Page 7 - CUA2018 Abstracts - Miscellaneous/Other

Poster session 2: Education/Practice Management

York, ON, Canada; Urology, McGill University, Montreal, QC, Canada; incorporated into all stages of RAS training. Although new simulators
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11 Urology, Memorial University, St. John’s, NL, Canada and assessment tools show promising results, more validation studies
Introduction: Despite a publicly funded single–payer health system in are needed. Future work should focus on developing context–specific
Canada, there is significant interprovincial economic disparity in remu- assessment tools and establishing benchmarks for achieving competency
neration for urological services. in technical and non–technical skills.
Methods: The Canadian Urological Society (CUA) Health Policy
Committee (HPC) created a model to study interprovincial urological MP–2.12
economic disparity. A subcommittee was formed with a representative
urologist from each province to equate and validate fees. Arbitrarily, Health behaviours among Canadian men are predictors of
British Columbia (BC) was chosen as the base province for comparison medical comorbidities: An avenue for intervention 5
3,4
1
2,3,4
among all 10 provinces. BC Medical Services Plan Payment Data Series Nahid Punjani , Ryan Flannigan , John Oliffe , Donald McCreary , Nick
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4
3,4
2016/17 was used in the analysis. Urologists work fee–for–service and Black , Joe Rachert , Larry Goldenberg
1
income is determined by the sum of the product of services and fees. The 2 Division of Urology, Western University, London, ON, Canada;
top 20 fee items in BC comprise 84.7% of a BC urologist’s income. The Department of Urology, Weill Cornell Medicine, New York, NY, United
3
total income reported in the model was computed by extrapolation. The States; Department of Urologic Sciences, University of British Columbia,
4
model assumes that urologists follow a similar practice pattern across Vancouver, BC, Canada; Canadian Men’s Health Foundation, Vancouver,
5
the country, deliver the same number of services, and have a similar pro- BC, Canada; Department of Psychology, Brock University, St. Catharines,
portion of full–time–equivalent (FTE) physicians. Only urologists earning ON, Canada
more than the FTE threshold of $84 700 CAD per year, as set–forth by Introduction: Men’s health awareness is an increasingly prevalent issue
BC government economics, are included. There are 91 FTE urologists in and can have long–term consequences. The objective of our study was to
BC. Gross income is calculated in the analysis. Net income is not con- broadly sample Canadian men to obtain information regarding lifestyle
sidered, but would be calculated by subtracting expenses. Interprovincial and health behaviours and their impact on medical comorbidities.
gross income variance is computed and stratified across the provinces. The Methods: An online survey was sent to Canadian men and included
fee–value data is accurate as of November 1, 2017. questions regarding demographics, comorbidities, and health behav-
Results: The economic disparity model yields gross income in Canadian iours (smoking, alcohol consumption, sleep and exercise behaviours,
dollars (C$) and variance stratified by province, as shown in Table 1 dietary habits, and depression). Health behaviours were classified as
(available at https://cua.guide/). either healthy or unhealthy based on previous studies and questionnaire
Conclusions: Saskatchewan urologists have the highest fees and Ontario thresholds. Multivariate regression was performed to determine health
the lowest. Despite a mature single–payer healthcare system in Canada, behaviours as predictors for medical comorbidities.
there is significant interprovincial economic disparity in urologist com- Results: After exclusions and sample stratification, 2000 participants were
pensation. Annual study is recommended to track changes to interpro- included. Participants were aged 19–94 (median 48, interquartile rnage
vincial economic disparity. [IQR] 34–60). Approximately half (47.4%) had poor smoking behaviour,
38.7% unhealthy drinking, 53.9% unhealthy sleeping, 48.9% unhealthy
exercise, 61.8% unhealthy eating, and 20.4% classified with depression.
