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Sandhu NK, Rahimy E, Hutten R, Shukla U, Rajkumar-Calkins A, Miller JA, Von Eyben R, Deig CR, Obeid JP, Jimenez RB, Fields EC, Pollom EL, Kahn JM. Radiation Oncology Virtual Education Rotation (ROVER) 2.0 for Residents: Implementation and Outcomes. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:977-984. [PMID: 36083458 PMCID: PMC9461407 DOI: 10.1007/s13187-022-02216-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/21/2022] [Indexed: 06/02/2023]
Abstract
The COVID-19 pandemic catalyzed the integration of a virtual education curriculum to support radiation oncologists in training. We report outcomes from Radiation Oncology Virtual Education Rotation (ROVER) 2.0, a supplementary virtual educational curriculum created for radiation oncology residents globally. A prospective cohort of residents completed surveys before and after the live virtual webinar sessions (pre- and post-surveys, respectively). Live sessions were structured as complex gray-zone cases across various core disease sites. Resident demographics and responses were summarized using means, standard deviations, and proportions. Nine ROVER sessions were held from October 2020 to June 2021. A total of 1487 registered residents completed the pre-survey, of which 786 attended the live case discussion and 223 completed post-surveys. A total of 479 unique radiation oncology residents (of which 95, n = 19.8%, were international attendees) from 147 institutions (national, n = 81, 55.1%; international, n = 66, 44.9%) participated in the sessions. There was similar participation across post-graduate year (PGY) 2 through 5 (range n = 86 to n = 105). Of the 122 unique resident post-surveys, nearly all reported learning through the virtual structure as "very easy" or "easy" (97.5%, n = 119). A majority rated the ROVER 2.0 educational sessions to be "valuable or "very valuable" (99.2%, n = 121), and the panelists-attendee interaction as "appropriate" (97.5%, n = 119). Virtual live didactics aimed at radiation oncology residents are feasible. These results suggest that the adoption of the ROVER 2.0 curricula may help improve radiation oncology resident education.
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Affiliation(s)
- Navjot K. Sandhu
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Elham Rahimy
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Ryan Hutten
- Department of Radiation Oncology, University of Utah School of Medicine, Salt Lake City, UT USA
| | - Utkarsh Shukla
- Department of Radiation Oncology, Tufts Medical Center, Boston, MA USA
| | - Anne Rajkumar-Calkins
- Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, TN USA
| | - Jacob A. Miller
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Rie Von Eyben
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Christopher R. Deig
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239 USA
| | - Jean-Pierre Obeid
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Rachel B. Jimenez
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA USA
| | - Emma C. Fields
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA USA
| | - Erqi L. Pollom
- Department of Radiation Oncology, Stanford School of Medicine, 875 Blake Wilbur Drive, Stanford, CA 94305 USA
| | - Jenna M. Kahn
- Department of Radiation Medicine, Oregon Health & Science University, Portland, OR 97239 USA
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Dizendorf E, Sturdza A, Tagliaferri L, Russo L, Nesvacil N, Kirisits C. Implementation of online workshops on image-guided adaptive brachytherapy (interventional radiotherapy) in locally advanced cervical cancer: Experience of BrachyAcademy. Brachytherapy 2023; 22:343-351. [PMID: 36828765 DOI: 10.1016/j.brachy.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/17/2023] [Accepted: 01/21/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To provide educational support to brachytherapy users during the COVID-19 pandemic, online workshops were developed and implemented by BrachyAcademy, non-profit peer-to-peer educational initiative in Elekta. METHODS AND MATERIALS In 2021-2022 two online workshops were organized. Participating teams had to send a clinical case of locally advanced cervical cancer (LACC) including brachytherapy Digital Imaging and Communications in Medicine (DICOM) files and questions to the faculty. During the workshop, feedback was given to each clinical case by five faculty members (two Radiation Oncologists, one Radiologist, two Medical Physicists). Participants competed a post-workshop questionnaire which included combination of qualitative and quantitative questions via yes/no responses, Likert scale, and 1 to 10 scale. RESULTS Twenty-one teams from eight countries (Europe, Asia, Latin America) participated in two online workshops. The total number of participants was 49. The clinical cases represented LACC with The International Federation of Gynecology and Obstetrics (FIGO) stages from IB3 to IVA. During both, Workshop1 (W1) and Workshop 2 (W2) the following areas of improvement were identified: familiarity with the GEC ESTRO and The International Commission on Radiation Units & Measurements, Report 89 (ICRU 89) recommendations for contouring and planning based on clinical drawings and MRI sequencing choice; appropriate applicator selection; experience with interstitial needles; appropriate applicator reconstruction; dose optimization. The participants rated both workshops with overall scores 8,3 for W1, and 8,5 for W2. In 82% participants the training course fully met expectations for W1, and in 76% in W2. CONCLUSIONS We successfully implemented the online workshops on image-guided adaptive brachytherapy (IGABT) in LACC. Main performance issues and areas for improvement were identified based on multidisciplinary discussion of participant's clinical cases through all steps of the brachytherapy procedure. We encourage teams to consider online workshops in addition to hands-on training.
