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Albert FA, Seidu AA, Mason HM, Anderson E, Alele FO, Heggarty P, Hollins A, Gupta TS, Hays RB, McArthur L, Malau-Aduli BS. A systematic review of medical practitioners' retention and application of basic sciences to clinical practice. BMC MEDICAL EDUCATION 2024; 24:997. [PMID: 39272053 PMCID: PMC11396528 DOI: 10.1186/s12909-024-05952-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 08/23/2024] [Indexed: 09/15/2024]
Abstract
BACKGROUND Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors. METHODS A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies. RESULTS A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of 'encapsulated knowledge' demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice. CONCLUSION Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review's findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.
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Affiliation(s)
- Francis A Albert
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Abdul-Aziz Seidu
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Hannah M Mason
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Emma Anderson
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Faith O Alele
- School of Health, University of the Sunshine Coast, Sippy Downs, QLD, 4556, Australia
| | - Paula Heggarty
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Aaron Hollins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Tarun Sen Gupta
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Richard B Hays
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia
| | - Lawrie McArthur
- Adelaide Rural Clinical School, University of Adelaide, Adelaide, SA, 5606, Australia
| | - Bunmi S Malau-Aduli
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, 4811, Australia.
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW, 2308, Australia.
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Koppes DM, Triepels CPR, Notten KJB, Smeets CFA, Kruitwagen RFPM, Van Gorp T, Scheele F, Van Kuijk SMJ. The Level of Anatomical Knowledge, Hard to Establish: a Systematic Narrative Review. MEDICAL SCIENCE EDUCATOR 2022; 32:569-581. [PMID: 35528299 PMCID: PMC9054958 DOI: 10.1007/s40670-022-01509-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This literature review aimed to gain more insight into the level of anatomical knowledge based on published measurements among medical students, residents, fellows, and specialists. METHODS We performed an extensive literature search in three online databases: Medline (using PubMed), Web of Science, and Education Resources Information Centre (ERIC). RESULTS A total of 30 relevant studies were found. In these studies, participants took different anatomy tests, and their mean/median scaled scores range from 22.5 to 82.4% on a 0 to 100% scale. CONCLUSION This review provides an overview of what is known about measured anatomical knowledge. After critically reviewing the literature, we have to conclude that the existing literature confirms that anatomical knowledge is hard to establish, mainly due to the lack of standardisation.Further research should focus on ways to define and assess 'desired anatomical knowledge' in different contexts. In a next phase, we can discuss if anatomical knowledge is lacking and if interventions are needed.
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Affiliation(s)
- Dorothea Maria Koppes
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
- Present Address: GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Charlotte Petronella Robertus Triepels
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
- Present Address: GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Carlijn Franscisca Anna Smeets
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Rutgerus Franciscus Petrus Maria Kruitwagen
- Department of Obstetrics and Gynaecology, Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
- Present Address: GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Toon Van Gorp
- Department of Obstetrics and Gynaecology, Leuven University Medical Centre, Leuven, Belgium
| | - Fedde Scheele
- Department of Obstetrics and Gynaecology/Medical Education, OLVG Hospital, Amsterdam, The Netherlands
- Department of Medical Education, VU University Medical Centre, Amsterdam, The Netherlands
- Athena Institute for Trans-Disciplinary Research, VU University, Amsterdam, The Netherlands
| | - Sander Martijn Job Van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+, Maastricht, The Netherlands
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Streith L, Cadili L, Wiseman SM. Evolving anatomy education strategies for surgical residents: A scoping review. Am J Surg 2022; 224:681-693. [PMID: 35180995 DOI: 10.1016/j.amjsurg.2022.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Dedicated anatomy educational time in medical schools has decreased significantly, disproportionately affecting surgical residents. In this scoping review, we aim to consolidate existing evidence, describe ongoing research, and highlight future directions for surgical anatomy education. METHODS Two independent investigators searched MEDLINE, EMBASE, and the Cochrane library, for educational interventions targeting anatomy knowledge in surgical residents. English articles until October 28, 2021, were reviewed. RESULTS 1135 abstracts were considered, and 59 (5.2%) included. Agreement on inclusion was excellent (k = 0.90). The majority were single-cohort studies (53%) and prospective cohort studies (17%). The most common disciplines were General Surgery (17%) and Obstetrics and Gynecology (17%). DISCUSSION Cadavers consistently produce positive knowledge gains and are heavily favored by residents. They remain the educational method to which new educational models are compared. New technologies do not yet match cadaver fidelity. Research showing knowledge translation from cadaver labs to patient outcomes remains limited.
