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License: 12055)), and sequential blood samples were collected at baseline and 1, 3, 6 and 12 months post-RC. Postoperative CT findings for all patients were collected to
monitor for metastatic recurrence. For patients with
known recurrence, samples from time of recurrence and
before recurrence were analyzed. Cell-free DNA (cfDNA)
was extracted from plasma using QIAamp Circulating
Nucleic Acid Kit. Targeted amplification was performed
using pre-designed duel-indexed primers, and next generation sequencing (NGS) performed using 22 bladder-cancer specific mutations.
Results: cfDNA was isolated from all collected samples,
with a mean of 77.5 ng/ml and IQR 10.9-72.7 ng/ml
(Qubit). Mutations were detectable in cfDNA at baseline
for all patients. Additionally, mutations became detectable
in post-cystectomy samples of 5 of 6 patients who subsequently went on to develop metastatic recurrence visible
on CT scanning.
Conclusions: Genomic analysis of plasma cfDNA has the
potential to supplement imaging in the detection of micrometastatic disease, and to select patients for systemic treatment. Dynamic changes in mutational burden may represent
tumour heterogeneity and could have an application in
tracking sub-clonal populations in metastatic disease.

ePoster Session 2:
Management, Governance, Education
and Quality
Improvement
Tuesday 26 June
08:30 - 10:00
Room 4
Chairs: Luke Forster & Nikhil Vasdev
P2-1 Development, delivery and theorydriven evaluation of an evidence-based quality
improvement training module for urology
trainees
Pallari E1, Khadjesari Z1, Biyani S2, Jain S2, Sevdalis N1,
Green J3
1King's College London, United Kingdom, 2Leeds Teaching Hospitals
NHS Trust, Leeds, United Kingdom, 3Barts NHS Health Trust,
London, United Kingdom

Introduction: We developed and evaluated an evidencebased training module in quality improvement (QI) for
urology trainees.
Materials and Methods: A half-day training module, utilising lectures and workshops, was delivered to 43 trainees
from 13 LETBs. The well-validated Kirkpatrick framework
was used as evaluation framework. Quantitative assessment

Journal of Clinical Urology 11(1S)
Pre/Post-training using validated knowledge/skills/attitudes
scales was applied, including psychometric and inferential
statistics.
Results: All scales showed acceptable reliability
(Cronbach-alphas pre-training=0.642-0.912; post-training=0.667-0.922) except trainees' views on conducting a
QI project and influencing QI at work. Objective knowledge was overall high and did not increase post-training
(M-pre=5.79, SD=1.82; M-post=5.89, SD=1.46; p>0.05).
Post-training, we found statistically significant improvements in trainees' subjective knowledge (M-pre=2.72,
SD=0.78; M-post=4.09, SD=0.56), t(38), p<0.0005; attitudes regarding conducting a QI project (M-pre=3.63,
SD=XX; M-post=4.37, SD=), z=4.882, p<0.001; attitudes
regarding QI at work (M-pre=3.69, SD=0.44; M-post=3.99,
SD=0.49), t(38), p<0.0005; and attitudes towards influencing QI at their workplaces (M-pre=3.54, SD=0.44;
M-post=3.89, SD=0.49), z=3.618 p<0.0005. Self-reported
trainee skills also showed improvement post-training:
intentions to initiate or engage in a QI project in the
next six months increased significantly (M-pre=3.61,
SD=0.65; M-post=4.14, SD=0.59), z=4.720 p<0.0005. Etasquared statistics for all analyses showed large effect
sizes with substantial differences in the scores obtained
before and after the QI intervention. We assessed trainees' overall satisfaction with course content and delivery
and found they were all very high (median scores for
content, delivery and global satisfaction 4 on 5-point
Likert scales).
Conclusions: We have developed the first evidencebased and prospectively evaluated QI skills course for
urology trainees. Larger-scale evaluation is currently
underway.
P2-2 Subspecialty urology - can we predict
where gaps will be in 7 years' time? Results
from the BAUS workforce survey
Manson R1, Palmer M
1Queen Elizabeth University Hospital, Glasgow, United Kingdom,
2Glasgow Royal Infirmary, United Kingdom, 3On behalf of BAUS and
the Specialist Advisory Committee in Urology

Introduction: This study aimed to establish whether or
not we can identify future gaps within subspecialty
urology.
Methods: All BAUS members in consultant posts in the
UK and Republic of Ireland were invited by email to complete an online survey. Questions included their age;
whether or not they consider themselves a general or
subspecialist urologist and subspecialty activity.
Results: A total of 536 responses were gathered from the
UK. This equates to approximately 50% of the UK workforce. 9% considered themselves as general urologists,



Table of Contents for the Digital Edition of JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018

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