This article is one of several emanating from a session during the 33rd Annual EAU Congress. The session focused on problems in bladder cancer, that while important and common, remain controversial. Each of the clinical challenges began with a case presentation highlighting the problem followed by two alternate paths for a clinical resolution presented by experts in the field. This so-called point/counterpoint format is frequently used at medical meetings and in journals because it generates interest and presents a broad and expert discussion of a controversial area.

The problem with this format is inherent in all debates, especially when the discussants are assigned opposing viewpoints. In an effort to “win” the debate, a discussant may take a position that does not reflect their actual belief and clinical practice. On the surface, this should not be a problem because the presented data are well-referenced, and the audience is composed of well-educated physicians with significant clinical expertise capable of deciding what is best for their clinical practice. Nevertheless, this format switches the educational onus from the presenter to the audience.

This article and the others that follow attempt to find an alternative to the conventional point/counterpoint format that minimizes the potential negative effect of contrived emphasis in the debate. This manuscript begins with a clinical problem that is important and controversial. Two experts discuss the problem and provide alternate solutions. Finally, a recommended method of resolving the clinical problem is conveyed taking into account the proposed alternative solutions. This novel format helps shift the educational burden back to the educator from the student. That, of course, does not relieve the audience of their obligation to critically evaluate the presented information and determine what resolution best fits their practice and their patients.

I hope that you will find this format useful and am pleased to report that the article is Open Access and available to all: Read the Abstract

Written by: Barton Grossman, MD, Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States