Predisposing Activity Form

Name: GP Urology Masterclass
Address: 480 Hay St, Perth, Western Australia, 6000, Australia
Telephone: +61865591888

Participants Name *

First

Last

RACGP Number *

Practice *

Email *

By the end of the workshop participants should have improved:

Develop a strong urologic clinical knowledge base that will allow you to choose the appropriate diagnostic tools and management for common urological problems.
Increased awareness of current concepts in a range of urological diseases
Increased awareness of the current treatment options available for a range of urological conditions
Reinforce the “red flags” that should initiate action by the general practitioner
Demonstrate effective clinical problem solving and judgment to address patient problems, including interpreting available data and integrating information to generate differential diagnoses and management plans

	Nil	Minimal	Acceptable	Good	Excellent
Understand the typical and atypical presentations of urological stones and calculi	NilUnderstand the typical and atypical presentations of urological stones and calculi Nil	MinimalUnderstand the typical and atypical presentations of urological stones and calculi Minimal	AcceptableUnderstand the typical and atypical presentations of urological stones and calculi Acceptable	GoodUnderstand the typical and atypical presentations of urological stones and calculi Good	ExcellentUnderstand the typical and atypical presentations of urological stones and calculi Excellent
Perform a focused physical examination and urological history, in relation to chronic pain	NilPerform a focused physical examination and urological history, in relation to chronic pain Nil	MinimalPerform a focused physical examination and urological history, in relation to chronic pain Minimal	AcceptablePerform a focused physical examination and urological history, in relation to chronic pain Acceptable	GoodPerform a focused physical examination and urological history, in relation to chronic pain Good	ExcellentPerform a focused physical examination and urological history, in relation to chronic pain Excellent
Describe the investigations and treatments for a fracture penis	NilDescribe the investigations and treatments for a fracture penis Nil	MinimalDescribe the investigations and treatments for a fracture penis Minimal	AcceptableDescribe the investigations and treatments for a fracture penis Acceptable	GoodDescribe the investigations and treatments for a fracture penis Good	ExcellentDescribe the investigations and treatments for a fracture penis Excellent
Differentiate between urgency and stress in female urine leakage	NilDifferentiate between urgency and stress in female urine leakage Nil	MinimalDifferentiate between urgency and stress in female urine leakage Minimal	AcceptableDifferentiate between urgency and stress in female urine leakage Acceptable	GoodDifferentiate between urgency and stress in female urine leakage Good	ExcellentDifferentiate between urgency and stress in female urine leakage Excellent
Discuss the casues and investigations for haematuria	NilDiscuss the casues and investigations for haematuria Nil	MinimalDiscuss the casues and investigations for haematuria Minimal	AcceptableDiscuss the casues and investigations for haematuria Acceptable	GoodDiscuss the casues and investigations for haematuria Good	ExcellentDiscuss the casues and investigations for haematuria Excellent

	< 1 month	1 month – 1 year	1 year- 5 years	> 5 years
Be involved in the assessment of erectile dysfunction, male incontinence or male infertility?	< 1 monthBe involved in the assessment of erectile dysfunction, male incontinence or male infertility? < 1 month	1 month – 1 yearBe involved in the assessment of erectile dysfunction, male incontinence or male infertility? 1 month – 1 year	1 year- 5 yearsBe involved in the assessment of erectile dysfunction, male incontinence or male infertility? 1 year- 5 years	> 5 yearsBe involved in the assessment of erectile dysfunction, male incontinence or male infertility? > 5 years
Be involved in the management of surgical andrology?	< 1 monthBe involved in the management of surgical andrology? < 1 month	1 month – 1 yearBe involved in the management of surgical andrology? 1 month – 1 year	1 year- 5 yearsBe involved in the management of surgical andrology? 1 year- 5 years	> 5 yearsBe involved in the management of surgical andrology? > 5 years
Be involved in the assessment of bladder cancer, kidney cancer or prostate cancer?	< 1 monthBe involved in the assessment of bladder cancer, kidney cancer or prostate cancer? < 1 month	1 month – 1 yearBe involved in the assessment of bladder cancer, kidney cancer or prostate cancer? 1 month – 1 year	1 year- 5 yearsBe involved in the assessment of bladder cancer, kidney cancer or prostate cancer? 1 year- 5 years	> 5 yearsBe involved in the assessment of bladder cancer, kidney cancer or prostate cancer? > 5 years
Be involved in the treatment of pelvic and testicular chronic pain	< 1 monthBe involved in the treatment of pelvic and testicular chronic pain < 1 month	1 month – 1 yearBe involved in the treatment of pelvic and testicular chronic pain 1 month – 1 year	1 year- 5 yearsBe involved in the treatment of pelvic and testicular chronic pain 1 year- 5 years	> 5 yearsBe involved in the treatment of pelvic and testicular chronic pain > 5 years
Be involved in the assessment a patient for haematuria	< 1 monthBe involved in the assessment a patient for haematuria < 1 month	1 month – 1 yearBe involved in the assessment a patient for haematuria 1 month – 1 year	1 year- 5 yearsBe involved in the assessment a patient for haematuria 1 year- 5 years	> 5 yearsBe involved in the assessment a patient for haematuria > 5 years