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Affiliation(s)
- Lucas Streith
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada
| | - Lina Cadili
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital & University of British Columbia, C303-1081 Burrard Street, Vancouver, Canada.
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Roy A, Andruska N, Orlowski HL, Pipkorn P, Daly MD. The Novel Use of a Commercially Available Video-Conference Platform to Facilitate Multidisciplinary Target Volume Review and Delineation for Skull-Base Radiation Therapy During the Coronavirus Disease 2019 Pandemic. Adv Radiat Oncol 2021; 6:100598. [PMID: 33521392 PMCID: PMC7833513 DOI: 10.1016/j.adro.2020.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/05/2020] [Accepted: 10/13/2020] [Indexed: 12/25/2022] Open
Abstract
Multidisciplinary involvement in radiation therapy (RT) treatment planning is currently underused. A radiation oncologist sought input for generating target contours from a neuro-radiologist (NR) and otolaryngologist (OL) for 3 patients requiring skull-base RT during the coronavirus disease 2019 pandemic. A Health Insurance Portability and Accountability Act compliant virtual meeting between the radiation oncologist, NR, and OL was arranged. Involvement of the OL and NR led to significant changes in the clinical target volume for all patients. Our experience highlights the feasibility of using commercially available video-conference platforms for multidisciplinary target volume delineation for complex RT cases. Further applications include interdisciplinary contour review for RT cases requiring special expertise and joint attending/resident physician contour review for resident education. The video-conference platform technology has demonstrated benefit during the coronavirus disease 2019 pandemic, and we believe it will remain an integral component of our field moving forward.
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Affiliation(s)
- Amit Roy
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri
| | - Neal Andruska
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri
| | - Hilary L.P. Orlowski
- Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Patrik Pipkorn
- Department of Otolaryngology, Washington University School of Medicine, St Louis, Missouri
| | - Mackenzie D. Daly
- Department of Radiation Oncology, Washington University School of Medicine, St Louis, Missouri
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Price JG, Spiegel DY, Yoo DS, Moravan MJ, Mowery YM, Niedzwiecki D, Brizel DM, Salama JK. Development and Implementation of an Educational Simulation Workshop in Fiberoptic Laryngoscopy for Radiation Oncology Residents. Int J Radiat Oncol Biol Phys 2020; 108:615-619. [PMID: 32417408 DOI: 10.1016/j.ijrobp.2020.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/23/2020] [Accepted: 05/06/2020] [Indexed: 02/01/2023]
Abstract
PURPOSE Fiberoptic laryngoscopy (FOL) is a critical tool for the diagnosis, staging, assessment of treatment response, and detection of recurrence for head and neck (H&N) malignancies. No standardized recommendations exist for procedural FOL education in radiation oncology. We therefore implemented a pilot simulation workshop to train radiation oncology residents in pertinent H&N anatomy and FOL technique. METHODS AND MATERIALS A 2-phase workshop and simulation session was designed. Residents initially received a lecture on H&N anatomy and the logistics of the FOL examination. Subsequently, residents had a practical session in which they performed FOL in 2 simulated environments: a computerized FOL program and mannequin-based practice. Site-specific attending physicians were present to provide real-time guidance and education. Pre- and postworkshop surveys were administered to the participants to determine the impact of the workshop. Subsequently, postgraduate year (PGY)-2 residents were required to complete 6 supervised FOL examinations in clinic and were provided immediate feedback. RESULTS Annual workshops were performed in 2017 to 2019. The survey completion rate was 14 of 18 (78%). Participants ranged from fourth-year medical students to PGY-2 to PGY-5 residents. All PGY-2 residents completed their 6 supervised FOL examinations. On a 5-point Likert scale, mean H&N anatomy knowledge increased from 2.4 to 3.7 (standard deviation = 0.6, P < .0001). Similarly, mean FOL procedural skill confidence increased from 2.2 to 3.3 (standard deviation = 0.7, P < .0001). These effects were limited to novice (fourth-year medical students to PGY-2) participants. All participants found the exercise clinically informative. CONCLUSIONS A simulation-based workshop for teaching FOL procedural skills increased confidence and procedural expertise of new radiation oncology residents and translated directly to supervised clinical encounters. Adoption of this type of program may help to improve resident training in H&N cancer.
