Simulated uro-oncology multi-disciplinary team meetings: a novel training approach

Oral Presentation 4
Mr Mark Evans, Dr Gemma Clements, Dr Corinna Clarke, Mrs Paula Ryan, Mr David Curry, Dr Ajit Dhillon

Simulated uro-oncology multi-disciplinary team meetings: a novel training approach

Introduction
Multi-disciplinary team meetings (MDTM) provide a space for clinicians, nurses and allied health professionals to discuss individual patient treatment recommendations, an ideal place for trainee learning. An aging population and plethora of management options has increased both medical complexity and caseload. Cancer Research UK reported greater than half of MDTM case discussions are less than two minutes duration, resulting in a pressure of activity that does not lend itself to teaching or trainee engagement. We aim to simulate MDTMs focused on urological cancer as a vehicle for Urology Specialist Trainee (ST) learning and acclimation with local procedure.

Materials and Methods
2 MDTMs were undertaken on the urology ST mandatory teaching days. The first focused on bladder and the second renal cancer. In total 28 real cases representing a range of complexity, were prepared with patient consent. Documentation mimicked the original MDTM. A radiology ST was recruited to present the imaging for the first MDTM. During the second MDTM a radiology, oncology, pathology ST and specialist uro-oncology nurse were recruited to their respective roles. The simulated MDTMs were undertaken with trainees tasked to present cases and generate outcomes which could then be compared with their authentic counterparts in the subsequent debriefing session. A mix-methods feedback questionnaire was emailed to participants after each session.

Results
8 participants attended the bladder session and 7 the renal. Participants ranged from ST3 to ST7. The questionnaire response rate was 87%. Prior to the first session no trainee had experienced a similar session. 100% of respondents felt that the teaching was grade relevant and addressed curricular topics.  Suggested improvements after the first MDTM were inclusion of a guideline re-cap and introduction of more trainee MDT members, which were addressed in the second session. Participants particularly enjoyed the realism, inclusivity and interaction with other specialties and nursing specialists. Respondents now felt more confident to present at real MDTMs.

Conclusion
Simulated MDTMs are a well-received novel teaching modality, promoting multi-disciplinary learning and drive acclimation. Given the prevalence of MDTM in clinical practice this teaching method is widely scalable. Future developments include exploring MDTM streamlining through translational simulations.