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Lawson McLean A, Lawson McLean AC. Integrating Shared Decision-Making into Undergraduate Oncology Education: A Pedagogical Framework. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:374-382. [PMID: 38448671 PMCID: PMC11219368 DOI: 10.1007/s13187-024-02419-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
The integration of shared decision-making (SDM) into undergraduate oncology education represents a critical evolution in medical pedagogy, reflecting the growing complexity and patient-centric focus of contemporary healthcare. This paper introduces a comprehensive pedagogical framework designed to embed SDM within the undergraduate medical curriculum, particularly in oncology, where the multiplicity of treatment options and their profound impact on patient life underscore the necessity of this approach. Grounded in a systematic literature review and aligned with established educational theories, this framework proposes twelve strategic approaches to cultivate future physicians proficient in both clinical acumen and patient-collaborative decision-making. The framework emphasizes real-world clinical experience, role-playing, case studies, and decision aids to deepen students' understanding of SDM. It advocates for the development of communication skills, ethical deliberation, and cultural competence, recognizing the multifaceted nature of patient care. The inclusion of patient narratives and evidence-based decision-making further enriches the curriculum, offering a holistic view of patient care. Additionally, the integration of digital tools within the SDM process acknowledges the evolving technological landscape in healthcare. The paper also addresses challenges in implementing this framework, such as curricular constraints and the need for educator training. It underscores the importance of continual evaluation and adaptation of these strategies to the dynamic field of medical education and practice. Overall, this comprehensive approach aims not only to enhance the quality of oncological care but also to prepare medical students for the complexities of modern medicine, where patient involvement in decision-making is both a necessity and an expectation.
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Affiliation(s)
- Aaron Lawson McLean
- Department of Neurosurgery, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Anna C Lawson McLean
- Department of Neurosurgery, Jena University Hospital - Friedrich Schiller University Jena, Am Klinikum 1, 07747, Jena, Germany
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Sport C, Yarden N, Fields EC. An Antidote to Decreasing Interest in Radiation Oncology: Earlier Engagement. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02478-x. [PMID: 39030375 DOI: 10.1007/s13187-024-02478-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/13/2024] [Indexed: 07/21/2024]
Abstract
PURPOSE In recent years, there has been a national decline in applicants to radiation oncology (RO) residencies, partly due to limited exposure to RO during medical school. Student Interest Groups (SIGs) give students early exposure to a variety of specialties. This study investigates the efficacy of a RO-SIG to increase knowledge and interest in the field. METHODOLOGY First and second-year medical students attending an RO-SIG event or shadowing experience completed surveys both prior and following participation. Students ranked their interest in oncology, in RO, and their perceived accessibility of mentors in oncology. Questions were rated on a Likert scale from 0 to 5 (5 highest, 0 lowest). The survey included one short response question about the understanding of the role of the RO, which was evaluated qualitatively. RESULTS 44 students (42 M1s, 2 M2s) completed the pre-survey and 18 (41%, 17 M1s, 1 M2) completed the post-survey. Of the 18 matched responses, interest in oncology increased from 3.67 pre-SIG to 3.89 (p = 0.19) and in RO specifically from 3.17 to 3.89 (p < 0.01). The mean perceived accessibility of faculty mentors in oncology increased from 3.18 to 3.72 (p < 0.01). After interacting with the RO-SIG, the short response answers were more detailed in the understanding of the role of RO. CONCLUSIONS RO-SIGs can increase interest in RO through early exposure to the field. In a time where RO has seen a decline in student interest, RO-SIGs are an option to increase engagement, develop interest, and form relationships with mentors in pre-clinical years.
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Affiliation(s)
- Catherine Sport
- Virginia Commonwealth University School of Medicine, 1201 E Marshall Street, Richmond, VA, 23298, USA.