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Affiliation(s)
- Jeremy G Price
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina.
| | | | - David S Yoo
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Michael J Moravan
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina
| | - Yvonne M Mowery
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina
| | - Donna Niedzwiecki
- Department of Biostatistics, Duke University School of Medicine, Durham, North Carolina
| | - David M Brizel
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Department of Head and Neck Surgery and Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Joseph K Salama
- Department of Radiation Oncology, Duke University School of Medicine, Durham, North Carolina; Durham VA Health Care System, Durham, North Carolina
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Matalon SA, Howard SA, Abrams MJ. Assessment of Radiology Training During Radiation Oncology Residency. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:691-695. [PMID: 29623563 DOI: 10.1007/s13187-018-1357-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
A strong foundation in diagnostic imaging is essential to the practice of radiation oncology. This study evaluated radiology training in radiation oncology residency. An online survey was distributed to current radiation oncology residents in the USA by e-mail in 2017. Responses were summarized using frequency and percentages and compared with chi-square test and Spearman's rank correlation when appropriate. One hundred five residents completed the survey. Although most residents felt that a strong knowledge base in diagnostic radiology was moderately or extremely important (87%, n = 90/104), the majority were only somewhat confident in their radiology skills (61%, n = 63/104) and were only somewhat, minimally, or not at all satisfied with their training (79%, n = 81/103). Although there was an association between increasing post-graduate training and confidence level (p = 0.01062, ρ = 0.24959), the majority of graduating residents feel only somewhat confident in radiology skills (63%, n = 12/19). Residents were most commonly exposed to radiology via multidisciplinary conferences (96%, n = 100/104), though only 15% (n = 16/104) of residents ranked these as the most beneficial component of their radiology training and 13% (n = 13/101) of residents felt these were the least beneficial. Most residents (60%, n = 63/105) believe there is a need for dedicated radiology training during residency, preferring monthly formal didactics (68%, n = 71/105) co-taught by a radiologist and radiation oncologist (58%, n = 61/105). Radiation oncology residents feel their radiology training is suboptimal, suggesting a need for more guidance and standardization of radiology curriculum. A preferred option may be monthly didactics co-taught by radiologists and radiation oncologists; however, future studies should assess the effectiveness of this model.
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Affiliation(s)
- Shanna A Matalon
- Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Stephanie A Howard
- Harvard Medical School, Boston, MA, USA
- Department of Imaging, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Matthew J Abrams
- Harvard Medical School, Boston, MA, USA.
- Department of Radiation Oncology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA.
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Juo YY, Hanna C, Chi Q, Chang G, Peacock WJ, Tillou A, Lewis CE. Mixed-Method Evaluation of a Cadaver Dissection Course for General Surgery Interns: An Innovative Approach for Filling the Gap Between Gross Anatomy and the Operating Room. JOURNAL OF SURGICAL EDUCATION 2018; 75:1526-1534. [PMID: 29674109 DOI: 10.1016/j.jsurg.2018.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/21/2018] [Accepted: 03/25/2018] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To evaluate an innovative whole cadaver dissection curriculum designed to focus on teaching procedure-relevant anatomy and surgical skills to surgery interns. DESIGN A mixed methods explanatory sequential design incorporating both quantitative and qualitative evaluations was used to evaluate the cadaver dissection course. Quantitative data were prospectively collected and retrospectively reviewed in order to compare anatomy knowledge and operative skills before and after the course. In the qualitative phase, open-ended telephone interviews were conducted in order to explore the major strengths and weaknesses of the course and gain a more in-depth understanding of resident perceptions and attitudes toward the course. SETTING All UCLA categorical surgery interns who have undergone the cadaver dissection curriculum between the years 2010 to 2016 were recruited for evaluation and interview. PARTICIPANTS From 2010 to 2016, 6 to 7 categorical surgery interns were enrolled in the cadaver dissection course each year. RESULTS Anatomy practical examination scores increased following implementation of the course from 50.5% to 83.5% (p < 0.01). Faculty ratings of operative skills improved as well (average Likert scale rating for technical skills improved from 4.1 ± 0.4 to 4.4 ± 0.3, p = 0.06). Almost all interviewees (96%) reported that the course improved their knowledge of anatomy, and 78% of respondents believed the course was conducive to improving technical skills. CONCLUSIONS We believe that cadaver dissection courses offer a superior educational model for teaching clinically relevant anatomy as well as surgical skills. We found improvements in anatomy knowledge and technical skills, and trainees expressed strongly favorable views of the program.