MP–2.11 On multivariate analysis, poor sleep predicted hypertension (HTN) (odds
Simulation–based assessments of robotic–assisted technical and ratio [OR] 1.43; p<0.01); poor drinking behaviour predicted HTN (OR
non–technical skills in urological education: A systematic review 1.39; p<0.01) and protected against type 2 diabetes (DM) (OR 0.61;
and synthesis of the validity evidence p<0.01); poor eating behaviour protected against cerebrovascular acci-
Mitchell Goldenberg , Jason Lee , Jethro Kwong , Teodor Grantcharov , dents (CVA) (OR 0.34; p=0.01); poor exercise predicted HTN (OR 1.29;
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1
1
2
Anthony Costello 4 p=0.03); depression predicted HTN (OR 1.61; p<0.01), elevated choles-
1 Division of Urology, Department of Surgery, University of Toronto, terol (OR 1.61; p<0.01), bowel disease (OR 2.44; p=0.01), and erectile
Toronto, ON, Canada; Faculty of Medicine, University of Toronto, dysfunction (OR 2.88; p<0.01); and smoking behaviour predicted heart
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Toronto, ON, Canada; Division of General Surgery, Department of disease (OR 2.07; p<0.01), elevated cholesterol (OR 1.32; p=0.03), DM
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Surgery, University of Toronto, Toronto, ON, Canada; Department of (OR 1.56; p=0.02), CVA (OR 5.16; p<0.01), and osteoarthritis (OR 1.41;
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Surgery/Urology, University of Melbourne, Melbourne, Australia p=0.05).
Introduction: Robotic–assisted surgery (RAS) has been on the rise in the Conclusions: Our study confirms the association of lifestyle factors and
past decade and has established a significant foothold in urological sur- chronic illnesses common to aging males. We emphasize the potential
gery. Developing expertise in RAS requires mastery of both technical scope of education and awareness campaigns with respect to chronic
and non–technical skills. However, an evidence–based robotic surgery disease prevention.
curriculum is still lacking. To date, the literature has focused on the
development of technical skill assessments. Non–technical skills remain MP–2.13
understudied, despite being a critical component of the surgical milieu
and clinical outcome. The purpose of this review is to present the valid- Baseline characteristics of patients initiating mirabegron or
ity evidence of available simulation–based tools to assess technical and antimuscarinic treatment for overactive bladder: Results from
non–technical skills in RAS, and to provide recommendations on how the PERSPECTIVE registry 3 4 4
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to best implement them in urology training programs. Eric Rovner , Kavita Nair , Kevin Carlson , Eva Oakkar , Julie Park , Priscilla
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Methods: A literature search of MEDLINE, EMBASE, and PsycINFO was 1 Velentgas , Rita Kristy , Katherine Gooch , Carol Schermer
conducted to identify primary articles using simulation–based assessments Department of Urology, Medical University of South Carolina,
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of technical and non–technical skills in RAS in urology. Messick’s validity Charleston, SC, United States; Department of Clinical Pharmacy, Center
framework and the Medical Education Research Study Quality Instrument for Pharmaceutical Outcomes Research, Aurora, CO, United States;
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3
(MERSQI) were used to structure and evaluate the quality of the evidence Section of Urology, University of Calgary, Calgary, AB, Canada; IQVIA,
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of the abstracted articles. Durham, NC, United States; Medical Affairs, Astellas Pharma Global
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Results: The search identified 556 articles, of which 85 met the inclusion Development, Northbrook, IL, United States; Medical Affairs, Americas,
criteria. As shown in Tables 1 and 2 (available at https://cua.guide/), there Astellas Pharma Global Development, Northbrook, IL, United States
has been a surge of tools assessing technical and non–technical skills in Study Groups: Jackie van Bueren, Envision Scientific Solutions (medical
RAS, ranging from virtual reality–based simulation to live surgery. writing support).
Conclusions: As RAS continues to gain popularity as the mainstay method Introduction: PERSPECTIVE is a U.S. and Canadian prospective, observa-
of surgery, there will be an increased need for formalized robotic surgery tional one–year registry for patients with overactive bladder (OAB) treated
curricula. Assessments in technical and non–technical skills should be with either mirabegron, a β3–adrenoceptor agonist, or an antimuscarinic
S76 CUAJ • June 2018 • Volume 12(6Suppl2)