| | - Nophar Yarden
- Virginia Commonwealth University School of Medicine, 1201 E Marshall Street, Richmond, VA, 23298, USA
| | - Emma C Fields
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, VA, 23219, USA
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3
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Teles MS, Mamidanna S, Mattes MD. Assessment of Student Perceptions of Aspects of a Career in Radiation Oncology. J Am Coll Radiol 2024; 21:1079-1089. [PMID: 38369041 DOI: 10.1016/j.jacr.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE To determine medical students' views of various aspects of a career in radiation oncology (RO) to identify areas that may benefit from reform and to guide initiatives to stimulate broader and more diverse student interest in the specialty. METHODS AND MATERIALS An electronic survey was sent to student oncology interest group members at seven US medical schools. The survey asked students to rate 19 aspects of RO on a 5-point bipolar Likert-type scale. Descriptive statistics are reported, along with subgroup analyses based on participants' demographics. RESULTS The response rate was 51.1% (n = 275 of 538). The most favorably rated aspects of RO were outpatient working hours (mean ± SD Likert-type rating of 4.51 ± 0.82), routinely working with other physicians (4.45 ± 0.76), and use of advanced technology to treat patients. The most unfavorably rated aspects of RO were less geographic flexibility for residency or employment (1.98 ± 1.04), spending a lot of time on a computer doing treatment planning (2.80 ± 1.21), and having a job that is not well understood by most doctors and the general public (2.89 ± 1.02). Gender was associated with significant differences in 8 of 19 questions in how each aspect of RO was viewed. Few differences were observed based on race or ethnicity, though Asian participants had a significantly more favorable view of RO being a more science-oriented specialty compared with White or underrepresented students, respectively (3.50 versus 3.21 versus 2.84, P = .01). CONCLUSIONS These findings inform the RO community in the development of more effective initiatives to encourage students to fully explore the specialty.
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Affiliation(s)
| | - Swati Mamidanna
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; Member ASTRO Communications and Education Committees.
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Aziz AS, Rana MS, Ahmed S, Abdullah M, Tareen HK, Siddiq A, Abbasi AN. Integrating MDT Tumor Board Shadowing into the Undergraduate Medical Curriculum: Perspective of Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02446-5. [PMID: 38687461 DOI: 10.1007/s13187-024-02446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 05/02/2024]
Abstract
Site-specific multidisciplinary team (MDT) tumor boards are valuable resources for medical students, enabling them to familiarize themselves with the latest evidence-based cancer management strategies and observe effective teamwork in action. In this study, we looked at the awareness and perceptions of medical students about incorporating MDT tumor boards in the medical curriculum. A cross-sectional study was conducted among medical students from year 1 to year 5 at the Aga Khan University after exemption from ethical review committee. A 20-item self-administered questionnaire was used to evaluate the awareness and perceptions of medical students regarding MDT tumor boards. A total of 285 medical students participated in this study, with their mean age (± standard deviation) being 21.91 ± 1.67 years. A majority of 183 (64.2%) had no prior knowledge of the existence of a site-specific MDT tumor board for cancer management. Of the 285 students, 252 (88.4%) demonstrated sufficient awareness of the effectiveness of MDT tumor boards; similarly, 232 (81.4%) responded positively to the idea of mandatory tumor board rotations being incorporated into the undergraduate curriculum. No significant association was found between the student's year of study (χ2 = 6.03, p = 0.20) or gender (χ2 = 35, p = 0.84) and their perceptions of the effectiveness of MDT tumor boards. However, it was found that students who had prior knowledge of their existence had a stronger association with sufficient awareness (χ2 = 4.2, p = 0.04). The results indicate that while the majority of the medical students have no prior attendance or knowledge regarding MDT tumor boards, there is an overwhelming willingness among students to incorporate them into the medical curriculum.
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Affiliation(s)
| | | | - Salaar Ahmed
- Medical College, Aga Khan University, Karachi, Pakistan.
| | | | | | - Ayesha Siddiq
- Medical College, Aga Khan University, Karachi, Pakistan
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Ali N, Dhere TA, Bates JE, Lorenz JW, Janopaul-Naylor JR, Schlafstein AJ, Patel PR, Lin JY. Integration of Radiation Oncology Into the Preclinical Curriculum Through Problem-Based Learning. Pract Radiat Oncol 2024; 14:e1-e8. [PMID: 37802397 DOI: 10.1016/j.prro.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Early exposure to oncology care during the preclinical years of medical school may translate to increased student interest in oncology-related fields and improved understanding of oncologic treatment modalities, including radiation oncology. Many schools incorporate problem-based learning (PBL) into the medical school curriculum; this is an opportunity to immerse students in oncologic case management. We describe the effective incorporation of one course into the medical school curriculum that may be replicated at other institutions. METHODS AND MATERIALS A PBL case regarding pancreatic cancer was created by a radiation oncology resident and faculty member in collaboration with the gastrointestinal course director for first-year medical students at a single institution. Pancreatic cancer was chosen based on curricular needs. Learning objectives were discussed to guide the creation of the case. RESULTS All 140 first-year medical students participated in the 1-hour small group case focused on oncologic work up, multidisciplinary care, and radiation therapy concepts. Students were provided with a case prompt and resources to review prior to the PBL session. Volunteer radiation oncology facilitators attended a 30-minute educational meeting and were provided a detailed case guide 1 week before the PBL session. During the PBL case, facilitators guided students to achieve desired learning objectives. Among the 76 (54%) medical students who completed an optional post-PBL survey, the majority reported that the case motivated them to learn more about oncology (89%) and radiation oncology (82%). There was an increase in the number of subscribers to the Oncology Interest Group (43% increase from previous year) and preclinical students shadowing in the radiation oncology department. The PBL case was continued in future years for all first-year students and extended to 2 hours to promote additional discussion in response to student and facilitator feedback. CONCLUSIONS A cancer-specific PBL case facilitated by radiation oncology educators is an effective avenue to integrate radiation oncology into the preclinical curriculum and stimulate interest in oncology among first-year medical students.