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Affiliation(s)
- Yen-Yi Juo
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Christina Hanna
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Quach Chi
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Grace Chang
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Warwick J Peacock
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Areti Tillou
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California
| | - Catherine E Lewis
- Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, California.
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Gillespie EF, Panjwani N, Golden DW, Gunther J, Chapman TR, Brower JV, Kosztyla R, Larson G, Neppala P, Moiseenko V, Bykowski J, Sanghvi P, Murphy JD. Multi-institutional Randomized Trial Testing the Utility of an Interactive Three-dimensional Contouring Atlas Among Radiation Oncology Residents. Int J Radiat Oncol Biol Phys 2017; 98:547-554. [DOI: 10.1016/j.ijrobp.2016.11.050] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/22/2016] [Accepted: 11/27/2016] [Indexed: 12/27/2022]
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Program director and chief resident perspectives on the educational environment of US radiation oncology programs. Pract Radiat Oncol 2017; 7:e65-e70. [PMID: 27523441 DOI: 10.1016/j.prro.2016.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 05/26/2016] [Accepted: 06/01/2016] [Indexed: 11/21/2022]
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Labranche L, Johnson M, Palma D, D'Souza L, Jaswal J. Integrating anatomy training into radiation oncology residency: considerations for developing a multidisciplinary, interactive learning module for adult learners. ANATOMICAL SCIENCES EDUCATION 2015; 8:158-165. [PMID: 25045151 DOI: 10.1002/ase.1472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 04/18/2014] [Accepted: 06/03/2014] [Indexed: 06/03/2023]
Abstract
Radiation oncologists require an in-depth understanding of anatomical relationships for modern clinical practice, although most do not receive formal anatomy training during residency. To fulfill the need for instruction in relevant anatomy, a series of four multidisciplinary, interactive learning modules were developed for a cohort of radiation oncology and medical physics residents. Instructional design was based on established learning theories, with the intent of integrating knowledge of specific anatomical regions with radiology and radiation oncology practice. Each session included presentations by a radiologist and a radiation oncologist, as well as hands-on exploration of anatomical specimens with guidance from anatomists. Pre- and post-tests distributed during each session showed significant short-term knowledge retention. According to qualitative surveys and exit interviews, participants felt more comfort' with delineating structures, gross anatomy, and radiograph interpretation at the end of each session. Overall participant experience was positive, and the modules were considered effective for learning radiologic anatomy. Suggestions for future interventions include more time, increased clinical application, additional contouring practice and feedback, and improved coordination between each of the three disciplines. Results and conclusions from this study will be used to inform the design of a future multi-day national workshop for Canadian radiation oncology residents.
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Affiliation(s)
- Leah Labranche
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
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Evaluating the impact of a Canadian national anatomy and radiology contouring boot camp for radiation oncology residents. Int J Radiat Oncol Biol Phys 2015; 91:701-7. [PMID: 25596106 DOI: 10.1016/j.ijrobp.2014.11.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 11/06/2014] [Accepted: 11/10/2014] [Indexed: 11/20/2022]
Abstract
BACKGROUND Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course ("boot camp") designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach. METHODS The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing. RESULTS Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp more effective than educational sessions at their own institutions. All of the residents (100%) would recommend this course to others. CONCLUSIONS The ARC boot camp is an effective intervention for improving radiation oncology residents' knowledge and understanding of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring.
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Orsbon CP, Kaiser RS, Ross CF. Physician opinions about an anatomy core curriculum: a case for medical imaging and vertical integration. ANATOMICAL SCIENCES EDUCATION 2014; 7:251-61. [PMID: 24022941 DOI: 10.1002/ase.1401] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Revised: 08/03/2013] [Accepted: 08/06/2013] [Indexed: 05/20/2023]
Abstract
Pre-clinical anatomy curricula must provide medical students with the knowledge needed in a variety of medical and surgical specialties. But do physicians within specialties agree about what anatomical knowledge is most important in their practices? And, what is the common core of anatomical knowledge deemed essential by physicians in different specialties? Answers to these questions would be useful in designing pre-clinical anatomy courses. The primary aim of this study was to assess the importance of a human gross anatomy course by soliciting the opinions of physicians from a range of specialties. We surveyed 93 physicians to determine the importance of specific anatomical topics in their own practices. Their responses were analyzed to assess variation in intra- and inter-departmental attitudes toward the importance of anatomy. Nearly all of the topics taught in the course were deemed important by the clinicians as a group, but respondents showed little agreement on the rank order of importance of anatomical topics. Overall, only medical imaging received high importance by nearly all respondents, and lower importance was attached to embryology and lymphatic anatomy. Our survey data, however, also suggested distinct hierarchies in the importance assigned to anatomical topics within specialties. Given that physicians view the importance of anatomy differently, we suggest that students revisit anatomy through a vertically integrated curriculum tailored to provide specialty-specific anatomical training to advanced students based on their areas of clinical interest. Integration of medical imaging into pre-clinical anatomy courses, already underway in many medical schools, is of high clinical relevance.
