Page 3 - CUA2019 Abstracts - Miscellaneous/Other

2019 CUA Abstracts

(EPAs) associated with common urological procedures. The primary objec- Results: We screened 1258 abstracts, 257 of which moved to full text
tive of our study was to identify the shift in chief residency caseload at the screen. Eighteen articles met our inclusion criteria. Of the included
University of Alberta and evaluate procedure volumes at our institution articles, 12 reported on quality improvement, six on research efficiency,
in the context of incoming EPAs. five on provider efficiency/satisfaction, and one on cost-effectiveness.
Methods: A retrospective review of six-month case logs from a single The majority of the articles described improvements on the aforemen-
senior resident from July to December 1986 (MPC), three senior residents tioned outcomes, with no articles describing any detrimental effect.
from July to September, October to December 1997 (GG, TM, AP), one Only three articles specified the EMR used (EPIC, GE Centricity). Most
chief resident from July to December 2003 (NJ), and two chief residents LHS focused on a specific disease area, with oncology being the most
from April to September 2017 (NH, ML) were retrospectively reviewed. common. Most of the articles were published in the U.S. with some pub-
The case logs were averaged in the setting of greater than one resident lished in Europe and Asia.
per year. EPAs associated with a number volumes of procedures required Conclusions: Current publications suggest successful implementation of
were extracted from the Royal College website. several LHS in the world. These systems have been described as effec-
Results: The number of cases over a six-month period declined from tive at improving outcomes in specific disease areas.
1986 to 2003 to 215 cases in 2017. Transurethral surgery decreased from
181 cases in 1986 to 50 cases in 2017. Total urologic oncology cases MP-5.10
increased over the 40-year period from 25 cases in 1986 (6% of total
cases) to 88 cases in 2017 (41% of total cases). CBD requires competence Objective structured clinical examinations performance among
in three lap nephrectomies and 2017 residents took part in an average of Québec urology residents: A retrospective study from 2008–2018
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46 nephrectomy operations, with 11 being laparoscopic. Urethroplasty Laurianne Rita Garabed , Ahmad Almarzouq , Sero Andonian , Mohamed
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surgery was not performed in 1986, but was performed an average of 17 1 El-Sherbiny , Nader Fahmy
times by the 2017 resident cohort. Division of Urology, Department of Surgery, McGill University Health
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Conclusions: The focus of chief resident experience has appropriately Centre, McGill University, Montréal, QC, Canada; Division of Urology,
shifted with the change in clinical practice towards uro-oncology, endou- Department of Pediatric Surgery, McGill University Health Centre, McGill
rology, and reconstruction. Overall, the 2017 cohort met or largely University, Montréal, QC, Canada
exceeded case volumes attached to incoming EPAs in CBD, however, Introduction: Objective structured clinical examinations (OSCEs) have
resident-assisting does not necessarily equate to resident competence to been established as an efficient and standardized evaluation tool in medi-
perform that same procedure. cal education. In Québec, biannual OSCEs are organized across urology
This paper has figures, which may be viewed online at: residency programs in post-graduate year (PGY) residents year 3–5. OSCEs
https://2019.cua.events/webapp/lecture/145 may include standardized oral questions, visual recognition examinations
References (VREs), simulated patient stations, and telephone consultations. The aim
1. Royal College Physicians and Surgeons of Canada. Urology EPAs of this study is to evaluate trends in OSCE performance of Québec urol-
(2018). Available at: http://www.royalcollege.ca. Accessed April 5, ogy residents and identify strengths and weaknesses across urological
2019. subspecialties and years of training.
2. Chetner M, Gray G, McCallum T, et al. Changes in the profile of Methods: Individual OSCE station scores from PGY 3–5 residents across
resident’s surgical experience during urological training: A com- the four urology residency programs in Québec were retrospectively
parison of experience between 1986, 1997, and 2003. CUA 2004 reviewed from May 2008 to February 2018. Scores were grouped accord-
3. Hueber PA, Zorn KC. Canadian trend in surgical management of ing to PGY level and station subspecialty/type (oncology, endourology,
benign prostatic hyperplasia and laser therapy from 2007–2008 andrology, pediatrics, functional, reconstructive, VRE). Mean scores and
to 2011–2012. Can Urol Assoc J 2013;7: E582-6. https://doi. standard deviations were subsequently analyzed.
org/10.5489/cuaj.203 Results: In total, data from 17 OSCE sessions were included in the study.
Mean scores were consistently higher in PGY-5 than PGY-4 residents,
and in PGY-4 than PGY-3 residents, across all subspecialties and VREs.
MP-5.9 Scores were lower in VRE than in oral question stations (47.1% vs 68.3%).
Does the learning healthcare system work: A systematic review Among oral question stations, residents scored lower in functional urol-
Raees Cassim , Viviane Grandpierre , Beth Potter , Pranesh Chakraborty , ogy, notably in urodynamic studies, than in other subspecialties (61.8%
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Melise Keays 1 vs. 68.3%). Endourology and reconstructive urology stations were less
1 Division of Urology, Department of Surgery, Children’s Hospital of frequently included than stations from other subspecialties.
Eastern Ontario, Ottawa, ON, Canada; School of Epidemiology and Conclusions: This study identified a relatively weaker performance in
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Public Health, University of Ottawa, Ottawa, ON, Canada; Newborn VREs compared to other forms of examination. Additionally, residents had
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Screening Ontario, Children’s Hospital of Eastern Ontario, Ottawa, ON, relatively weaker scores in functional urology than in other subspecialties.
Canada; Department of Pediatrics, Children’s Hospital of Eastern Ontario, Furthermore, this study confirms that OSCE scores improve with PGY level
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Ottawa, ON, Canada across all subspecialties and station types. These results can give potential
Introduction: The Institute of Medicine describes a learning healthcare direction for effort investment in residency teaching.
system (LHS) as the alignment of science and informatics with the goal
of improving care and generating new knowledge. With the increased MP-5.11
uptake of electronic medical records (EMR) at healthcare centres, we
hypothesized that LHS have been developed and are improving health- Analgesic prescribing habits and patterns of Canadian urology
care and research outcomes. Our objective was to determine if existing residents 1 2 3 2
LHCS are effective in increasing research efficiency, provider efficiency/ Ali Dergham , Gregory Hosier , Melanie Jaeger , J. Curtis Nickel ,
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satisfaction, cost-effectiveness, and quality improvement. D. Robert Siemens , Thomas McGregor
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Methods: We searched MEDLINE, Cochrane CENTRAL Trials Registry, School of Medicine, Faculty of Health Sciences, Queen’s University,
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CINAHIL, and EMBASE for articles related to LHS. We included articles Kingston, ON, Canada; Department of Urology, Queen’s University,
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describing systems that automatically collected/analyzed data. Articles Kingston, ON, Canada; Department of Anesthesiology and Perioperative
had to describe effects on quality improvement, research efficiency, pro- Medicine, Queen’s University, Kingston, ON, Canada
vider efficiency/satisfaction, or cost-effectiveness. We screened abstracts Introduction: Prior studies have identified significant knowledge gaps in
using the liberal accelerated method (i.e., two reviewers to exclude, one acute and chronic pain management among graduating urology residents
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reviewer to move to full text). After double reviewer screening of full text, as of five years ago. Since then, there has been increasing awareness of
we extracted data from each article, including outcome measures, EMR the impact of excessive opioid prescribing on long-term narcotic use and
used, disease area, and publishing institution. development of adverse narcotic-related events. However, it is unclear
S114 CUAJ • June 2019 • Volume 13, Issue 6(Suppl5)