Teaching Urology to Undergraduates: A Prospective Survey of What General Practitioners Need to Know

Background: Higher education training in Medicine has considerably evolved in recent years. One of its main goals has been to ensure the training of students as future adequately qualified general practitioners (GPs). Tools need to be developed to evaluate and improve the teaching of Urology at the undergraduate level. Our objective is to identify the knowledge and skills needed in Urology for the real clinical practice of GPs. Methods: An anonymous self-administered survey was carried out among GPs of Primary Care and Emergencies which sought to evaluate urological knowledge and necessary urological skills. The results of the survey were exported and descriptive statistics were performed using IBM SPSS Statistics version 19.0. Results and limitations: A total of 127 answers were obtained, in which ‘Urological infections’, ‘Renal colic’, ‘PSA levels and screening for prostate cancer’, ‘Benign prostatic hyperplasia’, ‘Hematuria’, ‘Scrotal pain’, ‘Prostate cancer diagnosis’, ‘Bladder cancer diagnosis’, ‘Urinary incontinence’, and ‘Erectile dysfunction’ were rated as Very high or High formative requirements (>75%). Regarding urological skills, ‘Abdominal examination’, ‘Interpretation of urinalysis’, ‘Digital rectal examination’, ‘Genital examination’, and ‘Transurethral catheterization’ were assessed as needing Very high or High training in more than 80% of the surveys. The relevance of urological pathology in clinical practice was viewed as Very high or High in more than 80% of the responses. Conclusions: This study has shown helpful results to establish a differentiated prioritization of urological knowledge and skills in Primary Care and Emergencies. Efforts should be aimed at optimizing the teaching in Urology within the Degree of Medicine which consistently ensures patients’ proper care by future GPs.

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Detection limits of significant prostate cancer using multiparametric MR and digital rectal examination in men with low serum PSA: Up-date of the Italian Society of Integrated Diagnostic in Urology

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2021.1.92 ◽

2021 ◽

Vol 93 (1) ◽

pp. 92-100

Author(s):

Andrea B. Galosi ◽

Erika Palagonia ◽

Simone Scarcella ◽

Alessia Cimadamore ◽

Vito Lacetera ◽

...

Keyword(s):

Prostate Cancer ◽

Clinical Practice ◽

Early Stage ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Point Of View ◽

Italian Society ◽

Rectal Examination ◽

Normal Limits ◽

Low Serum

Reasons why significant prostate cancer is still missed in early stage were investigated at the 22nd National SIEUN (Italian Society of integrated diagnostic in Urology, Andrology, Nephrology) congress took place from 30th November to 1st December 2020, in virtual modality. Even if multiparametric magnetic resonance (MR) has been introduced in the clinical practice several, limitations are emerging in patient with regular digital rectal examination (DRE) and serum prostate specific antigen (PSA) levels approaching the normal limits. The present paper summarizes highlights observed in those cases where significant prostate cancer may be missed by PSA or imaging and DRE. The issue of multidisciplinary interest had been subdivided and deepened under four main topics: biochemical, clinical, pathological and radiological point of view with a focus on PI-RADS 3 lesions.

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Deficits in urological knowledge and skills among family medicine residents in Canada

Canadian Urological Association Journal ◽

10.5489/cuaj.6428 ◽

2020 ◽

Vol 14 (12) ◽

Author(s):

Elaine J. Redmond ◽

Sahar Saleem ◽

Trustin Domes ◽

Keith F. Rourke

Keyword(s):

Family Medicine ◽

Online Survey ◽

Medical Training ◽

Digital Rectal Examination ◽

Scrotal Pain ◽

Knowledge And Skills ◽

Urological Procedures ◽

Scrotal Swelling ◽

Tract Infections ◽

Family Medicine Residents

Introduction: The last 10–15 years has seen a decline in formal undergraduate urological education throughout Canada. Given the large volume of urological presentations in family practice, trainees need to acquire the requisite urological knowledge and skills to serve their patients. The objective of this study is to determine the perceived level of urological knowledge and skills among Canadian family medicine residents. Methods: A 15-item anonymous online survey was distributed via email to all Canadian family medicine program directors from September to December 2018 and distributed to their residents. The survey obtained data on demographics, training, undergraduate urology experience, self-reported proficiency in interpreting urological investigations, performing common urological procedures, and managing common urologic conditions. Descriptive statistics were used to summarize data. Results: The questionnaire was completed by 142 family medicine residents with representation from Western Canada (27.5%), Ontario (32.4%), and Quebec (40.1%); 39.4% of respondents had completed a urology rotation during medical school and only 29.1% felt that their medical training prepared them for the urological aspects of family medicine. Although the majority of respondents felt proficient in performing a digital rectal examination (58.5%) or managing urinary tract infections (97.9%), only a minority felt competent in performing male genitourinary examination (40.1%), uncomplicated male (34.5%), female (45.8%) or difficult (9.2%) urethral catheterization. Likewise, the minority of respondents felt comfortable managing erectile dysfunction (41.5%), scrotal swelling (34.7%), and scrotal pain (25.7%). Conclusions: There are significant deficiencies in urological knowledge and skills among family medicine residents in Canada, possibly as a consequence of insufficient educational experiences during medical training.

