National Urology Research Articles

Stone centers: a national survey on surgical techniques performed in Italy.

Recurrent and complex stone disease may be considered a challenging disease. In 2018, the Calculus group of the SIU (Italian Society of Urology) set itself the goal of establishing the minimum requirements for a center that could continuously manage urolithiasis pathology, named a Stone Center. In this study we present the results of a pilot survey carried out in 2019 with the aim of drawing a map of the situation of Italian urological centers dealing with urinary stones. A total of 260 national urology departments dealing with urolithiasis surgery were contacted for this study. A survey was issued to each of the centers to determine the number of patients treated for urinary stones and the amount of procedures performed per year: 1) extracorporeal shock wave lithotripsy ESWL; 2) ureterorenoscopy URS; 3) retrograde intrarenal surgery RIRS; 4) percutaneous nephrolithotomy PCNL. Out of 260 centers contacted, 188 fulfilled the survey. Outcomes were quite variable, with approximately 37% of the centers lacking a lithotripter, and 46% of those that did have it performing fewer than 100 treatments per year. In terms of endoscopic procedures, more than 80% of the centers contacted performed URS or RIRS; however, when it came to percutaneous lithotripsy, these numbers dropped significantly; 33% of the centers contacted did not perform PCNL, and of those who did, 18% had less than 5 years of experience as a center. Our survey shows a very heterogeneous national picture about urolithiasis treatments. Our goal is to create national paradigms to be able to define stone centers where the patient suffering from complex urinary stones can find a network of professionals with an adequate armamentarium suitable for the management of their pathology.

517 Ethnic Diversity in the English Urology Workforce and BAUS Leadership 2009-2020: A Retrospective Analysis

Abstract Aim Little is known about the ethnic composition of the national urology workforce. To assess the impact of existing strategies to promote equitable progression, with respect to ethnicity, in the English urology workforce and British Association of Urological Surgeons (BAUS) leadership between 2009 and 2020. Method A Freedom of Information (FOI) Act request was made to NHS Digital regarding demographic data of clinicians working in urology in England between 2009 and 2020. Data was collected on urology consultants, specialist registrars, specialty, and associate specialist (SAS) doctors over this period. The ethnicities of British Association of Urological Surgeons (BAUS) Trustees and Council Members were determined over the same period, by review of public profiles. Statistical analysis was performed using the Cochran-Armitage test. Results The proportion of consultant urologists identified as White decreased from 65.5% to 53.6%, p<.0001), while the proportion of Asian/Asian British consultants increased (26.9% to 36.6%, p<.0001). There was a significant increase in Black/Black British trainees (3.0% to 11.0%, p<0.0001) but a decrease in the proportion of Asian/Asian British trainees. There was a non-significant decrease in the proportion of White urologists occupying BAUS leadership positions (80.6% to 67.6%, p = 0.5). Conclusions Trends towards increased ethnic diversity was seen across all groups, especially consultants. More limited change was observed in the urology leadership, suggesting both a time lag and that there is further work to be done in addressing barriers to progression in the highest echelons of urology leadership in the UK.

Design, implementation and assessment of a novel, introductory curriculum into female, neurological and urodynamic urology: a 7-year experience of urology simulation bootcamp course.

To present the seven-year experience of a multi-component and interactive module on female, neurological and urodynamic urology (FNUU) training at the UK National Urology Simulation Bootcamp Course (USBC) and demonstrate trainee satisfaction and competency progression. During the week-long USBC, a four-hour module on FNUU was designed which consisted of short interactive presentations with an emphasis on practical stations in urodynamics, intravesical botulinum toxin injection, urethral bulking injection, female pelvic examination and, initially, mid-urethral tapes (subsequently replaced with percutaneous sacral nerve evaluation). The trainee's level of knowledge, operative experience and confidence were assessed pre- and post-course. The practical assessment consisted of preparation and intravesical administration of botulinum toxin, female pelvic examination, urodynamic trace interpretation or mid-urethral tape simulation. Trainee feedback was also collected. Two-hundred sixty-one newly appointed urology trainees participated in the USBC during this period. A high level of satisfaction was constantly reported. The highest rated session was urethral bulking with 72% being very satisfied, followed by Botox and urodynamics. The final assessment showed 70% had achieved level 4 competency in cystoscopy and Botox. Qualitative feedback was also obtained. To our knowledge, this is the first module of its kind, and it shows that it is feasible to develop, implement and evaluate an introductory curriculum into FNUU that is reproducible over a 7-year period with very positive feedback.

