Impact of a Non-small Cell Lung Cancer Educational Program for Interdisciplinary Teams

The Effectiveness of mHealth and eHealth Tools in Improving Provider Knowledge, Confidence, and Behaviors Related to Cancer Detection, Treatment, and Survivorship Care: a Systematic Review

Mobile health (mHealth) and eHealth interventions have demonstrated potential to improve cancer care delivery and disease management by increasing access to health information and health management skills. However, there is a need to better understand the overall impact of these interventions in improving cancer care and to identify best practices to support intervention adoption. Overall, this review intended to systematically catalogue the recent body of cancer-based mHealth and eHealth education and training interventions and assess the effectiveness of these interventions in increasing health care professionals' knowledge, confidence, and behaviors related to the delivery of care along the cancer continuum. Our initial search yielded 135 articles, and our full review included 23 articles. We abstracted descriptive data for each of the 23 studies, including an overview of interventions (i.e., intended intervention recipients, location of delivery, topic of focus), study methods (i.e., design, sampling approach, sample size), and outcome measures. Almost all the studies reported knowledge gain as an outcome of the education interventions, whereas only half assessed provider confidence or behavior change. We conclude that there is some evidence that mHealth and eHealth interventions lead to improvements in cancer care delivery, but this is not a consistent finding across the studies reviewed. Our findings also identify gaps that should be addressed in future research, offer guidance on the utility of mHealth and eHealth interventions, and provide a roadmap for addressing these gaps.

Acceptability, Utility, and Cost of a Mobile Health Cancer Screening Education Application for Training Primary Care Physicians in India

PURPOSE

Mobile health (mHealth)-based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. We developed a mobile application (M-OncoED) to educate physicians on cancer screening and tested the acceptability, utility, and cost of two different approaches to recruit physicians.

METHODS

M-OncoED was designed to perform pre- and postlearning assessments through the in-built quizzes; present case studies and educational materials for cervical, breast, and oral cancer screening; collect responses to interactive queries; document module completion; send reminders and alerts; and track user metrics, including number of sessions to complete each module and time spent per session. We tested two recruitment approaches: a broad-scale recruitment group, for which we relied on e-mails, messaging apps (e.g., WhatsApp), and phone calls, and the targeted recruitment group, for which we conducted a face-to-face meeting for the initial invitation.

RESULTS

Overall, about 35% of those invited in the targeted group completed the course compared with about 3% in the broad-based recruitment group. The targeted recruitment approach was more cost-efficient ($55.33 vs. $109.43 per person). Cervical cancer screening knowledge increased by about 30 percentage points, and breast cancer screening knowledge increased by 10 percentage points. There was no change in knowledge for oral cancer scorings.

CONCLUSION

This study has demonstrated the feasibility and utility of using an mHealth app to educate physicians. A more intensive hands-on recruitment approach is likely required to engage physicians to download and complete the app. Future studies should assess the impact of mHealth tools on physician behavior and patient outcomes.

IMPLICATIONS FOR PRACTICE

Mobile health (mHealth)-based oncology education can be a powerful tool for providing cancer screening knowledge to physicians, as mobile technology is widely available and inexpensive. This study has demonstrated the feasibility and utility of using an mHealth app to educate physicians and illustrates the type of recruitment approach (face-to-face) that is likely required to incentivize physicians to download the app and complete the training.

Teamwork competencies for interprofessional cancer care in multiteam systems: A narrative synthesis

Numerous teamwork competency frameworks are designed for co-located, procedure-driven teams delivering care in acute settings. Little is known about their applicability or evaluation among larger teams-of-teams, known as multiteam systems (MTS), involved in delivering care for complex chronic conditions like cancer. In this review we aimed to identify studies examining teamwork competencies or teamwork competency frameworks developed or tested in healthcare teams, identify the extent to which they have been applied or evaluated in cancer care, and understand their applicability to larger MTSs involved in coordinating cancer care. We identified 107 relevant original articles, consensus statements, and prior systematic reviews published from 2013-2019. Most original papers (n = 96) were intervention studies of inpatient acute care teams (52, 54%). Fifty-eight articles (60%) used existing frameworks to define competency domains. Four original articles and two consensus statements addressed teamwork competencies for cancer care. Few frameworks or interprofessional education (IPE) curricula specifically addressed teamwork among larger, distributed teams or examined competencies necessary to overcome care coordination challenges in cancer care MTSs. Research guiding the development of frameworks and IPE that consider challenges to effective coordination among larger MTSs and studies of their impact on patient and clinical outcomes is essential to optimal, high-quality care.