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Affiliation(s)
- Elena Dizendorf
- Nucletron Operations B.V. (Elekta), Veenendaal, The Netherlands
| | - Alina Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
| | - Luca Tagliaferri
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Luca Russo
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Nicole Nesvacil
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Christian Kirisits
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
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Eriksen JG, Boldrini L, Gershkevitsh E, Guckenberger M, van der Heide U, Heijmen B, Joiner M, Nout R, Pruschy M, Rasch C, Tan LT, Verellen D, Vozenin MC, Palmu M, La Porta L, Gasparotto C. Postgraduate education in radiation oncology during the COVID-19 pandemic - What did we learn? Tech Innov Patient Support Radiat Oncol 2022; 24:73-77. [PMID: 36247369 PMCID: PMC9554011 DOI: 10.1016/j.tipsro.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction During the COVID-19 pandemic the ESTRO School who provides international non-profit postgraduate education in Radiation Oncology and related disciplines, including Medical Physics and Radiation Technology, had to close down all live educational activities and turn online, although having only limited experience. The paper describes the experience, discusses the limitations and benefits of online education and suggests directions for the future. Materials and methods Data about format and feedback from attendees and faculty members from the course activities held in 2019, 2020 and 2021 were made available from the ESTRO School. Results In 2020, all but two out of thirty live courses that happened before the lockdown were canceled. Among the 18 courses scheduled in the second half of the year, seven went online with a short notice. Each course planned their activities quite differently, from compressed courses with consecutive full days online program to courses over several weeks with a few hours online a week. Both numbers of participants and different nationalities were higher than live courses in 2019 for the seven courses happening online, and courses were well evaluated by participants and faculties. Roughly-one-third of participants would prefer online courses in the future. Discussion Although online education was well received by the majority, pros and cons exist and especially the personal discussions and networking were missed. Online education and live education are not comparable but can complement each other. Careful balancing these activities in the future is important and strategies for online andragogy are needed.
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Affiliation(s)
- Jesper Grau Eriksen
- Corresponding author at: Dept of Experimental Clinical Oncology, Aarhus University Hospital, C108, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus, Denmark.