The Pattern of Prostate Cancer Screening and Diagnosis among Indonesian Urologists: A Questionnaire Survey

Background: Prostate cancer (PCa) screening and diagnosis are mandatory to deliver optimal management in the early phase. Even though it has been discussed in many guidelines, the implementation of PCa screening and diagnosis in Indonesia remains unknown. This study aims to evaluate the pattern of PCa screening and diagnosis among Indonesian urologists and their adherence to guidelines. Methods: This cross-sectional study was conducted between February and July 2019. Respondents were Indonesian urologists registered as members of the Indonesian Urological Association (IUA) and had already practiced for at least six months. Data were collected using questionnaires, which were distributed at a national urology symposium and electronically via Google Form. Data were presented descriptively, and all data were processed using SPSS version 23. Results: Of 458 urologists, 195 (42.6%) gave full responses. Most of the respondents, 181 (92.8%) urologists, used the IUA guidelines. Among the 103 (52.8%) respondents who performed screening, nearly half (42.7%) agreed to screen patients aged ≥ 50 years or ≥ 45 years with a family history of PCa. Moreover, 76.8% would repeat screening annually, and 35.6% would stop when the patient’s age reached 70 years old. Digital rectal examination (DRE) was frequently performed for screening (74.5%), while prostate-specific antigen (PSA) tests were only performed in 52.3% of cases. The PSA test was available in 74.8% of hospitals. Transurethral resection of the prostate (TURP) was still used by 67.2% of respondents for diagnosis. Only 52.3 % of participants used transrectal prostate biopsy for diagnosis, using anesthesia (78.1%) during the procedure, and increased PSA level (98%) as its indication. However, Transrectal Ultrasound (TRUS) was only available in 49% of hospitals. This study found that Indonesian urologist adherence level toward guidelines was 63.3% (9–100%). Conclusions: PCa screening and diagnosis are still varied among Indonesian urologists, which might arise due to the different availability of diagnostic modalities.

Understanding Options for the Unmatched Urology Applicant.

To evaluate recent literature regarding the pathways and options for unmatched urology applicants. Urology remains a competitive surgical sub-specialty with a match process independent of the National Resident Matching Program. Each year a cohort of competitive applicants go unmatched and are faced with the decision to reapply the following cycle while doing a research fellowship or a preliminary internship in the interim or choose a different specialty altogether. In this review, we sought to evaluate the current match process and literature regarding outcomes and options for unmatched applicants as well as to provide future directions for research and improvements to support unmatched urology applicants. Presently, data regarding outcomes for unmatched applicants is relatively limited. Going forward it is imperative for national urology organizations to create centralized resources for applicants to provide the best possible information for applicants and mentors alike.

Survey of Canadian urology residency programs: Perception of virtual education during the COVID-19 pandemic and beyond.

