Office Urology Practice forms a significant portion of any urological program. Medical schools’ curricula may contain ample exposure to hospital surgical operating room but little of Office practice procedures. Most of the residents graduate not having experience in office urological procedures such as uroflowmetry and ultrasound residual. In 2008, a review of several medical schools in the USA suggested that some do not feature urological training for their graduates (1). Where urology is taught, the exposure time is often not more than one week. The traditional management of lower urinary tract symptoms in men over 50 years had focused on accurate identification of anatomical factors. Endoscopic appearance often formed the basis for surgical decision to treat. These procedures were hospital based and often invasive. The understanding of and introduction of urodynamics brought to light new criteria for patient selection for operation. Uroflowmetry and post-void ultrasound residual urine measurement have become basic investigations in Office Urology practice and affords clinicians and patients relatively non-invasive testing format. As more procedures become office-based, learner’s preparation in techniques and competency is imperative. Between 25/05/2022 and 30/09/2022, a module was developed and implemented for Lower Urinary Tract Symptoms (LUTS) incorporating  uroflowmetry and ultrasound residual measurement  based on Kolb’s experiential learning model. We assessed the benefits for the learners and  the potential of this model for adoption in a urology program

: Module was developed based on literature review and needs assessment. Volunteer Learners were recruited. Consent to participate and confidentiality agreement were obtained. Various conditions of the lower urinary tract were categorized, subjects identified and consented. Participants were scheduled to a learning experience and cycle through multiple times The cycle of experience  as follows: Concrete experience-observation by learner of direct care by faculty; Reflective observation-faculty facilitated reflection, learning contracts, and feedback; Abstract conceptualization: Discuss other diagnosis  and management strategies based on experience; Active experimentation-hands on practice with real patient scenarios. Feedback from Volunteer learner and patient participants by oral or on-line

: There were 4 Volunteer learner participants scheduled in 3 months. Patient encounter scenarios   were BPH, Hematuria, Incontinence, Dysuria, Nocturia., Overactive Bladder. Learning experience included: performing and interpreting uroflows and ultrasound, digital rectal exams; Obtaining consent and informed consent process; IPSS and Urinary Diary. Learners were   guided to acquire skills useful for future career.  Faculty -learner relationship was built. Learners   make their choices; faculty encourages them to create, identify resources and devise strategies to achieve their   objectives. Limitations include -a pilot, few numbers, bias of 1 faculty, limited ultrasound access.

This model of learning provided learner guidance to acquire skills that will be useful in future career. It established good working relationship between the learner and faculty by the regular feedback and cycles of learning. Helpful in developing learner’s professional competence. There is the enhancement of knowledge and practice of relatively non-invasive office procedures and duties. Learners are involved in making their choices and faculty encourages them to formulate their own learning objectives. There are potential challenges. Faculty time and interest have to be assured and this could be costly and a big limiting factor. It could also be considered increased work load for any new learner to a urology program.

Kolb’s experiential learning theory, despite limitations, is useful for a learner module in Office Urology Curriculum. It is recommended for trial in well established and new Urology programs.

Loughlin K.R. The current status of medical student urological education in the United States J.Urol. 2008;179{1087-1091
Marcus Drake, Amanda L Lewis, J. Athene Lane  Urodynamic Testing for men with voiding symptoms considering interventional therapy .the merits of properly constructed randomized trial Eur Urol (2016)
Kolb D.A.(1981) Experiential  as the source of Learning and Development (Vol 1) Englewood Cliffs N.J Printicehall