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Affiliation(s)
- Courtney P Orsbon
- The University of Chicago Pritzker School of Medicine, Division of Biological Sciences, Chicago, llinois; Department of Organismal Biology and Anatomy, the University of Chicago, Chicago, Illinois
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D’Souza L, Jaswal J, Chan F, Johnson M, Tay KY, Fung K, Palma D. Evaluating the impact of an integrated multidisciplinary head & neck competency-based anatomy & radiology teaching approach in radiation oncology: a prospective cohort study. BMC MEDICAL EDUCATION 2014; 14:124. [PMID: 24969509 PMCID: PMC4102036 DOI: 10.1186/1472-6920-14-124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 06/19/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Modern radiation oncology demands a thorough understanding of gross and cross-sectional anatomy for diagnostic and therapeutic applications. Complex anatomic sites present challenges for learners and are not well-addressed in traditional postgraduate curricula. A multidisciplinary team (MDT) based head-and-neck gross and radiologic anatomy program for radiation oncology trainees was developed, piloted, and empirically assessed for efficacy and learning outcomes. METHODS Four site-specific MDT head-and-neck seminars were implemented, each involving a MDT delivering didactic and case-based instruction, supplemented by cadaveric presentations. There was no dedicated contouring instruction. Pre- and post-testing were performed to assess knowledge, and ability to apply knowledge to the clinical setting as defined by accuracy of contouring. Paired analyses of knowledge pretests and posttests were performed by Wilcoxon matched-pair signed-rank test. RESULTS Fifteen post-graduate trainees participated. A statistically significant (p < 0.001) mean absolute improvement of 4.6 points (17.03%) was observed between knowledge pretest and posttest scores. Contouring accuracy was analyzed quantitatively by comparing spatial overlap of participants' pretest and posttest contours with a gold standard through the dice similarity coefficient. A statistically significant improvement in contouring accuracy was observed for 3 out of 20 anatomical structures. Qualitative and quantitative feedback revealed that participants were more confident at contouring and were enthusiastic towards the seminars. CONCLUSIONS MDT seminars were associated with improved knowledge scores and resident satisfaction; however, increased gross and cross-sectional anatomic knowledge did not translate into improvements in contouring accuracy. Further research should evaluate the impact of hands-on contouring sessions in addition to dedicated instructional sessions to develop competencies.
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Affiliation(s)
- Leah D’Souza
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Jasbir Jaswal
- Division of Radiation Oncology, Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Francis Chan
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Marjorie Johnson
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Keng Yeow Tay
- Department of Medical Imaging, London Health Sciences Centre, Victoria Hospital, London, ON, Canada
| | - Kevin Fung
- Department of Otolaryngology - Head and Neck Surgery, London Health Sciences Centre - Victoria Hospital, London, ON, Canada
| | - David Palma
- London Regional Cancer Program, London, ON, Canada
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Lisk K, Flannery JF, Loh EY, Richardson D, Agur AMR, Woods NN. Determination of clinically relevant content for a musculoskeletal anatomy curriculum for physical medicine and rehabilitation residents. ANATOMICAL SCIENCES EDUCATION 2014; 7:135-43. [PMID: 23922307 DOI: 10.1002/ase.1393] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 06/07/2013] [Accepted: 06/30/2013] [Indexed: 05/20/2023]
Abstract
To address the need for more clinical anatomy training in residency education, many postgraduate programs have implemented structured anatomy courses into their curriculum. Consensus often does not exist on specific content and level of detail of the content that should be included in such curricula. This article describes the use of the Delphi method to identify clinically relevant content to incorporate in a musculoskeletal anatomy curriculum for Physical Medicine and Rehabilitation (PM&R) residents. A two round modified Delphi involving PM&R experts was used to establish the curricular content. The anatomical structures and clinical conditions presented to the expert group were compiled using multiple sources: clinical musculoskeletal anatomy cases from the PM&R residency program at the University of Toronto; consultation with PM&R experts; and textbooks. In each round, experts rated the importance of each curricular item to PM&R residency education using a five-point Likert scale. Internal consistency (Cronbach's alpha) was used to determine consensus at the end of each round and agreement scores were used as an outcome measure to determine the content to include in the curriculum. The overall internal consistency in both rounds was 0.99. A total of 37 physiatrists from across Canada participated and the overall response rate over two rounds was 97%. The initial curricular list consisted of 361 items. After the second iteration, the list was reduced by 44%. By using a national consensus method we were able to objectively determine the relevant anatomical structures and clinical musculoskeletal conditions important in daily PM&R practice.