The COVID-19 pandemic has caused many residency programs to pivot from traditional face-to-face to virtual teaching. The objective of this study was to assess the state of virtual education in Canadian urology programs and gauge interest in a national virtual curriculum. An electronic 15-item survey was distributed to all 13 Canadian urology programs' directors and administrative assistants for circulation to residents. Data collection took place over six weeks from September to November 2020. A mixed-methods approach was used, including descriptive statistics and an inductive thematic analysis of responses to open-ended questions. Eleven program directors and 32 residents from all four geographic areas (Atlantic, Ontario, Quebec, Western [MB, AB, BC]) responded to the survey. Overall, 95.3% of respondents indicated a role for virtual education in their program during the pandemic. Most respondents (74.4%) believe there is a significant or very significant role for a virtual national urology curriculum. All program directors indicated they are at least somewhat likely to require resident participation in such a curriculum. Most (90.6%) resident respondents indicated they believe such a curriculum will be at least somewhat important to their learning. Commonly described benefits include exposure to subspecialties, expertise at other institutions, and standardization of teaching. Commonly described barriers include difficulty with engagement, time zone differences, and lack of dedicated time for attendance. During the COVID-19 pandemic, virtual education has become well-integrated in Canadian urology programs. This study highlights interest in the development of a national virtual urology curriculum and puts forth some key considerations to ensure its success.

Effect of Gender on Practice Patterns of Andrology Fellowship Graduates

ABSTRACT Introduction Women in urology are more likely than their male counterparts to treat a majority female patient population, despite training in non-urogynecologic fellowships. Female urology is accordingly one of the most popular fellowship training choices for female urology residents, while less is known about the traditionally male-dominated subspecialties. Objective We sought to evaluate the current landscape of male reproductive and sexual medicine fellowships as well as characteristics of past andrology fellows and post-fellowship career paths. Methods The websites of the American Urological Association (AUA), Society for the Study of Male Reproduction (SSMR), and Sexual Medicine Society of North America (SMSNA) were reviewed for sponsored fellowships. Program coordinators and institutional websites were queried for information including length of training, curriculum, faculty, current and past fellows. A Google search was performed for each institution in combination with the keywords “male reproduction”, “sexual medicine”, “male infertility”, “prosthetics” and “fellowship” to identify former fellows not listed on institutional websites. Medical school, residency program, current employment, and conditions treated as advertised online were noted. Descriptive statistics and t-tests were used to compare outcomes by gender. P values <0.05 were considered statistically significant. Results The SMSNA endorsed 73% of programs (29/40), and SSMR 48% (19/40) while only 45% of all programs (18/40) participated in the 2021 AUA match. Median length of training was 1 year. Median number of fellowship faculty was 2. Only 20% (8/40) programs had any female andrology faculty. The earliest reported fellows dated back to 1982. From 1982-2021, 324 andrology fellows were identified, 53 of whom were female (16.4%). Of the fellows identified, 43.2% (140/324) were currently working in in an academic position, with 54.5% of women pursuing academia versus 45.5% of men (p=0.39). Men and women were equally likely to advertise an exclusive andrology practice, 65.4 and 61.4%, respectively (p=0.78) versus also seeing general urology indications. We assessed for a change in the proportion of female versus male fellows over time by comparing fellows who began training prior to 2010, and those who began training in 2010 or later. The number of andrology fellows increased from 111 to 213 (91.9%), with an increase in the proportion of female fellows from 8.1% to 20.7%, p=0.0038. Conclusions Less than half of andrology fellowships participate in the AUA match and over a quarter are not endorsed by the SMSNA. Only 1 in 5 fellowship programs had a female faculty member. Male andrology fellows were and remained in the majority over time. Despite this, female andrologists were equally likely to pursue academic careers. National urology and andrology societies have taken steps towards standardizing andrology fellowship training however much of the information is not easily available for residents to view. The limited information on fellowship graduates somewhat restricts interpretation of gender-based differences in practice environment. However, we found there was no negative impact in female andrologists’ ability to practice andrology or enter academic careers despite being in a male-dominated subspecialty. While encouraging, further work is needed by andrology societies to make program information accessible to all trainees and standardize the application process. Disclosure No

Design and assessment of a penile fracture simulation model

ObjectiveTo design and assess a novel penile fracture simulation model for teaching penile fracture repair. MethodsWe used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tunica”) and was applied over the penile model. A red jelly tablet (“clot”) was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a “One-way random model”. ResultsTwenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n = 13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n = 14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra. ConclusionThis is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp.

