1
|
Brothwell M, Slevin F, Pawsey A, Radhakrishna G, E Troost, Suresh P, Cooper R. Radiology Training for Clinical Oncology Trainees. Clin Oncol (R Coll Radiol) 2024; 36:537-540. [PMID: 38876806 DOI: 10.1016/j.clon.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 04/10/2024] [Accepted: 05/09/2024] [Indexed: 06/16/2024]
Affiliation(s)
- M Brothwell
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK.
| | - F Slevin
- University of Leeds, UK; Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Pawsey
- University College London Hospitals, London, UK
| | | | - E Troost
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Suresh
- University Hospitals Plymouth NHS Trust, Derriford Hospital, Plymouth, UK
| | - R Cooper
- Leeds Cancer Centre, St James's University Hospital, Leeds, UK
| |
Collapse
|
2
|
Farris MK, Razavian NB, Hughes RT, Ververs JD, Snavely AC, Leyrer CM, Tye KE, Allen LF, Pacholke HD, Weaver KE, Bunch PM, Chan MD, Clark H, Puthoff G, Farris JC, Steber CR, Wentworth S, Levine BJ, Nightingale CL, Ponnatapura J. Bridging the Communication Gaps: A Prospective Single-Arm Pilot Study Testing the Feasibility of Interdisciplinary Radiotherapy Planning in Locally Advanced Lung Cancer. Acad Radiol 2023; 30:2566-2573. [PMID: 36759296 PMCID: PMC10404636 DOI: 10.1016/j.acra.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/05/2023] [Accepted: 01/15/2023] [Indexed: 02/09/2023]
Abstract
RATIONALE AND OBJECTIVES The treatment of locally advanced lung cancer (LALC) with radiotherapy (RT) can be challenging. Multidisciplinary collaboration between radiologists and radiation oncologists (ROs) may optimize RT planning, reduce uncertainty in follow-up imaging interpretation, and improve outcomes. MATERIALS AND METHODS In this prospective clinical treatment trial (clinicaltrials.gov NCT04844736), 37 patients receiving definitive RT for LALC, six attending ROs, and three thoracic radiologists were consented and enrolled across four treatment centers. Prior to RT plan finalization, representative computed tomography (CT) slices with overlaid outlines of preliminary irradiation targets were shared with the team of radiologists. The primary endpoint was to assess feasibility of receiving feedback no later than 4 business days of RT simulation on at least 50% of plans. RESULTS Thirty-seven patients with lung cancer were enrolled, and 35 of 37 RT plans were reviewed. Of the 35 patients reviewed, mean age was 69 years. For 27 of 37 plans (73%), feedback was received within 4 or fewer days (interquartile range 3-4 days). Thirteen of 35 cases (37%) received feedback that the delineated target potentially did not include all sites suspicious for tumor involvement. In total, changes to the RT plan were recommended for over- or undercoverage in 16 of 35 cases (46%) and implemented in all cases. Radiology review resulted in no treatment delays and substantial changes to irradiated volumes: gross tumor volume, -1.9 to +96.1%; planning target volume, -37.5 to +116.5%. CONCLUSION Interdisciplinary collaborative RT planning using a simplified workflow was feasible, produced no treatment delays, and prompted substantial changes in RT targets.
Collapse
Affiliation(s)
- Michael K Farris
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157.
