Lawrence L. Yeung*, Gainesville, FL; Charles D. Scales, Jr.,. Durham, NC ... Raymond C. Sultan*, Kelly C. Johnson, New Brunswick, NJ;. Wayland Hsiao, New ...
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THE JOURNAL OF UROLOGY姞
13 EVIDENCE BASED MEDICINE TRAINING IN UROLOGY RESIDENCY: A SURVEY OF UROLOGY RESIDENTS Lawrence L. Yeung*, Gainesville, FL; Charles D. Scales, Jr., Durham, NC; Philipp Dahm, Gainesville, FL INTRODUCTION AND OBJECTIVES: The importance of formally teaching urology residents the principles of evidence based medicine (EBM) is being increasingly recognized, as witnessed by its incorporation in the forthcoming AUA Core Curriculum. We conducted a web-based survey of urology residents to assess the current status of EBM training in residency prior to implementation of the new curriculum. METHODS: The survey was distributed to urology residents in post-graduate years 3-6 at residency programs in the United States. Questionnaire items addressed perceptions of EBM in urology, interest in EBM training opportunities, knowledge of EBM terminology, current and prior levels of EBM training, and respondent demographics. Response options ranged from 1 (strongly disagree) to 10 (strongly agree). Averages were calculated as means ⫾ standard deviation. RESULTS: The response rate was 56.4% (309/548). A majority of participants agreed that formal EBM training is valuable to residents (8.1⫾2.4) and should be part of the residency program curriculum (mean 7.9⫾2.6); 63% reported that their residency program directed educational activities towards teaching EBM. Most stated that they could understand and explain to others the concepts of mean/median (91%), number needed to treat (65%), meta-analysis (67%), and selection bias (79%). However, fewer residents were able to understand and explain the concepts of regression analysis (52%) or publication bias (37%). Residents identified lack of time (58%) and lack of qualified teachers (53%) as the leading obstacles to learning more about EBM. When asked about the interest in EBM training opportunities, respondents expressed strong interest in an EBM section in the Journal of Urology (7.6⫾ 2.1), a dedicated web-based EBM training program (7.5⫾2.4), and an EBM workshop designed for urology residents (7.3⫾2.3). CONCLUSIONS: A majority of urology residents recognize formal EBM teaching as an important aspect of residency training and agree that it should be incorporated into the curriculum. Time limitations in residency and the lack of qualified teachers of EBM are the leading constraints to achieving these goals. These findings support ongoing efforts to provide residents with opportunities to learn about EBM in a variety of educational formats.
Vol. 183, No. 4, Supplement, Saturday, May 29, 2010
1988, 1998 and 2008 was 5.9, 6.3 and 2.5 years respectively. When examining the source of the references, journals were used most frequently as a reference source for years 1988 and 1998 (Table 2). For the 2008 SASP, Campbell’s Urology was the most frequently used reference source. The most frequently cited journal for all time periods examined was the Journal of Urology (49%) followed by Urology (6%). CONCLUSIONS: Urology is a rapidly advancing field where the average age of essential referenced materials is less than 5 years old. It is important for residents and practicing urologist to participate in continuing medical education to stay abreast of the latest developments in the field. Our data suggests that successful and efficient test preparation can be accomplished by focusing on Campbell’s Urology and the Journal of Urology.
Source of Funding: None
Source of Funding: None
14 ANALYSIS OF SASP REFERENCES: INSIGHTS FOR EFFECTIVE CONTINUING MEDICAL EDUCATION FOR UROLOGISTS. Raymond C. Sultan*, Kelly C. Johnson, New Brunswick, NJ; Wayland Hsiao, New York, NY; Robert E. Weiss, Joseph G. Barone, New Brunswick, NJ INTRODUCTION AND OBJECTIVES: There are many study materials available for residents and physicians studying for in–service, board and recertifying examinations. One of the best resources is the AUA’s Self-Assessment Study Program (SASP). The AUA website states” Twenty percent of the content of the ABU Recertification Examination comes from the SASP”. We investigated the references to each SASP question in order to identify the best information sources for test preparation. METHODS: The questions from the 1988, 1998 and 2008 SASP were examined for their reference source. Each exam contained 150 questions for a total of 450 SASP questions. The total number of references for 1988, 1998 and 2008 were 179, 168, and 167 respectively with a total of 514 references for the three exams. The age of each reference at the time of SASP publication and the source of the reference for each question was determined. RESULTS: The average age for references used for all SASP examined was 4.9 years old (Table 1). The average reference age for
15 OPEN VS. MINIMALLY INVASIVE RADICAL PROSTATECTOMY AND THE LIKELIHOOD OF POSITIVE SURGICAL MARGINS AND USE OF ADDITIONAL CANCER THERAPIES Marcos Freire*, Wesley Choi, Yin Lei, Xiangmei Gu, Stuart Lipsitz, Anthony D’amico, Michael Barry, Aaron Weinberg, Fernando Carvas, Jim Hu, Boston, MA INTRODUCTION AND OBJECTIVES: Tactile sensation, absent during minimally invasive radical prostatectomy (MIRP), purportedly allows surgeons during open retropubic radical prostatectomy (ORP) to better assess tumor extent, which may result in fewer positive surgical margins (PSM). We examined MIRP vs. ORP and the likelihood of PSM and use of additional post-prostatectomy hormonal and radiation therapy. METHODS: Using SEER – Medicare linked data, we identified 4,665 men ⱖ 65 years who underwent ORP and MIRP with and without the use of robotic assistance from 2004 to 2006. After stratifying cumulative surgeon volume into tertiles, we examined the incidence of PSM in men with pT2 and pT3a disease by surgeon volume and surgical approach, and determined factors predictive of post-prostatectomy radiation and/or hormonal therapy. Adjusting for age, co-morbidities, race, and D’Amico risk stratification, logistic regression was per-
