Training activity information
Details
Dissect a range of urological specimens received for prostate, bladder, renal and/or testicular cancer, including at least two of the following:
- Prostatectomy
- Nephrectomy
- Cystectomy
- Orchidectomy
Type
Developmental training activity (DTA)
Evidence requirements
Evidence the activity has been undertaken by the trainee.
Reflection on the activity at one or more time points after the event including learning from the activity and/or areas of the trainees practice for development.
An action plan to implement learning and/or to address skills or knowledge gaps identified.
Considerations
- Local SOPs
- Specimen preparation, orientation, inking, block sampling and macroscopic description
- Quality of blocks
- RCPath cancer datasets
- Macroscopic pathological features specific to the disease entity
- Molecular testing strategies and national guidance
Reflective practice guidance
The guidance below is provided to support reflection at different time points, providing you with questions to aid you to reflect for this training activity. They are provided for guidance and should not be considered as a mandatory checklist. Trainees should not be expected to provide answers to each of the guidance questions listed.
Before action
- What are the key anatomical structures and relationships to consider in each type of specimen?
- What are your objectives for each specimen type in terms of assessing tumour characteristics, extent of spread, and margin status?
- Discuss the different types of urological cancers and their typical macroscopic appearances with your training officer.
- Review the standard dissection protocols for prostatectomy, nephrectomy, cystectomy, and orchidectomy specimens, including guidelines for margin assessment, lymph node evaluation, and handling of specific structures like the seminal vesicles or spermatic cord.
- What are the important considerations for orientating each of these specimen types for accurate dissection?
- Consider the specific insights you hope to gain regarding the macroscopic presentation of prostate, bladder, renal, and testicular cancers and their potential patterns of spread.
- Think about your existing knowledge of urological anatomy and how this will guide your dissection of each specimen type.
- What specific skills in dissecting these diverse urological specimens, identifying key pathological features, and sampling relevant areas do you aim to develop?
- Discuss this training activity with your training officer to ensure you understand the expected dissection techniques and the rationale for block selection for at least two of the specified urological specimens.
- Consider potential challenges specific to each specimen type (e.g., inking radical prostatectomy margins, assessing renal sinus involvement, identifying bladder diverticula, handling testicular appendages) and how you might approach them.
- Reflect on your understanding of the staging systems for these urological cancers and the role of macroscopic examination in determining pathological stage.
In action
- What is your chosen approach for dissecting each type of urological specimen (prostatectomy, nephrectomy, cystectomy, orchidectomy)?
- Why are you prioritising certain aspects of the dissection (e.g., assessing surgical margins in prostatectomy, examining the renal sinus in nephrectomy, evaluating the bladder wall in cystectomy, examining the spermatic cord in orchidectomy)?
- What decisions are you making regarding the sampling of the tumour, margins, lymph nodes, and other relevant structures (e.g., seminal vesicles, adrenal gland, ureters)?
- What macroscopic features are guiding your block selection?
- How comfortable are you with identifying the different anatomical components of the urological system in the surgical specimens?
- What aspects of assessing tumour extension or involvement of adjacent structures are requiring more concentration?
- How well is your dissection demonstrating the macroscopic features of the tumour and its relationship to surrounding tissues?
- Are you encountering any difficulties in assessing specific areas of interest (e.g., extracapsular extension in prostate cancer, collecting system invasion in renal cancer)?
- What immediate learning points are emerging as you dissect different types of urological malignancies?
- How does the gross appearance relate to your knowledge of urological pathology and clinical findings?
- Are there alternative dissection techniques you could employ to better evaluate critical features for staging and prognosis?
- Would seeking immediate guidance on a complex case be appropriate?
- Are you ensuring that your dissection and sampling are in accordance with established protocols for each type of urological malignancy?
On action
- What were the key macroscopic features of the urological specimens you dissected (prostatectomy, nephrectomy, cystectomy, orchidectomy)?
- How did the type of urological cancer influence the macroscopic appearance of the specimens?
- What were the key steps in dissecting each type of specimen to identify tumour location, size, extent, and other relevant features?
- How did the clinical information and imaging findings correlate with the macroscopic findings at dissection?
- What challenges did you encounter during the dissection of these urological specimens?
- What did you learn about the specific requirements for dissecting different types of urological malignancy specimens to provide accurate diagnostic and staging information?
- How did this experience enhance your understanding of urological anatomy and pathology in the context of cancer?
- How will this experience impact your future dissection of urological specimens?
- What specific dissection techniques for urological specimens do you need to refine?
- How will you ensure you are correctly identifying and assessing key features such as surgical margins and lymph nodes in these specimens?
- Should you seek further guidance on dissecting specific or complex urological cancer cases?
Beyond action
- How did dissecting different types of urological specimens broaden your understanding of the diverse pathological features of urological cancers?
- Review your reflections on urological specimen dissection. What key insights did you gain regarding the specific challenges associated with dissecting each type of specimen?
- Did discussing your experiences with dissecting urological specimens with peers or near peers highlight different approaches or considerations?
- How has the knowledge gained from dissecting urological malignancy specimens informed your understanding of the clinical significance of different tumour locations and grades? How has this influenced your subsequent dissection practice?
- Consider how your understanding from this DTA will contribute to your ability to request and interpret appropriate immunohistochemical and molecular tests.
- What transferable skills, such as meticulous attention to anatomical detail, did you develop?
- What clear actions will you take to enhance your expertise in dissecting urological malignancy specimens?
Relevant learning outcomes
| # | Outcome |
|---|---|
| # 2 |
Outcome
Dissect the most common malignant specimens from a range of organ systems. |
| # 3 |
Outcome
Employ the appropriate specimen preparation, orientation, inking, block sampling and dissection rationale based on the clinical history for malignant specimens. |
| # 5 |
Outcome
Practice safely in accordance with quality management and accreditation standards. |