Auditorium of the future: e learning platform

Principles of surgical training have not changed, but methods of training are evolving very fast. Online tools are being adopted in both knowledge and skills training for surgical residents. As a result, to evaluate the outcome of these tools, online assessment is also developing. Knowledge resources are very diverse ranging from lectures, webinars, surgical videos to three-dimensional planning and printing. Skills resources include virtual reality simulators, remote skills training and interdisciplinary teamwork. Assessment of E-learning tools can be performed using online questions, task-based simulations, branching scenarios and online interviews/discussions. In thoracic surgery, video assisted thoracic surgery (VATS) lobectomy simulator has been developed and it appears to be an important tool for minimally invasive thoracic surgery education. Training programs incorporate e-Learning in their curriculum and online training and assessment will become an important part of thoracic surgical training as well.

Higher Age Puts Lung Cancer Patients at Risk for Not Receiving Anti-cancer Treatment

PURPOSE

We aimed to determine the demographic and epidemiologic variables that are associated with no treatment in lung cancer patients.

Materials and Methods

Patient data were collected from the Korean National Health Insurance Database. The lung cancer group included patients with an initial diagnosis of lung cancer between January 2009 and December 2014. Treated cases were defined as those that underwent surgery, radiation, or chemotherapy until death, after the diagnosis of lung cancer. Risk of no treatment was calculated by multiple logistic regression analysis.

RESULTS

Among the 2148 new cases of lung cancer from 2009 to 2104, 612 (28.4%) were not treated. Risk of no treatment was higher in the following patients: patients in their 60s (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.75 to 1.84), 70s (OR, 3.64; 95% CI, 2.41 to 5.50), and >80 years old (OR, 16.55; 95% CI, 10.53 to 25.03) than those in their 50s; patients with previous myocardial infarction (OR, 2.07; 95% CI, 1.01 to 4.25) or chronic kidney disease (OR, 2.88; 95% CI, 1.57 to 5.30); and patients diagnosed at a non-referral hospital (OR, 1.40; 95% CI, 1.01 to 1.92) or primary care provider (OR, 1.81; 95% CI, 1.43 to 2.29) compared with referral hospital. Low-income patients receiving Medicaid were 1.75 times (95% CI, 1.14 to 2.68) more likely to forgo treatment than high-income patients (upper 20%). Risk was not associated with sex or the year in which the lung cancer was diagnosed.

CONCLUSION

Age predominantly determines whether patients with lung cancer undergo anti-cancer treatment.

Gamifying anatomy education

The objective of our research is to find out if gamification increases motivation for self-directed learning (SDL) of human anatomy among year 1 medical students, and more importantly, their academic grades (n = 120). At the NUS Yong Loo Lin School of Medicine, anatomy teaching has traditionally been delivered via didactic means. To encourage more active learning, suitable games (non-digital) and the script concordance test were utilized to enhance the process. The flipped classroom approach was also introduced to further trigger active learning. In addition, the use of mobile apps (digital) was also initiated as supplements for SDL. Feedback was collected based on the previously validated PRO-SDL scale. Results from the research yielded inconclusive evidence to support enhanced motivation among our students due to gamification (P > 0.05). However, it did help to encourage active participation for a "fun learning" experience supported by numerous positive comments. More importantly, the participant's continuous assessment (CA1, CA2, and CA3) and objective specific practical exam results were better than the cohort's average (P < 0.05), suggesting that enhanced meta-cognition, and factual recall had taken place. While it is positive, there are some caveats to note with gamification, first and foremost, that it is tutor dependent. Taken together, gamification could represent a new paradigm for anatomy education, and also an opportune time to change the prevailing culture in the healthcare and education industry. Clin. Anat. 31:997-1005, 2018. © 2018 Wiley Periodicals, Inc.