Assessment of Urological Knowledge and Practice Among Emergency and Primary Health Care Physicians

ORIGINAL ARTICLE
Badr Alharbi, Emad Alwashmi, Faisal Awadh Al-Harbi, Adel H. Alharbi, Abdulaziz Alhuraisi, Khaled Almansour, Watban Alwatban, Abdulrahman Saleh Alqazlan, Adil Khalaf Altwairgi

 
For citation: Alharbi B, Alwashmi E, Al-Harbi FA, Alharbi AH, Alhuraisi A, Almansour K, Alwatban W, Alqazlan AS, Altwairgi AK. Assessment of Urological Knowledge and Practice Among Emergency and Primary Health Care Physicians. International Journal of Biomedicine. 2024;14(4):607-614. doi:10.21103/Article14(4)_OA12
 
Originally published December 5, 2024
 

Abstract: 

Background: Emergency and primary health care (PHC) are critical settings for addressing urological health problems and related emerging complaints. Therefore, physicians in these fields must possess the knowledge, skills, and competencies to diagnose and manage common urologic presentations accurately. This study aimed to evaluate the general level of knowledge about common urological problems among PHC and emergency room physicians in Qassim province, Saudi Arabia.
Methods and Results: A cross-sectional questionnaire-based study included 82 PHC and emergency room physicians. The study was mainly a descriptive study utilizing non-probability convenience sampling of all participants who completed online or hardcopy surveys. As for the urological knowledge, it was found that 40.2% of the participants knew correctly that prostate-specific antigen (PSA) screening should be performed on a 60-year-old man who presents with urinary retention. In addition, 40.2% knew that patients should be referred for further urological evaluation of hematuria if they have a single episode of gross hematuria, a finding of microhematuria on 3 successive urine analyses, or when persistent microhematuria after treatment with antibiotics is present. Only 23.2% knew that when inserting a Foley catheter in a man, it is appropriate to inflate the balloon after the catheter has been inserted at its full length or when urine return is noted. More than half (58.5%) knew that patients should be referred to a urologist if they have a nodular prostate. Only 24.4% knew that the best test to evaluate for the presence of a kidney stone is a CT abdomen/pelvis, and 63.4% correctly defined microscopic hematuria.
As for the participants’ urological skills, 70.7% agreed that they were proficient in performing a digital rectal examination and 76.9% said they performed male genitourinary examinations; 87.8% agreed that they are proficient in taking sexual history, 23.2% performed digital rectal examination >20 times, and 31.7% performed male genitourinary examination >20 times; 79.3% agreed they were proficient in performing male urinary catheterization, while 79.3% were proficient in performing female urinary catheterization. Only 24.4% were proficient in the insertion of a suprapubic catheter. As for the practice frequency, 37.8% performed male urinary catheterization more than 20 times, while only 12.2% performed it for females at the same frequency.
Conclusion: The general knowledge of emergency and PHC physicians in the Qassim region appears insufficient. The study identified significant gaps in urological knowledge among these physicians, highlighting the need for adequate training programs to bridge these gaps.

