Page 11 - CUA 2020_Technology and Training_v2

Moderated Posters 6: Training, Evaluation

confidence and theoretical knowledge. This easily modifiable and repro-
ducible course can be used as an introductory tool for urology residents
to begin developing competency in ultrasound, and may act as a stepping
stone for further competency-based training programs.
Reference
1. Sonography Canada. National competency profiles version 5.1. 2018.
Available at: https://sonographycanada.ca/app/uploads/2019/03/
NCP-5.1-Final.pdf. Accessed Dec. 30, 2019.

MP-6.5
National discrepancies in residency training of open simple
prostatectomy for benign prostatic enlargement: Redefining
our gold standard
Patrice Levasseur-Fortin , Kyle W. Law , David-Dan Nguyen , Ahmed
2
1
2
Zakaria , Vincent Misrai , Dean S. Elterman , Naeem Bhojani , Enrique
4
3
3
5
Rijo , Kevin C. Zorn 3
6
1 Faculty of Medicine, Université de Montréal, Montreal, QC,
Canada; Faculty of Medicine, McGill University, Montreal, QC,
2
Canada; Division of Urology, Centre hospitalier de l’Université de
3
Montréal, Montreal, QC, Canada; Department of Urology, Clinique
4
Pasteur, Toulouse, France; Division of Urology, University of Toronto,
5
Toronto, ON, Canada; Department of Urology, Hospital Quiron
6
Barcelona, Barcelona, Spain
Introduction: In light of recent urological association (CUA, AUA,
EAU) recommendations for the treatment of benign prostate hyperpla-
sia (BPH), open simple prostatectomy (OSP) remains the recommended
approach for prostates with volumes over 80 cc. We sought to assess the
1
current state of OSP and other BPH surgical training across Canadian urol-
ogy residency programs and the use of guideline-recommended imagery
prior to BPH surgery.
Methods: A survey was distributed among Canadian urology program
directors in June 2019. We identified the various surgical modalities avail-
able for the treatment of BPH offered by each program and obtained the
MP-6.4. Fig. 2. Suprapubic catheter model. annual number of OSP performed at each academic residency program.
Additionally, we evaluated for the routine performance of preoperative
well as self-rated confidence in manipulation of ultrasound controls, transrectal ultrasound (TRUS) of the prostate during patient counselling
doppler imaging, and PoCUS of the kidney, bladder, and testicles (all as recommended by 2018 CUA guidelines.
p<0.001) (Table 1). All participants indicated that the course increased Results: All 13 program directors from the Canadian urology programs
their likelihood of PoCUS use in clinical practice, and that PoCUS training responded to our survey. OSP and monopolar transurethral resection of
should be integrated into a urology training curriculum. the prostate (TURP) are practiced across all 13 centers. Greenlight photo-
Conclusions: We successfully developed and implemented a feasible vaporization, bipolar TURP, holmium laser enucleation of the prostate,
foundational PoCUS course for urology residents based on national and robot-assisted simple prostatectomy were practiced in 76.8%, 69.2%,
ultrasound training guidelines. Residents significantly improved in user 23.1%, and 23.1% of centers, respectively (Fig. 1). The mean number
of OSP per academic training program was 4.7 cases annually (Fig. 2).
Moreover, only five (38%) academic centers routinely performed a pre-
MP-6.4. Table 1. Pre- and post-course changes in operative TRUS to evaluate prostate volume for BPH counselling (Fig. 3).
Conclusions: Although recognized and referenced as the BPH gold stan-
theoretical knowledge and user confidence dard for the treatment of prostates over 80 cc, Canadian urology trainees’
Pre-course Post-course p
Theoretical knowledge
Multiple choice assessment 52.8 (11.2) 72.3 (6.7) <0.001
(%)
Extra questions - 76.4 (8.4) -
User confidence †
Ultrasound interpretation 2.2 (1.1) 4.1 (0.7) <0.001
PoCUS controls 2.2 (0.9) 4.2 (0.6) <0.001
Doppler imaging 1.6 (0.8) 3.8 (0.7) <0.001
Kidney PoCUS 1.8 (0.7) 4.2 (0.7) <0.001
Bladder PoCUS 2.7 (0.9) 4.3 (0.5) <0.001
Testicular PoCUS 1.8 (0.9) 4.1 (0.6) <0.001
Standard deviation in brackets; † Confidence assessed via 5-point Likert Data: 1 = very MP-6.5. Fig. 1. Variety of resection techniques of the prostate practiced in the
unskilled (little to no experience), 2 = unskilled (beginner proficiency), 3 = intermediate per- 13 Canadian residency programs.
former (proficient), 4 = skilled user (comfortable with use), 5 = very skilled (expert).
CUAJ • June 2020 • Volume 14, Issue 6(Suppl2) S111