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Affiliation(s)
- Kristina Lisk
- Graduate Department of Rehabilitation Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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15
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Chino J, Doyle S, Marks LB. The Anatomy of Radiation Oncology Residency Training. Int J Radiat Oncol Biol Phys 2014; 88:3-4. [DOI: 10.1016/j.ijrobp.2013.09.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 09/20/2013] [Accepted: 09/20/2013] [Indexed: 12/25/2022]
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16
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Radiation Oncology Medical Student Clerkship: Implementation and Evaluation of a Bi-institutional Pilot Curriculum. Int J Radiat Oncol Biol Phys 2014; 88:45-50. [DOI: 10.1016/j.ijrobp.2013.10.041] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/17/2013] [Accepted: 10/29/2013] [Indexed: 11/23/2022]
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17
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Defining Imaging Literacy in Radiation Oncology Interprofessionally: Toward a Competency Profile for Canadian Residency Programs. J Med Imaging Radiat Sci 2013; 44:150-156. [DOI: 10.1016/j.jmir.2013.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 02/24/2013] [Accepted: 03/12/2013] [Indexed: 11/21/2022]
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18
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RTOG 0529: Intensity Modulated Radiation Therapy and Anal Cancer, a Step in the Right Direction? Int J Radiat Oncol Biol Phys 2013; 86:8-10. [DOI: 10.1016/j.ijrobp.2013.01.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/24/2013] [Accepted: 01/30/2013] [Indexed: 12/22/2022]
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19
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Andolsek KM, Murphy G, Nagler A, Moore PR, Schlueter J, Weinerth JL, Cuffe MS, Dzau VJ. Fostering creativity: how the Duke Graduate Medical Education Quasi-Endowment encourages innovation in GME. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2013; 88:185-191. [PMID: 23269302 DOI: 10.1097/acm.0b013e31827c2b65] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The Duke Medicine Graduate Medical Education Quasi-Endowment, established in 2006, provides infrastructure support and encourages educational innovation. The authors describe Duke's experience with the "grassroots innovation" part of the fund, the Duke Innovation Fund, and discuss the Innovation Fund's processes for application, review, and implementation, and also outcomes, impact, and intended and unintended consequences.In the five years of the Innovation Fund described (2007-2011), 105 projects have been submitted, and 78 have been funded. Thirty-seven projects have been completed. Approved funding ranged from $2,363 to $348,750, with an average award of $66,391. This represents 42% of funding originally requested. Funding could be requested for a period of 6 months to 3 years. The average duration of projects was 27 months, with a range from 6 months to 36 months. Eighty percent of projects were completed on time. Two projects were closed because of lack of progress and failure to adhere to reporting requirements. Thirty-nine are ongoing.Program directors report great success in meeting project outcomes and concrete impacts on resident and faculty attitudes and performance. Ninety-two percent report that their projects would have never been accomplished without this funding. Projects have resulted in at least 68 posters, abstracts, and peer-reviewed presentations. At least 12 peer-reviewed manuscripts were published.There has been tremendous diversity of projects; all 13 clinical departments have been represented. Interdepartmental and intradepartmental program cooperation has increased. This modest seed money has resulted in demonstrable sustainable impacts on teaching and learning, and increased morale and scholarly recognition.
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Affiliation(s)
- Kathryn M Andolsek
- Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina, USA.
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Golden DW, Langer M. Education: the third, but not last, pillar of academic radiation oncology. Int J Radiat Oncol Biol Phys 2012; 83:1353-4. [PMID: 22768987 DOI: 10.1016/j.ijrobp.2012.03.039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 03/20/2012] [Accepted: 03/21/2012] [Indexed: 10/28/2022]
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