Our urodynamic unit has delivered an International Continence Society (ICS) approved, non-commercial course in Urodynamics (Certificate in urodynamics) for over 20 years.  During the Covid pandemic, online courses were introduced to enable training to be given via a Zoom platform, while assessment was done through a Google Docs page.  We now run both face-to-face and virtual courses, both in the United Kingdom and overseas, as demand and capacity has allowed. The course is the most internationally delivered urodynamics course in the world.
We aimed to understand how participants on these courses experienced the methods of delivery, in order to gauge whether only one of the formats or both should be continued.

A questionnaire (Table 1) was developed and sent to approximately 1200 previous delegates over the last 12 years on our courses via the Google Forms platform. A reminder was sent to all delegates, a month after sending the original 
Responses were collated and analysed by the spreadsheet downloaded from the Google Forms platform.

305 responses were received. 75% of respondents work in urology or urogynaecology, and the remaining 25% worked across neurology, geriatrics, and rehabilitation.  64% were female, 35% male and 1% left this question blank. Approximately half of the respondents were nurses or physician associates, while 47% were medical doctors. Approximately half the respondents were in the (current) age range 31-40 years, and just over a quarter were 21-30 years old.
61% had the course provided in their native language, and 86% attended a course being run face to face or virtually in the United Kingdom. Of the 142 respondents who did not report English as their first language, all of them rated their proficiency in English as ‘fair’ or better but only 21% of those had the course provided in their native language.  
For 54% of respondents, the course was virtual (Zoom platform), for 39% it was in-person while 7% experienced both formats. 69% stated the format they attended was their preferred choice, and of those 43% attended the virtual course.  Of the 95 for whom the format was not their preferred choice, 89% attended the virtual course because no other option was available to them at that time.  Other reasons for attending virtually were cost (1%) and no need to travel (2%), 8% did not give a reason.
In terms of perception of the benefits of each format, 67% of the 165 respondents who had experienced the virtual format felt they would have benefitted more by attending a face-to-face course.  Of the 3 who had experienced both formats, 57% responded that face-to-face was more beneficial. All 305 respondents gave their opinion on the respective merit of each format using a given set of criteria (16-24 in Table 1), the data of which are displayed in Figure 1.

There are clear perceived benefits of delivering urodynamics training in a face-to-face format, but individual situations often require delegates to choose the online option.  While there may be savings for the participants in terms of travel costs and time, there should be research devoted to answering whether the benefits of face-to-face training are outweighed by these savings.  It is possible that the face-to-face training that is perceived by participants as being more effective could result in better quality urodynamic testing and therefore greater savings in the long term.

It is necessary to continue to offer training in urodynamics both in-person and virtual formats.  However, the effectiveness of each format needs to be assessed by looking at the quality of urodynamics after each format before the long-term benefits for patients can be measured.