Background Eight novel virtual surgery electives (VSEs) were developed and implemented in April–May 2020 for medical students forced to continue their education remotely due to COVID-19. Methods Each VSE was 1–2 weeks long, contained specialty-specific course objectives, and included a variety of teaching modalities. Students completed a post-course survey to assess changes in their interest and understanding of the specialty. Quantitative methods were employed to analyze the results. Results Eighty-three students participated in the electives and 67 (80.7%) completed the post-course survey. Forty-six (68.7%) respondents reported “increased” or “greatly increased” interest in the course specialty completed. Survey respondents’ post-course understanding of each specialty increased by a statistically significant amount ( p -value = <0.0001). Conclusion This initial effort demonstrated that VSEs can be an effective tool for increasing medical students’ interest in and understanding of surgical specialties. They should be studied further with more rigorous methods in a larger population.
Highlights The COVID-19 pandemic has greatly impacted medical education, including cancellation of clinical rotations and novel use of virtual platforms for didactic teaching. We provide an outline of virtual teaching techniques to be employed to introduce medical students to the specialty of urology and increase clinical knowledge surrounding common urologic conditions.
Background Erectile dysfunction (ED) is a multidimensional sexual disorder that is being increasingly diagnosed in younger men. Although mental illnesses such as depression and anxiety are known risk factors for ED, the association between these conditions and ED has been understudied in young men. Aim To explore the temporal association between depression, anxiety, and ED in a population-based cohort of young men. Methods Using 2009–2018 MarketScan Commercial Claims data, we identified all men with ED aged 18–40 years (cases). Using ICD-9/-10 codes and prescription data, we evaluated the prevalence and incidence of depression and anxiety in this cohort. Cases were matched with men without a diagnosis of ED (controls) based on age, Charlson Comorbidity Index, history of hypertension, geographic region, and year of presentation. We examined the prevalence of depression and anxiety within 12 months prior to ED diagnosis and incidence of depression and anxiety up to 36 months after ED diagnosis in cases vs controls. Differences between cases and controls were tested with Wilcoxon rank-sum test for numerical covariates, and chi-square test for categorical covariates. Significance was set at P < .05. Outcomes Prevalence and incidence of depression and anxiety in young men with and without ED. Results Within the 12-month period preceding ED diagnosis, the prevalence of depression and anxiety in cases vs controls were 17.1% vs 12.9%, respectively (P < .001). The incidence of depression and anxiety were higher amongst cases vs controls at 12- (11.7% vs 6.3%), 24- (14.5% vs 9.0%,) and 36- (15.9% vs 10.6%) months following ED diagnosis (P < .001). Clinical Implications High incidence and prevalence of depression and anxiety in young men diagnosed with ED highlight the importance of normalizing mental health screenings and routine psychiatric follow-up in this population. Strengths & Limitations Our contemporary, case-control study utilizes a population-based cohort of young men with ED to study the temporal association between depression, anxiety, and ED, which is understudied to date. The MarketScan commercial claims database used in this analysis includes men covered by private insurers only and lacks data on symptoms and treatments. Conclusion Young men with ED had significantly higher rates of depression and anxiety both before and after ED diagnosis in comparison to young men without ED.
Articles were reviewed and were included if they assessed race in their outcomes reporting among bladder cancer patients enrolled in clinical trials. "Trials" was defined as all those that were randomized trials and clinical trials, phase I-III, in patients diagnosed with bladder cancer. A total of 2,305 articles were initially identified, with 544 meeting our initial inclusion criteria. RESULTS:We identified 544 clinical trials meeting our initial search criteria, with only 24 (4.4%) studies reporting racial demographic data. Enrollees were largely Caucasian (81-98%), with a strikingly small proportion of enrolled patients consisting of African-Americans (2-8%) and Hispanics (2-5%). There were no published clinical trials stratified by race.CONCLUSION: Race is poorly studied in bladder cancer clinical trials. The potential association between race and efficacy, safety or tolerability of the tested interventions is unknown. Given the up to two-fold increase in bladder cancer-specific death among African-Americans, further research is needed to address the impact of race in clinical trials, while encompassing socioeconomic factors and disease risk factor exposures.
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