Keywords: 
primary health care • emergency room • urological knowledge • urological practice
References: 
  1. Badalato GM, Holden M, McKiernan JM. Urological knowledge in primary care and ER settings: are education initiatives indicated? J Med Person. 2012 Apr 5;10(1):25–9.
  2. Redmond EJ, Saleem S, Domes TS, Rourke KF. Deficits in urological knowledge and skills among family medicine residents in Canada. Can Urol Assoc J. 2020 Dec;14(12):E631-E635. doi: 10.5489/cuaj.6428. PMID: 32569565; PMCID: PMC7704087.
  3. Mishail A, Shahsavari M, Kim J, Welliver RC Jr, Vemulapalli P, Adler HL. Deficits in urological knowledge among medical students and primary care providers: potential for impact on urological care. J Urol. 2008 Nov;180(5):2140-7. doi: 10.1016/j.juro.2008.07.043. Epub 2008 Sep 18. PMID: 18804235.
  4. Patel P, Nayak JG, McGregor TB. The value of a core clinical rotation in urology for medical students. Can Urol Assoc J. 2015 Nov-Dec;9(11-12):392-6. doi: 10.5489/cuaj.3297. Epub 2015 Dec 14. PMID: 26788227; PMCID: PMC4707890.
  5. Binsaleh S, Al-Jasser A, Almannie R, Madbouly K. Attitude and perception of urology by medical students at the end of their medical school: An appraisal from Saudi Arabia. Urol Ann. 2015 Apr-Jun;7(2):211-20. doi: 10.4103/0974-7796.150511. PMID: 25835262; PMCID: PMC4374261.
  6. Chung E, Sprott P. Interns' assessment and management of three common urological conditions: a survey of their knowledge and skills. Are they adequately prepared for clinical practice? N Z Med J. 2008 May 9;121(1273):45-50. PMID: 18480885.
  7. Nassir AM, Baazeem A, Saada H, Elkoushy MA, Badr H, Bahuwyrith M, Melebari HA, Nasser J, Azhar RA. Urological knowledge among primary health care physicians in Saudi Arabia. Saudi Med J. 2019 May;40(5):483-489. doi: 10.15537/smj.2019.5.24080. PMID: 31056626; PMCID: PMC6535177.
  8. Loughlin KR. The current status of medical student urological education in the United States. J Urol. 2008 Mar;179(3):1087-90; discussion 1090-1. doi: 10.1016/j.juro.2007.10.068. Epub 2008 Jan 18. PMID: 18206927.
  9. Scotta R, Sinclair AM, Pearce I. Is there a need for an undergraduate urological curriculum? J Clin Urol. 2012 Jan 1;5(1):16–9.
  10. Whiles BB, Thompson JA, Griebling TL, Thurmon KL. Perception, knowledge, and interest of urologic surgery: a medical student survey. BMC Med Educ. 2019 Sep 13;19(1):351. doi: 10.1186/s12909-019-1794-5. PMID: 31519190; PMCID: PMC6743171.
  11. Kan KM, Jayadevan R, Rodriguez N, Weissbart S, Stock JA. The Current State of Urological Education for Medical Students. Urol Pract. 2017 Jan;4(1):71-75. doi: 10.1016/j.urpr.2016.03.004. Epub 2016 Sep 16. PMID: 37592605.
  12. Cohen A, Nottingham C, Packiam V, Jaskowiak N, Gundeti M. Attitudes and knowledge of urethral catheters: a targeted educational intervention. BJU Int. 2016 Oct;118(4):654-9. doi: 10.1111/bju.13506. Epub 2016 May 18. PMID: 27104479.
  13. Liu JJ, Guo DP, Gill H. Patterns of urinary catheter consults in a tertiary care hospital. Can J Urol. 2013 Dec;20(6):7046-9. PMID: 24331347.
  14. Barayan GA, Nassir AM. Knowledge about urology in the general population of Jeddah, Saudi Arabia. Urol Ann. 2011 May;3(2):82-6. doi: 10.4103/0974-7796.82174. PMID: 21747598; PMCID: PMC3130484.
  15. Barayan GA, Nassir AM. Knowledge about urology in the general population of Jeddah, Saudi Arabia. Urol Ann. 2011 May;3(2):82-6. doi: 10.4103/0974-7796.82174. PMID: 21747598; PMCID: PMC3130484.
  16. Al-Abbad HM, Al-Haidary HM. The perception of physical therapy leaders in Saudi Arabia regarding physical therapy scope of practice in primary health care. J Phys Ther Sci. 2016 Jan;28(1):112-7. doi: 10.1589/jpts.28.112. Epub 2016 Jan 30. PMID: 26957740; PMCID: PMC4755986.
  17. Teoh M, Lee D, Cooke D, Nyandoro MG. Digital Rectal Examination: Perspectives on Current Attitudes, Enablers, and Barriers to Its Performance by Doctors-in-Training. Cureus. 2023 Jun 19;15(6):e40625. doi: 10.7759/cureus.40625. PMID: 37342303; PMCID: PMC10278382.

Download Article
Received October 14, 2024.
Accepted November 23, 2024.
©2024 International Medical Research and Development Corporation.