MP21-13 A SURVEY OF FERTILITY AND FATHERHOOD AMONG US MALE SURGEONS: AN UNDERREPRESENTED AND UNDERSTUDIED COHORT

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-13 A SURVEY OF FERTILITY AND FATHERHOOD AMONG US MALE SURGEONS: AN UNDERREPRESENTED AND UNDERSTUDIED COHORT John Sullivan, Kevin Campbell, Oscar Castro-Valesquez, Sagar Patel, Lori Lerner, and Larry Lipshultz John SullivanJohn Sullivan More articles by this author , Kevin CampbellKevin Campbell More articles by this author , Oscar Castro-ValesquezOscar Castro-Valesquez More articles by this author , Sagar PatelSagar Patel More articles by this author , Lori LernerLori Lerner More articles by this author , and Larry LipshultzLarry Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Whilst there has been much written about female surgeons and motherhood, there has been no attempt to characterize the journey of male surgeons with respect to fatherhood and medical careers. The aim of this study was to survey male surgeons across the United States to learn more about their experiences of balancing fatherhood and career. METHODS: A 76-question survey was electronically distributed in January 2021 to male surgeons on a national mailing database; the Veterans Affairs National Urology Mailgroup; and posted on the AUA Young Urologists website. Statistical analysis was performed via the Microsoft forms© platform. We compared data to results from a similar survey of female surgeons published in 2014. RESULTS: We received 226 responses: Urology 48%, General Surgery 14%, Neurosurgery 11%, Orthopedics 10%, Plastics and Maxillofacial 9%, Pediatric surgery 8%. Nearly 80% of male surgeons had fathered biological children, with only 2% reporting adoption. Stage of career at birth of first child was: 52% residency, 29% practice, 8% fellowship, 7% medical school, and 3% prior to medical school. Twenty-six percent stated they encountered reproductive difficulty with at least one pregnancy, but only 4% reported male factor as the cause. Reported female factor etiologies most commonly included PCOS 23%, recurrent miscarriage 23%, and advanced maternal age 18%. Regarding potential influences to fathering future children respondents cited their age (67%), their partners age (25%), financial security (17%), and a more structured lifestyle (11%) most commonly. When queried regarding how children impacted their careers, 22% reported “very much”, 28% “quite a bit”, 33% “a little bit”, and 17% “not at all”. Table 1 outlines comparisons between our current survey and previously studied female cohort. CONCLUSIONS: To our knowledge, this is the first survey of male surgeons and fatherhood. The vast majority of surgeons stated they had fathered biological children, with over half of births occurring during residency training. We observed that male surgeons father more children then their female counterparts. When asked about future influences on childbirth, individual surgeon and partners age were most commonly cited, with the majority of surgeons reporting that having children impacted their careers. Source of Funding: nil © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e351-e351 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information John Sullivan More articles by this author Kevin Campbell More articles by this author Oscar Castro-Valesquez More articles by this author Sagar Patel More articles by this author Lori Lerner More articles by this author Larry Lipshultz More articles by this author Expand All Advertisement Loading ...

Finding the Next Resident Physicians in the COVID-19 Global Pandemic: An Applicant Survey on the 2020 Virtual Urology Residency Match