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Campbell SR, Castillo R, Lalani N, Ingledew PA. COVID-19 Effects on Medical Education: A Viral Transfer of Knowledge to Radiation Oncology. Int J Radiat Oncol Biol Phys 2022; 113:705-713. [PMID: 35772437 PMCID: PMC9236201 DOI: 10.1016/j.ijrobp.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Richard Castillo
- Department of Radiation Oncology, Emory University, Atlanta, Georgia
| | - Nafisha Lalani
- Department of Radiation Oncology, University of Ottawa, Ottawa, Ontario, Canada
| | - Paris-Ann Ingledew
- Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
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Fields EC, Kahn JM, Singer L. Education in gynecological brachytherapy. Int J Gynecol Cancer 2022; 32:407-413. [DOI: 10.1136/ijgc-2021-002516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/02/2021] [Indexed: 11/03/2022] Open
Abstract
Brachytherapy is an essential component in the curative treatment of many gynecological malignancies. In the past decade, advances in magnetic resonance imaging and the ability to adapt and customize treatment with hybrid interstitial applicators have led to improved clinical outcomes with decreased toxicity. Unfortunately, there has been a shift in clinical practice away from the use of brachytherapy in the United States. The decline in brachytherapy is multifactorial, but includes both a lack of exposure to clinical cases and an absence of standardized brachytherapy training for residents. In other medical specialties, a clear relationship has been established between clinical case volumes and patient outcomes, especially for procedural-based medicine. In surgical residencies, simulation-based medical education (SBME) is a required component of the program to allow for some autonomy before operating on a patient. Within radiation oncology, there is limited but growing experience with SBME for training residents and faculty in gynecological brachytherapy. This review includes single institutional, multi-institutional and national initiatives using creative strategies to teach the components of gynecological brachytherapy. These efforts have measured success in various forms; the majority serve to improve the confidence of the learners, and many have also demonstrated improved competence from the training as well. The American Brachytherapy Society launched the 300 in 10 initiative in 2020 with a plan of training 30 competent brachytherapists per year over a 10 year period and has made great strides with a formal mentorship program as well as externships available to senior residents interested in starting brachytherapy programs. Moving forward, these curricula could be expanded to provide standardized brachytherapy training for all residents. SBME could also play a role in initial certification and maintenance of certification. Given the burden of disease, it would be valuable to develop similar training for providers in low and middle income countries.
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Lu DJ, Atkins KM, Small W, Kamrava M. Evaluation of sociodemographic and baseline patient characteristic differences in cervical cancer patients treated with either external beam or brachytherapy boost. Brachytherapy 2021; 21:22-28. [PMID: 34895839 DOI: 10.1016/j.brachy.2021.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/22/2021] [Accepted: 10/05/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Chemoradiation is considered the standard of care for locally advanced cervical cancer. While brachytherapy (BT) boost is associated with improved survival and less toxicity compared to external beam radiation therapy (EBRT) boost, it is unclear why many patients do not receive a BT boost. In this study, we compared sociodemographic and baseline patient characteristics between patients receiving EBRT boost versus BT boost. METHODS We analyzed patients in the National Cancer Database diagnosed between 2004 and 2016 with FIGO stage IIB-IVA cervical cancer treated with nonpalliative doses of chemoradiation. Logistic regression analysis was utilized to evaluate BT utilization over time and by other clinicopathological and sociodemographic factors. RESULTS Overall, 5764 patients were evaluated, of which 4937 (86%) underwent BT boost. Using multivariable logistic regression, higher FIGO stage was a significant predictor for utilization of EBRT versus BT boost, with odds ratio 2.92 (95% confidence interval [CI] 2.04-4.16; p < 0.001), 2.68 (95%CI 2.22-3.24; p < 0.001), and 4.51 (95%CI 3.05-6.67; p < 0.001) for IIIA, IIIB, and IVA, respectively, compared to IIB. Increased utilization of EBRT boost was also associated with community cancer facility types, lower income (based on zip code), earlier year of diagnosis, and higher comorbidity score. CONCLUSIONS In FIGO stage IIB-IVA cervical cancer patients treated with nonpalliative doses of chemoradiation, overall utilization of BT is 86%. Higher FIGO stage, community cancer facilities, lower income, earlier year of diagnosis, and higher comorbidity score were significant predictors of EBRT boost utilization. Future studies are needed to better understand reasons for this as higher FIGO stage patients are the mostly likely to benefit from a BT boost.
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Affiliation(s)
- Diana J Lu
- Cedars-Sinai Medical Center, Department of Radiation Oncology, Los Angeles, CA.
| | - Katelyn M Atkins
- Cedars-Sinai Medical Center, Department of Radiation Oncology, Los Angeles, CA
| | - William Small
- Loyola University Chicago, Stritch School of Medicine, Department of Radiation Oncology, Cardinal Bernardin Cancer Center, Maywood, IL
| | - Mitchell Kamrava
- Cedars-Sinai Medical Center, Department of Radiation Oncology, Los Angeles, CA
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