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Affiliation(s)
- Naba Ali
- Winship Cancer Institute of Emory University, Atlanta, Georgia.
| | - Tanvi A Dhere
- Emory University School of Medicine, Atlanta, Georgia
| | - James E Bates
- Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Joshua W Lorenz
- Winship Cancer Institute of Emory University, Atlanta, Georgia
| | | | | | - Pretesh R Patel
- Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Jolinta Y Lin
- Winship Cancer Institute of Emory University, Atlanta, Georgia
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Papazian MR, Chow M, Weed D, Liu JC, Bewley AF, Moore MG, Givi B. Virtual Tumor Boards for Remote Learning in Head and Neck Surgical Oncology. JAMA Otolaryngol Head Neck Surg 2023; 149:899-903. [PMID: 37615974 PMCID: PMC10450583 DOI: 10.1001/jamaoto.2023.2332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/24/2023] [Indexed: 08/25/2023]
Abstract
Importance In addition to their patient management value, multidisciplinary tumor boards have been recognized as effective learning tools. However, the value of using a virtual tumor board as a learning tool for head and neck surgical oncology fellows has not been studied. Objective To describe the structure and content of the American Head and Neck Society (AHNS) Virtual Tumor Board and assess its educational value as perceived by attendees. Design, Setting, and Participants All sessions of the AHNS Virtual Tumor Board from April 8, 2020, to June 1, 2022, were reviewed. Topics, presenters, participants, and viewership data were collected as of October 15, 2022, from session recordings posted to an online video sharing and social media platform. Additionally, an anonymous, 14-question online survey was designed to elicit feedback from head and neck surgery trainees on virtual tumor board engagement, strengths, and weaknesses. The survey was electronically distributed in June and July 2022 to the 101 fellows enrolled in AHNS-accredited programs between July 1, 2020, and June 30, 2022. Main Outcomes and Measures The primary aim was to tabulate online viewership of the sessions. The secondary aim was to qualitatively assess the experience of head and neck trainees with the AHNS Virtual Tumor Board using a survey. Results Forty-two sessions of the virtual tumor board were held between April 8, 2020, and June 1, 2022. Almost all sessions (41 [98%]) were case based. One hundred and sixteen cases were presented, representing 2 to 3 cases per session, by 75 unique faculty members. Each session was viewed a mean of 217 times (range, 64-2216 views). In the 2021 to 2022 academic year, a mean of 60 viewers (range, 30-92 viewers) attended each live session. In all, 29 survey responses were collected from 101 fellows in AHNS-accredited programs (29% response rate). Most respondents felt the format allowed for excellent teaching (18 of 26 respondents [69%]) and discussion (19 of 26 respondents [73%]). Most respondents (22 of 29 respondents [76%]) believed that practicing head and neck surgeons would benefit from the sessions. Conclusions and Relevance This survey study found that the AHNS Virtual Tumor Board was well-attended and well-reviewed by head and neck surgical oncology trainees. The virtual tumor board format could be used as model of remote learning for other organizations.