OBJECTIVETo assess interviewing applicant perceptions of a virtual urology residency interview in the setting of changes mandated by COVID-19 and to determine applicant preference for virtual or in person interviews. Applicant perceptions of multiple interview components were queried to identify program specific and interview modality specific strengths or weaknesses in the 2020 to 2021 Urology Match.METHODSA 12 question multiple choice and free text survey was emailed to 66 virtually interviewed applicants for open residency positions at a metropolitan training program after conclusion of interviews. Items of interest included interview type preference, overall interview impression, and recommendations for improvement.RESULTSA total of 50 of 66 (76%) applicants completed the survey corresponding to approximately 11% of the 2020 national urology applicant pool. A total of 49 of 50 (96%) respondents assessed faculty interaction and the virtual platform positively. A total of 38 of 50 (76%) was satisfied with their resident interaction and 32 of 50 (64%) applicants stated they were able to satisfactorily evaluate the site and program. Ultimately, 39 of 50 (78%) respondents would have preferred an in person interview to our virtual interview. Respondents cited challenges in assessing program culture and program physical site virtually.CONCLUSIONThe majority of survey respondents indicated a preference for in person interviews. A smaller proportion of applicants preferred virtual interviews citing their convenience and lower cost. Efforts to improve the virtual interview experience may focus on improving applicant-resident interaction and remote site assessment.

Diseño y evaluación de un modelo de simulación de fractura de pene

ObjectiveTo design and assess a novel penile fracture simulation model for teaching penile fracture repair. MethodsWe used a validated circumcision simulator to create a model. Foreskin for a circumcision was divided into two halves. A transverse slit (“simulated fracture”) was created on one part of the first half of the foreskin (mimicking “tunica”) and was applied over the penile model. A red jelly tablet (“clot”) was placed underneath the cut. A second full-length of foreskin was applied over it to cover the defect. The model was assessed by participants and expert faculty at the Urology Simulation Boot Camp. Evaluation was performed using a 5-point Likert Scale questionnaire. Data was analysed using Microsoft Excel and IBM SPSS Statistics V25. The intra-class correlation was calculated using a “One-way random model”. ResultsTwenty-two urology trainees and four experts participated in the evaluation. The majority of trainees strongly agreed (59%, n=13) the model is useful for training with experts similarly agreeing in 75% of cases. The appearance of penile fracture was considered good by both trainees (68%, n=14) and faculty (75%). Overall, the ability of the model to represent a realistic simulation of the task was considered excellent by 23% of participants and good by 64%. Personal confidence after simulation in managing a similar situation was considered high among trainees. The main difficulties reported were related to fascial planes and urethra. ConclusionThis is the first simulation model for penile fracture repair and has demonstrated face validity at a national urology bootcamp.

Use of Urology-Based Clinical Practice Guidelines in International Settings

Objective Clinical practice guidelines (CPGs) serve as frameworks to unify diagnostic criteria and guide clinical decision-making. There is a paucity of literature surrounding the uptake of CPGs in urology practice settings with varied levels of resources worldwide. This study aims to evaluate reported use of CPGs within the context of international urology practice, identify local barriers to uptake, and evaluate the role of stakeholders in the CPG-development process. Methods This was an international, multi-center, cross-sectional study. An online survey collecting variables pertaining to the use of CPGs was distributed to attending/consultant urologists in Latin America, Africa, and China. Statistical analysis was conducted using R software. Result A total of 249 practicing urologists from 28 countries completed the survey. The majority of participants were males, aged 36 to 45, and practiced in a non-academic setting. Ninety-three percent of urologists used CPGs in their everyday clinical practice, and 43% believed CPGs were very important to medical decision-making. However, barriers such as the lack of adaptability or applicability of CPGs to local settings were mentioned by 29% and 24% of participants, respectively. Urologists believed scientific associations (81%), national urology boards (68%), and ministries of health (56%), were important stakeholders to consult to foster the development of local CPGs. Conclusions Globally, CPGs are widely used tools for clinical practice. However, there are concerns about the adaptability and applicability of CPGs to settings that may lack the resources to implement their recommendations. Efforts should be directed towards incorporating scientific and medical stakeholders into the review and adaptation of urology CPGs to suit the unique features of local health care systems.