| | - Niema B Razavian
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Ryan T Hughes
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - James D Ververs
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Anna C Snavely
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Charles M Leyrer
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Karen E Tye
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Laura F Allen
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Heather D Pacholke
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Kathryn E Weaver
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Paul M Bunch
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Michael D Chan
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Hollins Clark
- Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Gregory Puthoff
- Department of Radiology, Medical University of South Carolina, Charleston, South Carolina
| | - Joshua C Farris
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Cole R Steber
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Stacy Wentworth
- Department of Radiation Oncology, Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157
| | - Beverly J Levine
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Chandylen L Nightingale
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | |
Collapse
|
3
|
Rajeev-Kumar G, Manjunath R, Hasan Y. Radiation Oncology Resident Evaluations: Current Methods and Resident Perceptions. Adv Radiat Oncol 2023; 8:101230. [PMID: 37179902 PMCID: PMC10172714 DOI: 10.1016/j.adro.2023.101230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose This study analyzes assessments within radiation oncology (RO) to determine characteristics of existing assessment methods and then report resident perceptions of these methods. We hypothesize familiarity with evaluation methods is predictive of the perceived utility of evaluations and behavioral changes. Methods and materials This study was conducted in 2 phases. Phase 1 involved requesting resident evaluation forms from RO residency programs to assess the Accreditation Council for Graduate Medical Education 6 Core Competencies. Analysis of variance was used to determine any significant differences between institutions or categories of questions. In phase 2, RO residents were surveyed about familiarity with the Accreditation Council for Graduate Medical Education Milestones and their perceptions about the current methods. Responses to questions were further analyzed using linear regression models. Results In phase 1, forms were obtained from 13 institutions, and they were based on the 6 Core Competencies with an average of 19 questions (standard deviation, 11; range, 5-47) in total. Analysis of variance did not show significant variation in the number of questions between the categories (F = 0.78, P = .6). A significant difference in the mean number of questions used for assessing each of the competencies was found between institutions (F = 6.6, P < .01). In phase 2, a majority of surveyed residents reported being "not" or only "slightly familiar" with the competencies (59.6%) and the factors used to assess them (73.1%). Resident-reported familiarity with the evaluation methods was not found to be a significant predictor of likelihood of changing postevaluation (coefficient = 0.41, P = .204), intimidation from receiving evaluations (coefficient = -0.06, P = .792), stress of receiving evaluations (coefficient = -0.11, P = .62), or usefulness of evaluations (coefficient = -0.02, P = .83). Conclusions Familiarity with evaluation methods is not correlated with perceptions or behavioral changes necessitating further investigation of alternative predictor variables. Despite the low familiarity with evaluation tools, most residents reported that evaluations were useful and likely to elicit changes in their behaviors and practice, highlighting the value of current evaluation methods.
Collapse
|
4
|
Ayesa SL, Katelaris AG, Brennan PC, Grieve SM. Medical imaging education opportunities for junior doctors and non-radiologist clinicians: A review. J Med Imaging Radiat Oncol 2021; 65:710-718. [PMID: 34180148 DOI: 10.1111/1754-9485.13266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Abstract
Medical imaging plays a critical role in clinical decision-making across disciplines, and as such, there is frequent need for non-radiologist clinicians to interact with medical imaging. This review examines the literature about the delivery of medical imaging education to non-radiologist clinicians, spanning junior doctors, advanced trainees and specialists. Knowledge of medical imaging among non-radiologist clinicians is paramount to the quality of patient care, with calls for formal implementation of radiology education into non-imaging specialty training programmes. Overall, there is a demand across non-imaging disciplines for greater formalised medical imaging education. Concerns are raised that too great a reliance on informal methods of teaching radiology, for example in ward settings, results in greater variation in the quality and volume of educational opportunities and risks the perpetuation of erroneous attitudes and practices. The evolution of the medical imaging workplace and increasing utilisation of remote reporting has distanced the collaborative relationship between radiologists and their non-imaging colleagues, diminishing opportunities for ad hoc learning and engagement in larger formalised educational collaborations. Ideally, radiologists should be directly involved in the development and delivery of medical imaging education to post-graduate doctors to not only benefit patient care but also foster inter-specialty relationships and respect. Evidence supports the value of structured radiological teaching opportunities, including tutorials, lectures and electronic resources, in improving medical imaging skills among non-radiologist clinicians. There is wide scope for growth in the e-learning arena to address this demand for quality and accessible imaging education for our non-radiology colleagues.