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Is digital rectal examination still useful in prostate cancer diagnosis? YES!

Urologia Journal ◽

10.1177/0391560319834463 ◽

2019 ◽

Vol 86 (1) ◽

pp. 34-34

Author(s):

Tommaso Prayer Galetti

Keyword(s):

Prostate Cancer ◽

Cancer Diagnosis ◽

Digital Rectal Examination ◽

Prostate Cancer Diagnosis ◽

Rectal Examination

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General practitioners’ approaches to prostate-specific antigen testing in the north-east of the Netherlands

BMC Family Practice ◽

10.1186/s12875-020-01350-3 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Sanny Kappen ◽

Lisa Koops ◽

Verena Jürgens ◽

Michael H. Freitag ◽

Marco H. Blanker ◽

...

Keyword(s):

Prostate Cancer ◽

Primary Care ◽

Clinical Practice ◽

Cancer Screening ◽

Early Detection ◽

The Netherlands ◽

Specific Antigen ◽

North East ◽

The North ◽

Psa Testing

Abstract Background There is wide variation in clinical practice for the early detection of prostate cancer, not least because of the ongoing debate about the benefits of prostate-specific antigen (PSA) testing. In this study, we aimed to assess the approaches, attitudes, and knowledge of general practitioners (GPs) regarding PSA testing in primary care in the Netherlands, particularly regarding recommendations for prostate cancer. Methods Questionnaire surveys were sent to 179 GPs in the north-east of the Netherlands, of which 65 (36%) were completed and returned. We also surveyed 23 GPs attending a postgraduate train-the-trainer day (100%). In addition to demographic data and practice characteristics, the 31-item questionnaire covered the attitudes, clinical practice, adherence to PSA screening recommendations, and knowledge concerning the recommendations for prostate cancer early detection. Statistical analysis was limited to the descriptive level. Results Most GPs (95%; n = 82) stated that they had at least read the Dutch GP guideline, but just half (50%; n = 43) also stated that they knew the content. Almost half (46%; n = 39) stated they would offer detailed counseling before ordering a PSA test to an asymptomatic man requesting a test. Overall, prostate cancer screening was reported to be of minor importance compared to other types of cancer screening. Conclusions Clinical PSA testing in primary care in this region of the Netherlands seems generally to be consistent with the relevant guideline for Dutch GPs that is restrictive to PSA testing. The next step will be to further evaluate the effects of the several PSA testing strategies.

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Prostate cancer testing: a snapshot of the attitudes and practice of Australian general practitioners

Australian Journal of Primary Health ◽

10.1071/py13078 ◽

2015 ◽

Vol 21 (1) ◽

pp. 111 ◽

Cited By ~ 3

Author(s):

Jane Crowe ◽

Addie C. Wootten ◽

Nicholas Howard

Keyword(s):

Prostate Cancer ◽

General Practice ◽

General Practitioner ◽

General Practitioners ◽

Digital Rectal Examination ◽

Web Based ◽

Rectal Examination ◽

Attitudes And Practices ◽

Asymptomatic Men

The role of the General Practitioner (GP) in testing for and managing men with prostate cancer (PCa) is significant. Very few studies have explored the attitudes and practices of Australian GPs in the context of the role of PCa testing. In this study, a 46-item web-based questionnaire was used to assess self-reported PCa testing attitudes and practices of GPs. This questionnaire was circulated to divisions of general practice and Medicare locals for further distribution to their GP members across Australia. GPs from all states and territories participated, and a total of 136 GPs completed the survey. Of the responding GPs, 57% always or usually offered PCa testing to asymptomatic men ≤70 years of age and 60% of GPs always or usually included a digital rectal examination (DRE). Many (80%) of the GPs stated that the current PCa testing guidelines were not clear. PCa testing was offered opportunistically by 56% while 39% offered testing at the patient’s request. The results captured in this study represent a snapshot of GP attitudes and practices from across Australia. The results presented indicate a wide variation in the approaches to PCa testing in general practice across Australia, which in most part appear to be related to the lack of clarity of the current prostate cancer testing guidelines.

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