A simple novel training model for teaching suprapubic catheter (SPC) exchange

ObjectivesTo develop a suprapubic catheter (SPC) training model as no specific realistic training model exists to replicate SPC exchange where a catheter tract is present. Materials and methodsWe describe a novel, anatomically realistic, animal simulator model for use in SPC training, which was trialed at a national urology simulation boot camp by new urology trainees and validated by expert urologists. A scale reproduction of an abdominal wall was created using a porcine abdominal wall. A segment of small bowel was stitched around a size 16F Foley catheter to form a tract. Abdominal wall tissue was excised cylindrically to create an opening, and the small bowel tract was passed through the abdominal wall and sutured anteriorly, producing a realistic SPC tract: inferiorly, the tract was anastomosed to a porcine urinary bladder. This model was evaluated by 10 expert urologists for content validity with an 8-item 5-point rating scale used to evaluate domains relevant to the simulator. ResultsThe domains were scored between 1 and 5 by 10 expert urologists, 1 being «strongly disagree» and 5 being «strongly agree». The average expert ratings of the domains were then calculated and tabulated following the training course. There was an average global rating of 4.2/5 for the model, with an average usefulness for training score of 4.6/5. ConclusionThe feedback from experts and trainees (informal) was overwhelmingly positive. On average, our experts reported high satisfaction with their experience using this simulator as a training tool.

Gender Representation Among Plenary Panel Speakers at the American Urological Association Annual Meeting

ObjectiveTo examine trends in the representation of women in plenary panels at the American Urological Association (AUA) Annual Meeting. MethodsA review of all plenary sessions from AUA Annual Meetings during 2017-2019 was performed. The number and proportion of invited moderators and panelists by gender were recorded and analyzed by the topic of each plenary session. We performed descriptive analyses and tested temporal trends in gender representation. ResultsA total of 168 plenary panels were held at the AUA meetings, 62 panels in 2017, 51 panels in 2018, and 55 panels in 2019. Overall, 59% of panels were all-male panels (61% in 2017, 67% in 2018, and 49% in 2019) with exclusively male moderators and panelists. There was no significant change in the proportion of all-male panels during the study period (P = .20). Among the 168 panels, 153 (91%) had a male moderator, and 107 (64%) had only male panelists. Seventy-five unique female speakers accounted for 90 (12%) of the 742 total panel speaking roles. There was significant variation in the proportion of female speakers among 6 plenary topics (P = .03); the overall proportion of all-male panels was highest for sexual medicine sessions (14 of 18 panels, 78%) and lowest for female pelvic medicine sessions (5 of 19 panels, 26%). ConclusionFemale representation in plenary panels at recent AUA Annual Meetings did not significantly change, with the majority of panels composed entirely of male speakers. Continued evaluation of these trends may inform efforts to achieve gender equality at national urology meetings.

Modelo simple y novedoso para la formación del recambio de catéter suprapúbico (CSP)

ObjectivesTo develop a suprapubic catheter (SPC) training model as no specific realistic training model exists to replicate SPC exchange where a catheter tract is present. Materials and methodsWe describe a novel, anatomically realistic, animal simulator model for use in SPC training, which was trialed at a national urology simulation boot camp by new urology trainees and validated by expert urologists. A scale reproduction of an abdominal wall was created using a porcine abdominal wall. A segment of small bowel was stitched around a size 16F Foley catheter to form a tract. Abdominal wall tissue was excised cylindrically to create an opening, and the small bowel tract was passed through the abdominal wall and sutured anteriorly, producing a realistic SPC tract: inferiorly, the tract was anastomosed to a porcine urinary bladder. This model was evaluated by 10 expert urologists for content validity with an 8-item 5-point rating scale used to evaluate domains relevant to the simulator. ResultsThe domains were scored between 1 and 5 by 10 expert urologists, 1 being «strongly disagree» and 5 being «strongly agree». The average expert ratings of the domains were then calculated and tabulated following the training course. There was an average global rating of 4.2/5 for the model, with an average usefulness for training score of 4.6/5. ConclusionThe feedback from experts and trainees (informal) was overwhelmingly positive. On average, our experts reported high satisfaction with their experience using this simulator as a training tool.

