Impact of the COVID-19 pandemic urology trainees in the West of Scotland

Hospitals worldwide have taken unprecedented steps to cope with the coronavirus disease 2019 (COVID-19) pandemic. Changes to services created challenges for delivering training in urology. Statutory education bodies implemented processes addressing trainee progression, but the extent of training disruption has not been quantified. To establish the impact on urology trainees in the West of Scotland, online questionnaires were sent to trainees and educational supervisors. Twenty-five trainees working at six hospitals across four health boards responded. Elective operating was significantly reduced, with 64% of trainees having no weekly sessions. Before the pandemic, the majority of trainees (92%) had one or two clinic sessions or more per week, but with new measures, 76% of trainees did not attend clinics. Trainee attendance at multidisciplinary team meetings halved during the pandemic. Sixteen per cent ( n=4) of trainees were redeployed, with 50% ( n=2) reporting no educational benefit. Commonly used alternative educational resources included webinars (52%) and online teaching modules (28%). Thirty-two per cent ( n=8) of trainees had examinations postponed. COVID-19 has impacted urology training in the West of Scotland, with a significant reduction in training opportunities across elective theatre, clinic exposure and education. However, trainees will be more adaptable, learn to work remotely, have opportunities to develop leadership and may help redesign services for the future of urology. Level of evidence: Not applicable.

Download Full-text

The Effects of Multidisciplinary Team Meetings on Clinical Practice for Colorectal, Lung, Prostate and Breast Cancer: A Systematic Review

Cancers ◽

10.3390/cancers13164159 ◽

2021 ◽

Vol 13 (16) ◽

pp. 4159

Author(s):

Lejla Kočo ◽

Harm H. A. Weekenstroo ◽

Doenja M. J. Lambregts ◽

J. P. Michiel Sedelaar ◽

Mathias Prokop ◽

...

Keyword(s):

Systematic Review ◽

Multidisciplinary Team ◽

Heterogeneous Data ◽

Cochrane Library ◽

Level Of Evidence ◽

Team Meetings ◽

Process Outcomes ◽

Management Plans ◽

The Impact ◽

Multidisciplinary Team Meetings

Objective: The aim of our systematic review is to identify the effects of multidisciplinary team meetings (MDTM) for lung, breast, colorectal and prostate cancer. Methods: Our systematic review, performed following PRISMA guidelines, included studies examining the impact of MDTMs on treatment decisions, patient and process outcomes. Electronic databases PUBMED, EMBASE, Cochrane Library and Web of Science were searched for articles published between 2000 and 2020. Risk of bias and level of evidence were assessed using the ROBINS-I tool and GRADE scale. Results: 41 of 13,246 articles were selected, evaluating colorectal (21), lung (10), prostate (6) and breast (4) cancer. Results showed that management plans were changed in 1.6–58% of cases after MDTMs. Studies reported a significant impact of MDTMs on surgery type, and a reduction of overall performed surgery after MDTM. Results also suggest that CT and MRI imaging significantly increased after MDTM implementation. Survival rate increased significantly with MDTM discussions according to twelve studies, yet three studies did not show significant differences. Conclusions: Despite heterogeneous data, MDTMs showed a significant impact on management plans, process outcomes and patient outcomes. To further explore the impact of MDTMs on the quality of healthcare, high-quality research is needed.

Download Full-text

Exploring the impact of uro-oncology multidisciplinary team meetings on patient outcomes: A systematic review

European Journal of Oncology Nursing ◽

10.1016/j.ejon.2021.102032 ◽

2021 ◽

pp. 102032

Author(s):

Blake Askelin ◽

Alica Hind ◽

Catherine Paterson

Keyword(s):

Systematic Review ◽

Patient Outcomes ◽

Multidisciplinary Team ◽

Team Meetings ◽

The Impact ◽

Multidisciplinary Team Meetings

Download Full-text

Multidisciplinary team meetings: are all patients presented and does it impact quality of care and survival – a registry-based study

BMC Health Services Research ◽

10.1186/s12913-021-07022-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Quentin Rollet ◽

Véronique Bouvier ◽

Grégoire Moutel ◽

Ludivine Launay ◽

Anne-Laure Bignon ◽

...

Keyword(s):

Colon Cancer ◽

Quality Of Care ◽

Multidisciplinary Team ◽

Poor Prognosis ◽

Metastatic Cancer ◽

Factors Associated ◽

Team Meetings ◽

The Impact ◽

Multidisciplinary Team Meetings

Abstract Background Multidisciplinary team meetings (MDTMs) are part of the standard cancer care process in many European countries. In France, they are a mandatory condition in the authorization system for cancer care administration, with the goal to ensure that all new patients diagnosed with cancer are presented in MDTMs. Aim Identify the factors associated with non-presentation or unknown presentation in MDTMs, and study the impact of presentation in MDTMs on quality of care and survival in patients diagnosed with colorectal cancer (CRC). Methods 3999 CRC patients diagnosed between 2005 and 2014 in the area covered by the “Calvados Registry of Digestive Tumours” were included. Multivariate multinomial logistic regression was used to assess the factors associated with presentation in MDTMs. Univariate analyses were performed to study the impact of MDTMs on quality of care. Multivariate Cox model and the Log-Rank test were used to assess the impact of MDTMs on survival. Results Non-presentation or unknown presentation in MDTMs were associated with higher age at diagnosis, dying within 3 months after diagnosis, unknown metastatic status, non-metastatic cancer and colon cancer. Non-presentation was associated with a diagnosis after 2010. Unknown presentation was associated with a diagnosis before 2007 and a longer travel time to the reference care centres. Presentation in MDTMs was associated with more chemotherapy administration for patients with metastatic cancer and more adjuvant chemotherapy for patients with stage III colon cancer. After excluding poor prognosis patients, lower survival was significantly associated with higher age at diagnosis, unknown metastatic status or metastatic cancer, presence of comorbidities, rectal cancer and non-presentation in MDTMs (HR = 1.5 [1.1–2.0], p < 0.001). Conclusions Elderly and poor prognosis patients were less presented in MDTMs. Geriatric assessments before presentation in MDTMs were shown to improve care plan establishment. The 100% objective is not coherent if MDTMs are only to discuss diagnosis and curative cares. They could also be a place to discuss therapeutic limitations. MDTMs were associated with better treatment and longer survival. We must ensure that there is no inequity in presentation in MDTMs that could lead to a loss of chance for patients.

Download Full-text