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Cases & Commentaries
- Web M&M
Michael J. Barry, MD, and Marc B. Garnick, MD; August 2019
Referred to urology for a 5-year history of progressive urinary frequency, nocturnal urination, and difficulty initiating a stream, a man had been reluctant to seek care for his symptoms because his father had a "miserable" experience with treatment for the same condition. A physician assistant saw him at that first visit and ordered a PSA test (despite the patient's expressed views against PSA testing) and cystoscopy (without explaining why it was needed), and urged the patient to self-catheterize (without any instructions on how to do so). The patient elected not to follow up with the tests because of this negative interaction. Ten weeks later, he sought care from a nurse practitioner at his primary care provider's office where his blood pressure and creatinine levels were found to be markedly elevated, 2L of urine were drained via catheter, and he was admitted to the hospital for renal failure.
Journal Article > Study
Accreditation Council on Graduate Medical Education technical skills competency compliance: urologic surgical skills.
Hammond L, Ketchum J, Schwartz BF. J Am Coll Surg. 2005;201:454-457.
The authors implemented a set of eight laboratory practicums to develop urologic surgical skills. Evaluations by participants indicated that they acquired technical experience through repetition in a low-stress environment with no threat to patient safety.