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Biomedical subjects

Louis Sibert

Publications and source records attributed to Louis Sibert.

9 recordsLinked to original sources
PubMed2003

[Impact of rectal prolapse and rectocele on TVT results].

OBJECTIVES: The comorbidity between rectal repair surgery and stress urinary incontinence (SUI) repair by TVT (simplified suburethral sling procedure) is a poorly defined entity. The objective of this study was to evaluate the influence of this combination on the quality of postoperative voiding and urinary continence. METHODS: Retrospective analysis of 12 patients (group 1) simultaneously treated by TVT and rectocele repair by anterior rectal mucosectomy (Sullivan: 6 cases) or rectal prolapse repair (open rectal fixation: 6 cases). They were compared to a group of 12 randomly selected patients (group 2) treated by TVT alone during the same period. RESULTS: A significant post-voiding residual urine volume was observed in 4 women of group 1 versus only one woman of group 2. All patients subsequently and spontaneously resumed satisfactory voiding except for one woman of group 1, in whom self-catheterization had to be maintained. After a mean follow-up of 18 months for group 1 and 17 months for group 2, only one woman, in group 2, was still incontinent. CONCLUSION: Rectal repair surgery, combined with TVT, increases the risk of transient postoperative urinary retention. This surgical combination does not appear to modify the medium-term result of the urological procedure.

Female↗
PubMed2002

Assessment of clinical reasoning competence in urology with the script concordance test: an exploratory study across two sites from different countries.

OBJECTIVES: The script concordance (SC) test is designed to measure the organisation of knowledge that allows interpretation of data in clinical reasoning. This study explores the use of this new written examination tool in urology. MATERIALS AND METHODS: An 80 items SC test was administered to participants from a French and a Canadian university. Three levels of experience were tested: urologists (n = 22), residents in urology (n = 25) and students (n = 23). Scores between groups were compared by analysis of variance. Reliability analysis was studied with Cronbach alpha coefficient. RESULTS: Mean global scores were 51.45 +/- 5.29 for students, 58.19 +/- 3.81 for residents and 62.27 +/- 5.46 for urologists. The difference between the three groups was statistically significant (P < 0.00001). Interaction between levels of expertise and sites was apparently not significant (P = 0.326). Cronbach alpha was 0.79 for the test. CONCLUSIONS: This study shows that the SC test is able to discriminate among participants according to their levels of clinical experience in urology. The results are similar in two different learning environments. The SC test appears as a simple and direct approach to testing organisation and use of knowledge in urology.

Clinical Competence↗
PubMed2002

Stability of clinical reasoning assessment results with the Script Concordance test across two different linguistic, cultural and learning environments.

The Script Concordance (SC) test is designed to measure the organization of knowledge that allows interpretation of data in clinical reasoning. An originality of the test is that answer keys use an aggregate scoring method based on answers given by a panel of experts. Previous studies have shown that the SC test has good construct validity. This study, done in urology, explores (1) the stability of the construct validity of the test across two different linguistic and learning environments and (2) the effect of the use of experts who belong to different environments. An 80-item SC test was administered to participants from a French and a Canadian university. Two levels of experience were tested: 25 residents in urology (11 from the French university and 14 from the Canadian university) and 23 students (15 from the French faculty, eight from the Canadian faculty). Reliability analysis was studied with Cronbach's alpha coefficient. Scores between groups were compared by analysis of variance. Reliability coefficient of the 80 items test was 0.794 for the French participants and 0.795 for the Canadian participants. Scores increased with clinical experience in urology in the two sites. Candidates obtained higher scores when correction was done using the answer key provided by the experts from the same country. These data support the stability of the construct validity of the tool across different learning environments.

Adult↗
PubMed2002

Communication between consultants and referring physicians: a qualitative study to define learning and assessment objectives in a specialty residency program.

BACKGROUND: Outpatient consultation constitutes a major part of medical practice. However, little is known about the skills which should be taught to residents in order for them to improve their consultant-referring physician relationships. PURPOSES: To specify the consultant skills which are required to ensure an effective communication between specialists and referring physicians. METHODS: A qualitative study based on (a) a literature search and (b) focus group interviews. RESULTS: Skills thus identified and described are classified in two groups: observable skills and principles/attitudes. CONCLUSIONS: The consensual specification of these abilities permits a greater efficacy in the teaching of consultant skills.

Ambulatory Care↗
PubMed2002

[Systematic planning of technical training in urologic surgery: methodologic trial].

OBJECTIVES: Trainee urologists must be helped and guided in order to acquire surgical techniques and professional skills. This methodological trial was designed to define the training objectives based on the needs formulated in terms of basic technical procedures. MATERIALS AND METHODS: Systematic planning based on the training cycle was used in this study. Training needs were identified by a questionnaire sent to 4 groups composed of a limited number (about twelve) of urologists, but representative of the various modes of urological practice in several regions of France. Data were acquired according to the Delphi method. RESULTS: A list of 10 operations to be mastered at the end of urology training was defined consensually based on the replies (79.2%) to the questionnaire. This list was used as the basis for the design of general and specific training objectives for each operation. These objectives were validated by the urologists consulted. Three examples of these objectives are presented. CONCLUSION: A clear determination of the surgical technique training needs and objectives could lead to standardization of the practical training of urology residents. This would subsequently need to be completed by determination of the methods of evaluation of achievement of these objectives for tutors and trainee urologists.

Education, Medical↗
PubMed2002

[Testicular microlithiasis and cancer of the testis].

The authors report the case of a patient with a history of testicular cryptorchidism followed for 4 years for infertility and who developed seminoma. Bilateral testicular microlithiasis was initially detected on ultrasonography. On the basis of this case and a review of the literature, the authors discuss the aetiopathogenesis and management of these microscopic stones in a context of cancer.

Adult↗
PubMed2002

[Breast metastasis of kidney cancer. Diagnostic and therapeutic features].

The breast is a rare site of metastasis from renal cancer and the preoperative diagnosis is often difficult. The treatment recommended for this type of metastasis is tumourectomy associated with frozen section examination, while mastectomy and lymph node dissection are unnecessary. The prognosis is often poor with a life expectancy rarely exceeding one year. The authors report a case of isolated right breast metastasis occurring two and a half years after left radical nephrectomy for renal cell carcinoma. Tumourectomy and frozen section examination were performed. The patient died four years later in a context of disseminated metastases despite immunotherapy.

Adenocarcinoma, Clear Cell↗
PubMed2001

Introducing the objective structured clinical examination to a general practice residency programme: results of a French pilot study.

OSCE for evaluating clinical competence still remains limited in France. This study presents the results of the first experimental use of an OSCE as a formative assessment of French general practice trainees. Fifty trainees rotated through a circuit of 15 standardized patient-based OSCE cases. Differences in scores were determined by analysis of variance. Reliability was calculated with the coefficient alpha. Pearson correlations were used to determine the relationship between station scores and overall OSCE score. Written questionnaires based on Likert-type scales were used to measure OSCE feasibility. No difference was found between total session scores. Significant item-total score correlations were found for 12 of the 15 clinical problems. The reliability of the examination was 0.58. Most participants agreed that the clinical situations were realistic, simulated patients were believable and sampling of cases was representative of general practice. These data confirm the feasibility of OSCE in assessing performance of general practice trainees. Optimal training of observers should improve examination reliability. This study warrants further development to confirm its usefulness as a summative assessment tool.

Journal Article↗