The contemporary exponential increase of surgical knowledge and technological advancements that allow for greater access to educational content are changing how urologists learn.¹ Traditional paradigms of education, such as large group, in-person lectures and individual passive learning, are being challenged by new approaches and infusion of technology into teaching. Passive absorption of knowledge, although convenient, has been criticized for a lack of engagement with the learner, while evidence supports that active learning in higher education has improved educational outcomes.^2,3 There is also evidence in the educational literature that active learning yields better educational results such as increased levels of content acquisition and retention, critical thinking, evaluation, and synthesis.^2,3

The current AUA membership encompasses a diversity of types of learners who are in different stages of their careers. There are also variations across geography (national and international), age, experience, gender, race, and career roles including practicing urologists, trainees, advanced practice providers (APPs), and practice managers. Given this diversity, it is reasonable to expect that there would not only be generational differences, but also a variety of learning preferences. Recognizing that one of the AUA’s missions is to promote urological clinical care through education of all diverse members, our 2023-2024 AUA Leadership Program team (Team Peters) chose our capstone project to explore the educational needs of our membership. The goal of this study was to capture the contemporary learning preferences of AUA members across a variety of learning scenarios to better inform and improve AUA educational strategies, as well as to guide educators and learners on how to develop contemporary innovative educational offerings for everyone in urology, clinical and nonclinical, across all levels of training and practice.

An anonymous, voluntary 20-question survey was administered in August and September 2023 via email communication to a random sample of 5103 AUA members representing approximately 20% of the current membership. The survey captured demographic and practice information, preferred learning styles across a variety of educational scenarios, and preferred methods of learning at in-person conferences. Hierarchical clustering was used to identify the top 3 preferred learning styles by learner role and years in practice and at in-person conferences. Five hundred and three people completed the survey (10% response rate). The table shows the baseline characteristics of the respondents. Respondents were comprised of 316 (63%) urologists, 59 (12%) residents, 19 (4%) medical students, 78 (16%) APPs, and 31 (6%) practice managers. Age range of respondents was evenly split between older and younger generations as well as between years in practice. A majority (66%) of respondents were male. Most respondents (85%) practice in a metropolitan area and 65% of respondents were international members of the AUA.

From the dataset, certain subsets of learners demonstrated preferences for unique groupings of learning styles. Four groups of learning settings were identified. Within each group, the most preferred learning styles were described (Figure 1). When learning a new surgical skill or refreshing a surgical skill they are familiar with, the preferred method of learning was in-person courses, followed by virtual courses and in-person conferences (Setting 1, Figure 1). When preparing for boards/recertification/in-service exam or designing or conducting a research study, learners preferred to utilize electronic journals, website resources, and review questions (Setting 2, Figure 1). For obtaining CME as well as learning a topic in urology that is new to them or refreshing a topic they are familiar with, learners preferred virtual courses followed by website learning and in-person conferences (Setting 3, Figure 1). For learning about the business of urology and/or practice management, learners preferred virtual courses, in-person conferences, and website learning (Setting 4, Figure 1).

Among all learners, learning styles also clustered into 5 different groups based on learning activity (Figure 2). For example, in-person and virtual conferences/courses were most useful for learning a new surgical skill, refreshing a surgical skill, and for CME (Style 1, Figure 2).

Among all physicians, distinct patterns in preferred learning styles were noted by years in training or practice, career role, and practice location. For those with < 15 years versus > 15 years in training/practice, significantly different preferences were noted in the preferred method of learning new topics in urology (P < 0.001). Younger learners favored electronic journals and textbooks, apps, websites, podcasts, and social media while older learners favored conferences, courses, paper media, and review materials.

Learning preference variations were examined, stratified by region of practice (international or domestic AUA section). While patterns of variation were noted, statistical significance in differences between groupings were not observed. The e-journal modality was strongly preferred by international urologists (preferred by 58%) compared to any domestic AUA section of urologists (range 18%-29%, P < 0.001).

With regard to learning preferences at in-person conferences, such as the AUA Annual Meeting, the top learning methods included plenary lectures (68% of participants ranked this in their top 3 offered learning approach), panel sessions/debates (51%), and hands-on courses (48%). In comparison, the least popular settings for learning included the technology hall (8%) and poster sessions (8%).

Finally, the top novel methods of learning that learners indicated they would like to see the AUA offer included utilization of real-time audience engagement (such as electronic question submission or electronic audience response, preferred by 50% of respondents), increased use of small group learning or breakout sessions (preferred by 46%), and increased use of microlearning (defined as lessons broken into 10-minute segments accessed virtually at your convenience, preferred by 38%).

This study found significant differences in preferred learning styles and preferences based on career role, location of practice, and years in practice. These findings can be utilized by the AUA as well as all of the educators and learners in the field of urology to optimally provide educational experiences for the diversity of learners in urology.

Support/Financial Disclosures funding: This survey was supported by the American Urological Association (AUA) Leadership Program.

Table. Demographics