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Affiliation(s)
- Michael R. Papazian
- Department of Otolaryngology–Head and Neck Surgery, NYU Langone Health, New York, New York
- Now Department of Otolaryngology–Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Michael Chow
- Department of Otolaryngology–Head and Neck Surgery, NYU Langone Health, New York, New York
| | - Donald Weed
- Department of Otolaryngology–Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Jeffrey C. Liu
- Department of Otolaryngology–Head and Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Arnaud F. Bewley
- Department of Otolaryngology–Head and Neck Surgery, University of California-Davis, Sacramento
| | - Michael G. Moore
- Department of Otolaryngology–Head and Neck Surgery, Indiana University School of Medicine, Indianapolis
| | - Babak Givi
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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Hiatt KD, White JC, Marsh KA, Geer CP. Subinternship in Diagnostic Radiology: Bringing the Shadowers Out of the Shadows. Curr Probl Diagn Radiol 2023; 52:269-274. [PMID: 37069019 DOI: 10.1067/j.cpradiol.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/16/2023] [Indexed: 04/19/2023]
Abstract
RATIONALE AND OBJECTIVES Diagnostic radiology subinternships are uncommon. We started a diagnostic radiology subinternship at our institution in 2020 and present 3 years of data assessing the impact of the course on students' perceptions of and interest in diagnostic radiology. MATERIALS AND METHODS The initial course design consisted of daily shadowing shifts, small group lectures with attending radiologists, asynchronous self-paced learning assignments, an ultrasound skills session, multidisciplinary tumor board attendance, and completion of 2 formal case presentations. "Junior resident" shifts, where students dictated studies under attending supervision, an emergency radiology call shift, and an ultrasound procedures shift were subsequently added in response to student feedback. Students were asked to complete surveys before and after completing the course. RESULTS Forty-seven fourth-year medical students completed the course over 3 years. The first 2 groups were predominantly male, whereas the third group showed near even gender representation (54% male). 21 (45%) chose to apply to diagnostic radiology for residency. Student reported interest in diagnostic radiology as a career, valuation of diagnostic radiology as a specialty, comfort with imaging interpretation, and perceptions of the availability of patient interaction and procedures in diagnostic radiology all significantly increased after participation in the course. Students ranked the junior resident shifts and small group attending lectures as the most valuable course components. CONCLUSION Implementation of a diagnostic radiology subinternship significantly improved students' interest in and perceptions of the field. We encourage the creation of similar courses in other radiology departments and stress the importance of active learning experiences.
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Affiliation(s)
- Kevin D Hiatt
- Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology, Atrium Health Wake Forest Baptist, Winston-Salem, NC.
| | | | | | - Carol P Geer
- Wake Forest School of Medicine, Winston-Salem, NC; Department of Radiology, Atrium Health Wake Forest Baptist, Winston-Salem, NC
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McCray E, Atkinson WR, McCray CE, Hubler Z, Maher Y, Waguia R, Kearney M, Kaprielian V. Impact of Medical Student Participation in Student-Run Clinics on Education, Residency Selection, and Patient Care: A Review of Selected Articles. Cureus 2022; 14:e26183. [PMID: 35891868 PMCID: PMC9306404 DOI: 10.7759/cureus.26183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
Student-run clinics (SRCs) are becoming increasingly popular at medical schools in the United States. These clinics have provided a variety of benefits, including serving disadvantaged populations and providing early clinical exposure for students. There has been no consensus on the impact of SRCs on medical education, specialty selection, and patient care. This review provides a thorough overview of student and patient outcomes as a function of medical students volunteering at SRCs. We queried PubMed for original literature published in English between the years 2000 and 2020. Inclusion criteria included primary research articles evaluating the impact of medical student participation in SRCs on education, specialty selection, and patient care. All articles included in the final review were agreed upon by three reviewers, and the pertinent data were extracted. Of 10,200 initial search results, seven papers were included in this review. These included two studies evaluating medical education, five studies evaluating residency selection, and three studies analyzing patient care. Three studies were included in multiple evaluations. The relationship between volunteering at SRCs and academic performance is unclear. Clinic volunteers had increased retention of empathy compared to non-volunteers. Additionally, clinic volunteers provided satisfactory care as determined by patient-reported outcomes, and were not more likely to pursue primary care specialties. As SRCs are increasing in number, research into the impact on medical students and patients is necessary to understand how these clinics may affect the field of health care. It is important to further evaluate how medical student involvement in SRCs can further improve patient care and outcomes.
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Arbab M, Holmes JA, Olivier KR, Fields EC, Corbin KS, Kahn JM, Zellars RC, Haywood AM. Integrating Radiation Oncology Into Undergraduate Medical Education. Adv Radiat Oncol 2021; 6:100765. [PMID: 34522827 PMCID: PMC8426518 DOI: 10.1016/j.adro.2021.100765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 07/12/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022] Open
Abstract
Cancer is one of the most important public health problems. However, medical education has not advanced at the same rate when it comes to cancer education. Currently, the United States Medical Licensing Examination subject examinations do not cover radiation oncology, prevention, and survivorship planning in its assessment model. Incorporating medical oncology and radiation oncology training into the undergraduate medical education curriculum can have a significant benefit in training future physicians. In this paper, we review current literature and propose some ideas that can help incorporate oncology, and specifically radiation oncology, into undergraduate medical education.
