Deficits In Urological Knowledge Among Medical Students And Primary Care Providers: Potential For Impact On Urological Care

Main Category: Urology / Nephrology
Also Included In: Medical Students / Training
Article Date: 28 Dec 2008 - 0:00 PDT

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UroToday.com - Increasing attention is being directed to the urological education of medical students. Recently a decline in this teaching at the medical school level has raised concerns with regards to general clinician knowledge of clinical problems related to urology and to the recruitment of students to urology residency training.

This study evaluates the general level of knowledge, attitudes and practices with regards to common urological issues seen in normal, daily, general medical practice among medical students, residents, fellows and practitioners involved in primary care at an academic institution. With 150 responses the researchers found that knowledge tended to be low for all groups with regards to the investigation and management of hematuria, recognition of age specific abnormality in PSA, and overactive bladder. This also resulted in a reduced likelihood of requesting formal urologic evaluation for these conditions. However, for those study participants took a urology elective in medical, there was a positive impact with regards to these components of the urologic evaluation.

This study highlights the need for a definitive urological curriculum in medical school as well as continued education at the resident and faculty level in general medicine. Other researchers in the United Kingdom have developed and implemented an innovative learning package for undergraduate medical students in urology.1 These researchers developed a simulated urology outpatient clinic which utilized an on-line self- and peer-assessed learning exercise to provide students with basic knowledge of core problems in urology. At the beginning of a one-week clinical teaching block in urology, fourth year medical students, were given the opportunity to participate in the on-line simulated urology outpatient clinic material. Evaluations were gathered using an anonymous on-line questionnaire and pre- and post-tests of knowledge for a sample group. Of 149 students offered the learning package 98%, chose to participate and 85% participated in the on-line self- and peer-assessed work.

The responding students unanimously found the online material helpful for learning about core clinical urology problems. This resulted in a 12% and 18% improvement in scores in the knowledge test at one week and one month after the teaching block, respectively, compared with the control group from the previous academic year in which the mean improvement was only 7% and 8% at one week and one month after the teaching program, respectively. Therefore, while there is general agreement that specific clinical skills and knowledge teaching in urology is important for medical school training, it will be interesting to see multi-institutional application of these types of training programs and their impact on the long term clinical skills of primary care physicians.

Reference:
1. L.E. Owen, D. J. Byrne, and J.S Ker, A learning package for medical students in a busy urology department: design, implementation, and evaluation. Urology 2008; 72 (5): 982-986

Mishail A, Shahsavari M, Kim J, Welliver RC Jr, Vemulapalli P, Adler HL
J Urol. 2008 Nov;180(5):2140-7
doi:10.1016/j.juro.2008.07.043
Written by UroToday.com Contributing Editor Elspeth M. McDougall, MD, FRCSC, MHPE

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