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How to improve the teaching of urine microscopy

  • Giovanni B. Fogazzi , Giuseppe Garigali , Barbara Pirovano , Maria Teresa Muratore , Sara Raimondi and Silvia Berti
Published/Copyright: March 1, 2007
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Volume 45 Issue 3

Abstract

Background: Urinary microscopy is difficult to teach. This paper describes a 1-day course on urine microscopy, which was based on both theoretical and practical sessions at the microscope, during which real urine samples were examined.

Methods: The course was based on: a) an introductory presentation with slides on the main components of urinary sediments and their clinical correlates; b) examination of fixed urine samples under the guidance of two experts; and c) the use of two microscopes, each equipped with a co-observation device for up to 15 observers.

Results: Throughout 2005, four courses were held in four Italian towns. Altogether, there were 97 participants (20–27 per course) from 75 laboratories, all graduates with wide but variable experience in the field. During each course, 17–22 urinary sediment components were shown by both bright-field and phase-contrast microscopy and, when indicated, by polarized light. Tests set before and after the course showed a significant improvement (p<0.01) in the identification of erythrocyte subtypes, epithelial cells, fatty components, various types of casts and drug crystals. A questionnaire conducted with participants by phone several months after the course demonstrated that 51.6% and 32.3% of laboratories have introduced or formally requested phase-contrast and polarized-light microscopy, respectively; 45.2% have changed the terminology for urinary epithelial cells; and 87.1% have identified for the first time urinary sediment components that were not recognized or not considered before the course.

Conclusions: Our course demonstrates that it is possible to improve the teaching of urinary microscopy.

Clin Chem Lab Med 2007;45:407–12.

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Corresponding author: Giovanni B. Fogazzi, U.O. di Nefrologia, Fondazione IRRCS, Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Via Commenda 15, 20122 Milan, Italy Phone: +39-02-55034583, Fax: +39-02-55034550,

References

1. Fogazzi GB, Ponticelli C, Ritz E. The urinary sediment. An integrated view, 2nd ed. Oxford: Oxford University Press, 1999.Search in Google Scholar

2. Phillips C, Henderson PJ, Mandel L, Kim S, Schaad D, Cooper M, et al. Teaching the microscopic examination of urine sediment to second year medical students using the Urinalysis-Tutor computer program. Clin Chem1998;44:1692–700.10.1093/clinchem/44.8.1692Search in Google Scholar

3. Astion ML, Kim S, Nelson A, Henderson PJ, Phillips C, Bien C, et al. A two-year study of microscopy urinalysis competency using the Urinalysis-Review computer program. Clin Chem1999;45:757–70.10.1093/clinchem/45.6.757Search in Google Scholar

4. Kim S, Schaad DC, Scott CS, Robins LS, Astion ML. A longitudinal evaluation of an educational software program: a case study of Urinalysis-Tutor. Acad Med2001;76:1136–43.10.1097/00001888-200111000-00018Search in Google Scholar PubMed

5. Kim S, Henderson PJ, Phillips C, Orkand AR, Maddox E, Bien C, et al. Web-based competency assessment system for microscopic urinalysis. Clin Chem2002;48:1608–11.10.1093/clinchem/48.9.1608Search in Google Scholar

6. Canaris GJ, Flach SD, Tape TG, Stierwalt KM, Haggstrom DA, Wigton RS. Can internal medicine residents master microscopic urinalysis? Results of an evaluation and teaching intervention. Acad Med2003;78:525–9.10.1097/00001888-200305000-00018Search in Google Scholar PubMed

7. Tsai JJ, Yeun JY, Kumar VA, Don BR. Comparison and interpretation of urinalysis performed by a nephrologist versus a hospital-based clinical laboratory. Am J Kidney Dis2005;46:820–9.10.1053/j.ajkd.2005.07.039Search in Google Scholar PubMed

8. Fogazzi GB, Secchiero S. The role of nephrologists in teaching urinary sediment examination [letter]. Am J Kidney Dis2006;47:713.10.1053/j.ajkd.2006.01.022Search in Google Scholar PubMed

9. Spencer ES, Pedersen I. Hand atlas of the urinary sediment. Bright-field, phase contrast, and polarized-light. Copenaghen: Munksgaard, 1971.Search in Google Scholar

10. Fairley KF, Birch DF. Hematuria: a simple method for identifying glomerular bleeding. Kidney Int1982;21:105–8.10.1038/ki.1982.16Search in Google Scholar PubMed

11. Daudon M, Jungers P, Lacour B. Intérêt clinique de l'étude de la cristallurie. Ann Biol Clin2004;62:379–93.Search in Google Scholar

12. Fogazzi GB, Garigali G. The clinical art and science of urine microscopy. Curr Opin Nephrol Hypertens2003;16:625–32.10.1097/00041552-200311000-00009Search in Google Scholar PubMed

13. Kouri T, Fogazzi GB, Gant H, Hallander W, Hofmann W, Guder WG. European urinalysis guidelines. Scand J Clin Lab Invest2000;60(Suppl 231):20–3.10.1080/00365513.2000.12056993Search in Google Scholar

14. Van der Snoek BE, Koene RAP. Fixation of urinary sediment. Lancet1997;350:933–4.10.1016/S0140-6736(05)63270-9Search in Google Scholar

15. Köhler H, Wandel E, Brunck B. Acanthocyturia – a characteristic marker for glomerular bleeding. Kidney Int1991;40:115–20.10.1038/ki.1991.188Search in Google Scholar PubMed

16. Kitamoto Y, Tomita M, Akamine M, Inoue T, Itoh J, Takamori H, et al. Differentiation of hematuria using a uniquely shaped red cell. Nephron1993;64:32–6.10.1159/000187274Search in Google Scholar PubMed

17. Fogazzi GB, Saglimbeni L, Banfi G, Cantù M, Moroni G, Garigali G, et al. Urinary sediment features in proliferative and non-proliferative glomerular diseases. J Nephrol2005;18:703–10.Search in Google Scholar

18. Ito K, Yagi S, Hirata M. Color atlas of urinary cytology. St Louis: Ishiyaku EuroAmerica, Inc, 1992:42–6.Search in Google Scholar

19. Fogazzi GB, Carboni N, Pruneri G. The cells of the deep layers of the uroepithelium in the urine sediment: an overlooked marker of severe diseases of the excretory urinary system. Nephrol Dial Transplant1995;10:1918–9.Search in Google Scholar

20. Fogazzi GB, Garigali G, Brambilla C, Daudon M. Ciprofloxacin crystalluria. Nephrol Dial Transplant2006;21:2982–3.10.1093/ndt/gfl320Search in Google Scholar PubMed

Published Online: 2007-03-01
Published in Print: 2007-03-01

©2007 by Walter de Gruyter Berlin New York

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