Collapse
Affiliation(s)
- Sally L Ayesa
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Department of Radiology & Nuclear Medicine, Gosford & Wyong Hospitals, Gosford, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Annette G Katelaris
- Faculty of Medicine and Health, University of NSW, New South Wales, Australia
| | - Patrick C Brennan
- School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Stuart M Grieve
- Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,Department of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| |
Collapse
|
5
|
An Analysis of the Residents' Research, Education, and Wellness Resources in Radiation Oncology Residency Programs in the United States. Adv Radiat Oncol 2021; 6:100548. [PMID: 33490723 PMCID: PMC7807139 DOI: 10.1016/j.adro.2020.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/20/2020] [Accepted: 08/12/2020] [Indexed: 11/22/2022] Open
Abstract
The purpose of this research was to evaluate the variations in research, education, and wellness resources for residents among radiation oncology (RO) residency programs across the United States. A list of accredited programs for the academic year 2018 to 2019 was collected using the Accreditation Council for Graduate Medical Education website. Individual residency program websites were used as the primary source of the data, and the Fellowship Residency Electronic Interactive Data Access System website complemented any missing data. We collected data on dedicated research time, resident rotations, wellness resources, and salary information. Excel 2013 was used for analysis. Information from the 94 Accreditation Council for Graduate Medical Education accredited RO residency programs during the academic year 2018 to 2019 was collected. Seventy-five (80%) programs reported the duration of dedicated research time on their websites. At least 6 months are allowed in 48 (51%) programs, and 27 (29%) programs report that dedicated research time is negotiable. Outstandingly, 20 (21%) programs allow 1 year of dedicated research time, and the median dedicated research time is 9 months. From our study, only 13 (14%) residency programs allow residents to rotate in other departments of the same institution. Fifty-nine (63%) programs allow away rotations at other institutions (external electives). An international rotation is permitted only in 19 (20%) programs. Wellness resoursces specifically fatigue managment, resident retreat and resident mentoring programs were available in 53%, 26% and 42% of programs, respectively. The salary information is obtainable for 63 institutions, and the yearly compensation ranges between $51,000 and $78,000. Moonlighting is allowed only in 28 (30%) programs. Our study found that major variations exist among RO residency programs in the United States regarding research, education, and wellness resources for residents.
Collapse
|
6
|
Walls GM, Hanna GG, McAleer JJ. Learning radiotherapy: the state of the art. BMC MEDICAL EDUCATION 2020; 20:150. [PMID: 32393250 PMCID: PMC7216702 DOI: 10.1186/s12909-020-02054-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The last two decades have seen revolutionary developments in both radiotherapy technology and postgraduate medical training. Trainees are expected to attain competencies using a mix of experiential learning, formal postgraduate teaching, self-directed learning and peer education. Radiation (Clinical) Oncology is a recognised 'craft specialty' where the apprenticeship model of training is applicable. This scoping review examines the evidence in relation to how medical trainees learn radiotherapy. METHODS A systematic search of MEDINE and EMBASE was undertaken to identify studies of trainee and/or trainer experience of radiotherapy learning published 1999-2018. Results pertaining to Medical Oncology, workforce trends, undergraduate radiotherapy exposure, academic training, global health, non-medical staff, health service infrastructure and recruitment to training programmes were not included. RESULTS A total of 146 publications were included in the synthesis. Five themes were apparent through careful iterative analysis representing broadly inter-related issues. Most articles studied radiotherapy training from the perspective of the trainee doctor. Most literature reports results of observational, local or national surveys with a tightly defined scope. Considerable variation exists within hospitals, within countries, over time and between different curricular areas. CONCLUSIONS Medical education has not kept pace with changes in the field of radiotherapy and large differences are demonstrated in experience between trainees in different hospitals, countries and training stages. Interpersonal relationships, departmental organisation, and national curricula impact on training quality. Qualitative and quantitative research examining modern radiotherapy learning has been uncommon and uncoordinated, until recently. To date no single study has been designed to comprehensively assess a department's training scheme.
Collapse
Affiliation(s)
- Gerard M Walls
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, Northern Ireland.
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland.
| | - Gerard G Hanna
- Patrick G Johnston Centre for Cancer Research, Queen's University Belfast, Belfast, Northern Ireland
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - James J McAleer
- Cancer Centre Belfast City Hospital, Belfast Health & Social Care Trust, Belfast, Northern Ireland
- Centre for Medical Education, Queen's University Belfast, Belfast, Northern Ireland
| |
Collapse
|