed via electronic mail. Respondents were asked about opportunities in fetal urology, availability and use of reference materials and perspectives on assuring progress to trainee independence in providing prenatal care. Participant responses served as a targeted needs assessment to identify gaps in competence. Using Kern’s 6-step approach for curriculum development (Figure 1), specific goals and objectives for a sample curriculum were created based on the targeted needs of our cohort. Educational strategies to achieve curriculum objectives were identified based on participant responses and available resources. Results:A total of 28 of 35 fellows and 24 of 27 PDs responded (80% and 88.9% response rate, respectively). No significant difference was noted among gender or AUA section . Among available educational resources for fetal urology, the more structured and comprehensive ones were less known to both cohorts (Figure 2). Additional resources that respondents felt could aid in fetal urology education include a fellows’ course in fetal urology, dedicated time to attend multidisciplinary clinics and with a GU radiologist, electronic curricula, and simulated encounters. The targeted needs assessment revealed 4 themes: a need to increase fellow exposure to rare diagnoses, more opportunities for fellows to counsel, opportunities outside direct participation in prenatal consultation, and increase awareness of and access to existing electronic curricula. This information was used to form specific objectives for a fetal urology curriculum. The curriculum content was separated into 3 categories: prenatal imaging, counseling and postnatal management. Each category contains a series of enabling objectives in which proficiency in the first serves as a prerequisite to success with subsequent objectives. Figure 3 displays our proposed curriculum with recommendations for implementation. Conclusion:Varied opportunities appear to exist within individual training programs for fellows to advance their knowledge in fetal urology. This highlights the need for structured curricula and innovative educational strategies. Here we provide the foundation for development of a structured curriculum with the goal of equipping graduating fellows with confidence and competence necessary for effective prenatal counseling.
