Module information

Module details

Title
Advanced Diagnostic and Therapeutic Management of the Male
Type
Specialist
Module code
S-RA-S3
Credits
10
Phase
3
Requirement
Compulsory

Aim of this module

This module will provide trainees with knowledge and understanding of diagnostic andrology and novel innovations in the field. Trainees will consider the evidence for existing and emerging sperm function tests and where these tests can offer a greater insight into potential therapeutic management.

Work-based content

Competencies

# Learning outcome Competency Action
# 1 Learning outcome 1,2 Competency

Provide guidance as to appropriate ART and outcome prediction using laboratory investigations in andrology and patient histories

Action View
# 2 Learning outcome 2,3,8 Competency

Make recommendations for the next steps in patient care from clinical history and laboratory investigations from andrology and other specialties for males under investigation to include:

  • Retrograde ejaculation
  • Varicocele
  • Infection/round cells
Action View
# 3 Learning outcome 2,3,4,5 Competency

Identify a case and recommend the use of an advanced test, for example:

  • Sperm ploidy
  • Immunohistochemistry for accurate identity of round cells
  • Test of seminal composition
Action View
# 4 Learning outcome 4,5,6 Competency

Deliver a presentation on an emerging technology available for the diagnostic andrology lab, including the pathway to routine use

Action View
# 5 Learning outcome 4,5,6 Competency

Perform an options appraisal for sperm DNA tests, including assessment of the comparative evidence base

Action View
# 6 Learning outcome 4,7 Competency

Perform validation and recommend actions where required for a:

  • Process
  • Piece of equipment
Action View
# 7 Learning outcome 3,7 Competency

Work with healthcare professionals in allied specialty to make a recommendation to improve the pathway for patients undergoing investigation, including one of the following specialties

  • Urology
  • Endocrinology
  • Sexual health
Action View
# 8 Learning outcome 2,3,8 Competency

Identify the next stage of care and discuss the options with patients for:

  • Dietary habits
  • Environmental/occupational risks
  • Exogenous toxin intake (e.g. alcohol/caffeine)
  • Lifestyle habits e.g. supplementation
Action View
# 9 Learning outcome 2,8 Competency

Provide instruction to a male with retrograde ejaculation on producing a sample

Action View
# 10 Learning outcome 4,8 Competency

Discuss a result with a patient that has negative implications for the patient, and provide the relevant information, options and support within professional practice

Action View
# 11 Learning outcome 2, 4, 5, 6, 8 Competency

Critically appraise the use of an emerging technology, and produce or review an information leaflet for patients

Action View

Assessments

Complete 2 Case-Based Discussions

Complete 2 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Perform a laboratory diagnostic test for identifying round cells in semen.
  • Identify local and/or national support services available to a male patient/couple for infertility.
  • Perform and prepare a preliminary report for an advanced or emerging analysis.
  • Prepare a testicular biopsy specimen.

Observed Clinical Event Titles

  • Discuss provision of a diagnostic semen sample with a patient, including requirements before and after receipt of the sample.
  • Discuss the impact of male infertility with the individual and/or the couple.
  • Discuss the impact of male infertility on the individual and/or the couple with a healthcare professional.
  • Present a case in partnership with a healthcare professional from another clinical specialism as part of the diagnosis and review process.

Learning outcomes

# Learning outcome
1

Interpret common andrology diagnoses to provide assisted reproductive technologies (ART) outcome prediction and patient management.

2

Identify additional tests to aid in diagnosis or implications of observed disease.

3

Practice in partnership with other clinical specialties as part of the systematic diagnosis and review of individual cases.

4

Practice safely in accordance with quality management and regulatory standards.

5

Appraise and apply advanced tests on the basis of their benefit to investigation and patient outcome.

6

Evaluate new and emerging techniques in andrology practice.

7

Develop services to evolve practice and the improve the patient experience of andrology services.

8

Explain procedures and care options to patients, providing support within the scope of practice and identifying options for onward referral.

Clinical experiences

Important information

Clinical experiences help you to develop insight into your practice and greater understanding of your specialty. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. While Clinical Experiences are not assessed, reflections and observations from your experiences can be used to support evidence for competencies to demonstrate your awareness and appreciation of your specialty and it’s impact on patient care. You may find it helpful to capture thoughts from your experiences in your reflective log.

Activities

  1. Observe a Pathologist scoring stained testicular specimens to appreciate the process and scoring requirements.
  2. Observe clinic appointments where diagnostics are discussed with patients by medical staff, for example an erectile function clinic, an infertility clinic, a urology service, and or an STI clinic.
  3. Attend a national or international conference discussing new and emerging technologies.
  4. Visit another andrology lab to appreciate practice in another environment.
  5. Observe patient counselling or discuss counselling offered to males with counsellors to appreciate the value and role of counselling to the patient.
  6. Observe a medical/surgical intervention on a male patient aimed at affecting male fertility to appreciate the patient pathway and experience.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Critically appraise advanced laboratory testing options of andrological function.
  2. Critically evaluate relevant guidelines and evidence base for advanced diagnostics, “add-ons”, and developments in andrology practice.
  3. Critique tests to select the most appropriate, within the strategy, purpose and content of the latest WHO manual for semen analysis, appreciating the wider links between semen analysis and male health.
  4. Differentiate between sexual transmitted infections and transmissible diseases, and associated risks.

Indicative content

  • Molecular andrology – DNA and chromatin integrity assays. Sequencing technology (NextGen), sperm telomere assessment, role of epigenome (e.g., non-coding RNAs and DNA methylation).
  • Role of molecular andrology in investigating male reproductive health.
  • New developments in andrology and diagnostic semen analysis (including sperm isolation techniques.
    • The HFEA and learned society position statements around “add-ons”, when and how further testing may be offered and ethical arguments.
    • Guiding patient options and expectations.
  • WHO manual, latest editions.
  • Learned bodies, andrology and male reproductive health.
  • Marketing and advertising regulatory compliance in reproductive health and ART.
  • STIs, male reproductive health and infertility.
  • Evidence-based clinical science and clinical trials.

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SLS3-2-22 Specialty title Andrology [2022] Action View