Standardized Office Cystoscopy Training for Advanced Practice Providers in Urology.

Abstract

Cystoscopy is one of the most commonly performed urological procedures. Indications include evaluation of hematuria and bladder cancer monitoring, which requires frequent surveillance for management. The challenges of maintaining the urology workforce are well-documented, and alternative options should be developed for performing cystoscopy safely and effectively. Nurse practitioners and physician assistants (ie advanced practice providers) are established professionals who have provided urological care for decades and who could acquire the necessary procedural skills following establishment of practice guidelines. Review and synthesis of the available world literature were completed to form an evidence-based proposal for a flexible cystoscopy training curriculum targeted to advanced practice providers in outpatient urology care settings. Of 49 primary sources 10 were appropriate for evaluation, resulting in development of clinical and technical knowledge domains for training U.S. based advanced practice providers in cystoscopy. Skills checklists were developed to aid in training, evaluation and privileging. Based on analysis of the existing literature, we propose a framework for standardizing outpatient flexible cystoscopy training for U.S. based advanced practice providers. Adoption of this framework will establish the standards necessary to ensure high quality, reproducible outcomes essential for seamlessly integrating advanced practice providers into this procedural role within the urological health care team.