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Affiliation(s)
- Mona Arbab
- Department of Radiation Oncology, Indiana University, Indianapolis, Indiana
| | - Jordan A Holmes
- Department of Radiation Oncology, Indiana University, Indianapolis, Indiana
| | | | - Emma C Fields
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia
| | | | - Jenna M Kahn
- Department of Radiation Oncology, Oregon Health & Science University, Portland, Oregon
| | - Richard C Zellars
- Department of Radiation Oncology, Indiana University, Indianapolis, Indiana
| | - Antwione M Haywood
- Department of Radiation Oncology, Indiana University, Indianapolis, Indiana
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Brower JV, Chen S, Ritter A, Liauw SL, Rosenberg SA, Reddy AV, Golden DW, Gillespie EF, Mattes MD. Comfort Level of US Radiation Oncology Graduates: Assessment of Transition to Independent Clinical Practice. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:278-283. [PMID: 31728920 PMCID: PMC7441593 DOI: 10.1007/s13187-019-01625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Radiation training programs are designed to prepare graduates for independent practice, with metrics in place to assess appropriateness of clinical decision-making. Here, we investigated the self-assessed preparedness of US graduates during the transition to independent practice.An anonymous, Internet-based survey was distributed to recent graduates of radiation oncology residencies (2016-2017). A Likert scale was used to assess comfort with various aspects of practice, as well as "time" to development of comfort in independent practice.Responses were obtained from 70/210 (33%), the majority reported training in programs with 5-8 residents (n = 35). Most (77%) reported designing between 500 and 900 treatment plans during training (n = 54). Only 41% of respondents reported the opportunity to review treatment plans and make decisions about safety/adequacy without attending input > 50% of the time (n = 29). Thirty percent of residents reported being responsible for seeing/managing on-treatment visits (OTVs) ≤ 75% of the time. Aspects with which practitioners reported the least comfort were understanding of billing/application to practice (2.43, IQR 2-3), orthovoltage (superficial radiation) setup and field design (2.57, IQR 1-4), and planning/delivery of prostate implants (2.82, IQR 2-4). Increased mean comfort levels were reported by those designing > 700 treatment plans in training as well as those reporting an opportunity to evaluate plans and make clinical decisions prior to attending input > 50% of the time during residency. Comfort with the delivery of stereotactic body radiation (SBRT) correlated with caseload for liver, spine, prostate, and CNS disease sites but not lung.Variations in training experiences exist across institutions. Here, a lower than expected number of residents reported seeing/managing OTVs as well as reviewing treatment plans prior to attending input during training. Overall comfort was correlated with case volume and opportunities to independently review treatment plans prior to attending input. These data highlight areas of opportunity for improving resident education with implications for ease of transition to independent clinical practice.
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Affiliation(s)
- Jeffrey V Brower
- Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, K4/334 600 Highland Ave, Madison, WI, USA.
| | - Shuai Chen
- Department of Public Health Sciences Division of Biostatistics, University of California, Davis, USA
| | - Alex Ritter
- Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Stanley L Liauw
- Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Stephen A Rosenberg
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Abhinav V Reddy
- Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Daniel W Golden
- Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Erin F Gillespie
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Malcolm D Mattes
- Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, WV, USA
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Arifin AJ, Liubchenko K, Boldt G, Nguyen TK. A Scoping Review of Radiation Oncology Educational and Career-Planning Interventions in Undergraduate Medical Education. ACTA ACUST UNITED AC 2021; 28:740-749. [PMID: 33572574 PMCID: PMC7985784 DOI: 10.3390/curroncol28010072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
Radiation oncology (RO) teaching in undergraduate medical education (UME) is lacking worldwide with potentially detrimental effects on medical student career choices and patient care. The objective of this scoping review is to examine the extent of published literature describing RO educational and career-planning interventions in UME. Online databases were searched from respective dates of inception to June 2020 for articles that reported outcomes from RO educational and career-planning interventions in UME. Two independent reviewers screened entries for inclusion. Following full-text reviews, 25 articles were analyzed. Most interventions were a single session, involved clinical medical students, and were based in North America. Didactic teaching was most commonly used, though a majority included interactive learning in addition to or in place of didactic teaching. As expected, there was a heterogeneity of outcomes reported, and most studies collected data using surveys alone. Recurring topics included the multidisciplinary nature of oncology and psychosocial oncology. There was a paucity of studies reporting on formal mentorship programs and research programs. The data collated in this study can help develop new initiatives based on what has succeeded in the past. Areas that may benefit from future studies include mentorship programs, research programs, and interventions from outside North America.