MP34-05 INTRODUCING OPERATIVE SKILLS TESTING IN UROLOGY BOARD EXAMINATIONS: RESULTS OF FIVE YEARS EXPERIENCE

You have accessJournal of UrologySurgical Technology & Simulation: Training & Skills Assessment I (MP34)1 Apr 2020MP34-05 INTRODUCING OPERATIVE SKILLS TESTING IN UROLOGY BOARD EXAMINATIONS: RESULTS OF FIVE YEARS EXPERIENCE Ashraf Mosharafa*, Mohamed Abdelrassoul, Hany Elfayoumy, Mohamed Elsheikh, Ismail Saad, and Ahmed Morsy Ashraf Mosharafa*Ashraf Mosharafa* More articles by this author , Mohamed AbdelrassoulMohamed Abdelrassoul More articles by this author , Hany ElfayoumyHany Elfayoumy More articles by this author , Mohamed ElsheikhMohamed Elsheikh More articles by this author , Ismail SaadIsmail Saad More articles by this author , and Ahmed MorsyAhmed Morsy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000878.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Operative surgical skills are among the most crucial competencies required for the independent practice in surgical specialties, yet they are rarely assessed as part of specialty-training exit / board examinations. Although there are tools to evaluate surgical training (e.g. logbooks and work-place based assessments), these tools have their shortcomings and may not be sufficient to guarantee adequate operative competency at exit level. The current report describes the introduction of operative skills testing as part of national Urology board final examinations, with an evaluation of the performance of “operative skills stations” in comparison to other standardized elements. METHODS: Starting in 2013, an “operative skills” station was introduced as part of the Objective Structured Practical / Clinical Examination (OSP/CE) of the Egyptian Board of Urology’s final examinations. Feedback was collected from candidates and assessors, and the performance of the “operative skills” station (discriminating ability and reliability) was compared to the remaining stations of the examination. RESULTS: Candidates were asked to perform a surgical task in a wet lab setting (e.g. suturing a urinary bladder laceration or an intestinal anastomosis) while being assessed (using a checklist) for various technical aspects. Over five examinations (2013-2018), the OSP/CE stations had high internal reliability (average Cronbach’s alpha 0.853), with the “operative skills” station having relatively high item-total correlation (above 0.75), and very high correlation with other practical stations focusing on use of instruments, interpretation and reporting of operative findings. Assessors and candidates’ feedback was consistent with high validity (most responding “agree” or “strongly agree” to questions on “able to assess surgical competency” and “simulates real-life situation”). CONCLUSIONS: Testing surgical operative skills as part of Urology specialty exit examination is feasible and can add an important dimension to candidates’ assessment. Well-designed operative OSPE stations have high reliability and discriminating ability, complementing the evaluation of other clinical skills and domains. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e504-e505 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ashraf Mosharafa* More articles by this author Mohamed Abdelrassoul More articles by this author Hany Elfayoumy More articles by this author Mohamed Elsheikh More articles by this author Ismail Saad More articles by this author Ahmed Morsy More articles by this author Expand All Advertisement PDF downloadLoading ...

The current landscape of urological undergraduate education in Canada.

