Background
Teaching residents how to teach is a critical part of resident education because residents are often the major teachers of medical students. The importance of formal residents-as-teachers (RAT) curricula has been emphasized throughout the literature, yet not all residency programs have such a curriculum in place.
Objective
The purpose of our study was to (1) review the medical education literature for established RAT curricula, (2) assess published curricula's reproducibility, (3) evaluate the type of outcomes achieved using the Kirkpatrick model of evaluation, and (4) identify curricula that training programs could feasibly adopt.
Methods
We performed a literature review using PubMed, Medline, Scopus, PsycINFO, ERIC, and Embase. Key search words included residents, residents as teachers, teaching, internship and residency, and curriculum. In addition, a search of MedEdPORTAL was performed using the same key terms. Articles were evaluated based on the reproducibility of curricula and the assessment tools. Evaluation of educational outcomes was performed using the Kirkpatrick model.
Results
Thirty-nine articles were deemed appropriate for review. Interventions and evaluation techniques varied greatly. Only 1 article from the literature was deemed to have both curricula and assessments that would be fully reproducible by other programs.
Conclusions
A literature review on RAT curricula found few articles that would be easily reproduced for residency programs that want to start or improve their own RAT curricula. It also demonstrated the difficulty and lack of rigorous outcome measurements for most curricula.
Background: The 2021 European Association of Urology (EAU) guidelines contain updated prognostic factor risk groups for non-muscle-invasive bladder cancer (NMIBC). These groups are based on the following predictors of progression: tumour stage, grade, number, and size; concomitant carcinoma in situ; and age. However, the groups were derived from datasets excluding patients treated with bacillus Calmette-Guérin (BCG). Objective: To determine the validity of the updated EAU prognostic factor risk groups in patients with NMIBC treated with BCG. Design, setting, and participants: We reviewed patients treated with BCG at our institution between 2000 and 2018. Patients were analysed according to the receipt of ''at least induction'' and ''adequate'' BCG (as defined by the US Food and Drug Administration). Risk groups were assigned according to the 2021 EAU NMIBC risk calculator (https:// nmibc.net/). Outcome measurements and statistical analysis: The Kaplan-Meier method was used to estimate the risks of progression at 1 and 5 yr. Probabilities of progression obtained with the updated prognostic factor risk groups in our series were compared with those reported by the EAU. Discrimination was assessed using the concordance index (cindex). Results and limitations: A total of 529 patients received at least induction BCG with a median follow-up of 47.3 mo (interquartile range 25.3-86.9). Of these patients, 494 received adequate BCG. We found lower progression rates at 1 yr in the very-high-risk group patients receiving at least induction (6.9%) and adequate BCG (4.0%) versus 16.0% for the EAU predicted rates. Additionally, progression rates were also lower at 5 yr in the high-risk group-7.4% for at least induction and 5.3% for adequate BCG versus 9.6% for EAU predicted rates; the rates in the very-high-risk group were as follows: 16.7% for at least induction and 14.9% for adequate BCG versus 40.0% for EAU predicted rates. The c-index in our series was lower than that reported by the EAU (0.63 vs 0.80). Of interest, our multivariable analysis identified grade, stage, and age (p < 0.02) to be the predictors of progression after BCG therapy. Conclusions: While the 2021 EAU prognostic factor risk groups successfully stratified
IMPORTANCE Low-risk non-muscle-invasive bladder cancer (NMIBC) is associated with extremely low rates of progression and cancer-specific mortality; however, patients with low-risk NMIBC may often receive non-guideline-recommended and potentially costly surveillance testing and treatment. OBJECTIVE To describe current surveillance and treatment practices, cancer outcomes, and costs of care for low-grade papillary stage Ta (low-grade Ta) NMIBC and identify factors associated with increased cost of care. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study identified 13 054 older adults (aged 66-90 years) diagnosed with low-grade Ta tumors in the Surveillance,
Conclusions: Even among high risk patients with MIBC, gynecologic organ involvement of MIBC is rare, and organ preservation, especially of the ovaries, is likely safe.
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