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Affiliation(s)
- Andrew J. Arifin
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
| | - Karina Liubchenko
- Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada;
| | - Gabriel Boldt
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
| | - Timothy K. Nguyen
- Department of Radiation Oncology, London Regional Cancer Program, London, ON N6A 3W9, Canada; (A.J.A.); (G.B.)
- Correspondence: ; Tel.: +1-519-685-8500
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Mattes MD, Bugarski LA, Wen S, Deville C. Assessment of the Medical Schools From Which Radiation Oncology Residents Graduate and Implications for Diversifying the Workforce. Int J Radiat Oncol Biol Phys 2020; 108:879-885. [PMID: 32561501 DOI: 10.1016/j.ijrobp.2020.06.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 01/02/2023]
Abstract
PURPOSE To identify factors predictive of a medical school graduating a high volume of future radiation oncology (RO) residents to better understand potential pathways to effectively recruit women and underrepresented minority (URM) students into RO. METHODS AND MATERIALS Demographics for US allopathic medical schools and affiliated RO departments were collected from web resources and correlated with the percentage of graduates from each school currently enrolled in RO residency in 2019, and the probability of at least 1 female or URM student from each school pursuing RO. RESULTS The median percentage of students per medical school who pursued RO residency was 0.37% (interquartile range, 0.16%-0.66%). A total of 79.7% of schools graduated at least 1 RO resident, whereas 51.7% graduated at least 1 female RO resident and 14.0% graduated at least 1 URM RO resident. The 30 schools graduating the highest percentage of RO residents accounted for 52.1% of current RO residents, only 4 of which were in the top quartile for URM enrollment. Medical students were significantly more likely to pursue RO when there was an affiliated RO department (0.42% vs 0.18%, P < .001) or RO residency program (0.51% vs 0.18%, P < .001), more total RO faculty (rs = 0.521, P < .001), female RO faculty (rs = 0.481, P < .001), and URM RO faculty (rs = 0.197, P < .001). The probability of at least 1 female student pursuing RO was also correlated with the number of female faculty in the affiliated RO department (rpb = 0.348, P = .001), and a similar correlation was observed between URM students and URM faculty (rpb = 0.312, P = .011). CONCLUSIONS Most RO residents graduate from medical schools with larger affiliated RO departments but fewer URM students. To promote greater RO diversity, outreach should be considered among schools with greater URM enrollment but fewer affiliated radiation oncologists, and among female and URM students in schools that graduate many RO residents.
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Affiliation(s)
- Malcolm D Mattes
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | - Luka A Bugarski
- School of Medicine, West Virginia University, Morgantown, West Virginia
| | - Sijin Wen
- Department of Statistics, West Virginia University, Morgantown, West Virginia
| | - Curtiland Deville
- Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland
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13
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LaRiviere MJ, Santos PMG, Jones JA, Lukens JN, Vapiwala N, Swisher-McClure SD, Berman AT. Introducing Multidisciplinary Oncology Management to the Medical Student. Adv Radiat Oncol 2020; 5:289-291. [PMID: 32280829 PMCID: PMC7136620 DOI: 10.1016/j.adro.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 12/03/2022] Open
Abstract
Despite the fact that a large portion of medical students pursue training in a cancer-related discipline, oncology is emphasized to a disproportionately lesser extent than are other disciplines in medical school. Medical students have wide gaps in their oncology-specific knowledge, and undergraduate medical education fails to address the multidisciplinary nature of oncology. To address these shortcomings and improve medical students’ understanding of the multidisciplinary nature of oncology, we have instituted a clinical oncology elective for medical students: an optional, 2-day session held after classes and promoted by student interest groups. Day 1 comprised a series of short faculty lectures beginning with the concepts of and rationale for staging, an approach to breaking bad news, guideline-based management, and multidisciplinary tumor board discussion. Three multidisciplinary tumor boards were simulated on the second day, run by attending surgeons, medical oncologists, and radiation oncologists with expertise in the cancer of interest, using real patient examples. Ultimately, the clinical oncology elective shows medical students how the oncology care team works together to care for cancer patients.
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Affiliation(s)
- Michael J LaRiviere
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Joshua A Jones
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John Nicholas Lukens
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Neha Vapiwala
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Abigail T Berman
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania
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