Urological presentations are commonly seen in primary care and urologists are concerned that educational gaps exist in undergraduate curricula in Canadian medical schools. A pan-Canadian survey of undergraduate urology education directors (UUEDs) was used to determine the current status of undergraduate urology education in Canada. In the fall of 2018, a survey was administered to all 17 UUEDs representing every Canadian medical school. The survey assessed multiple factors, including the timing and duration of urologist-led instruction, the perceived adequacy of urological content in the curriculum, and the level of preparedness of graduating students. The response rate was 100%. Variation in the duration (mean total instructional hours: 22.5±17.2 [5-75] hours) and timing of formal urological instruction was seen. The majority of schools covered core content areas, however, erectile dysfunction, urotrauma, and pediatric urology topics were under-represented. One school had a mandatory urology clerkship rotation (one week), while the other 16 schools offered a selective, with 24.3% of students completing this experience. The majority of UUEDs (64.7%) believed the curricular time devoted to urology was inadequate, 29.4% felt that their graduates were unprepared to diagnose and treat common urological problems, and 76.5% strongly agreed or agreed that a national urology curriculum would be useful. There was significant variability in the duration of instruction and delivery of urological topics in Canadian medical schools. There was a perceived need for more urological instruction by most UUEDs, who welcomed a more standardized national curriculum as a strategy to address this need.

Selected Abstracts from the 28th National Urology Congress.

Selected Abstracts from the 28th National Urology Congress.

Association Between Twitter Reception at a National Urology Conference and Future Publication Status

BackgroundSocial media is an increasingly popular means to disseminate medical research. However, it is unknown whether the extent to which content is shared mirrors conventional measures of scientific merit or impact. ObjectiveTo examine whether Twitter activity (as measured by the number of “likes” and “retweets” [RTs]) relating to original research presented at a national urology meeting was associated with subsequent publication status and journal impact factor (IF). Design, setting, and participantsWe retrospectively reviewed Twitter data obtained through the Keyhole archiving platform using the hashtag “#aua15” from May 1 through June 1, 2015 reflecting the hashtag of the American Urological Association (AUA) meeting. Outcome measurements and statistical analysisWe analyzed all posts containing keywords related to research studies. Among posts reporting on newly presented studies with discernable attribution, we evaluated subsequent publication status within 45 mo, including journal IF. We compared social media reception (number of likes/RTs) by publication status, and assessed the relationship between social media reception and subsequent journal IF using Pearson’s correlation. Results and limitationsA total of 15 303 posts were associated with #aua15 between May 1 and June 1, 2015, which reached 2 263 438 users. The median number of likes/RTs was 2 (interquartile range 1–3). We analyzed all posts receiving at least one like/RT (n = 2964) for text content related to research and identified 496 associated with new scientific studies presented at the meeting. Forty-five months following the AUA meeting, 96 studies were identifiable on PubMed (19.4%). Research with more likes/RTs at the AUA meeting were more likely to be subsequently published (p = 0.001). Among published studies, there was a modest, positive correlation between the number of likes/RTs and publication journal IF (r2 = 0.36). ConclusionsMeasures of social media engagement with data presented at a national medical meeting were positively correlated with subsequent publication and journal IF after presentation. Patient summaryNew urological research that was shared more often at a national meeting was more likely to be published in journals that are more highly cited.

Laparoscopic Training in Urology Residency Programs: A Systematic Review

Background/Aims: Laparoscopy is a widespread surgical approach for many urological conditions. Achieving prof-ciency in laparoscopic surgery requires considerable effort due to the steep learning curve. Several residency programs include standardized laparoscopic training periods in their curricula. Our aim was to systematically analyze the evidence on the current status of training in laparoscopy in different residency programs in urology. Methods: We performed a systematic review of PubMed/Medline and the Cochrane library, in February 2018, according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses Statement. Identified reports were reviewed according to the previously defined inclusion criteria. Eight publications, comprising a total of 985 urology residents, were selected for inclusion in this analysis. Results: There was a wide variation between training programs in terms of exposure to laparoscopy. Most residents considered that training in lap-aroscopy was inadequate during residency and had a low degree of confidence in independently performing laparo-scopic procedures by the end of the residency. Only North American residents reported high degrees of confidence in the possibility of performing laparoscopic procedures in the uture, whereas the remaining residents, namely from European countries, reported considerably lower degrees of confidence. Conclusion: There were considerable differences between national urology residency programs in terms of exposure to laparoscopy. Most residents would prefer higher exposure to laparoscopy throughout their residencies.