Mentorship Initiatives in Radiation Oncology: A Scoping Review of the Literature

Evaluation of a National Radiation Oncology Research and Mentorship Program

PURPOSE

The Canadian Association of Radiation Oncology Annual Scientific Meeting Medical Student Research and Mentorship Award was established in 2020 to support medical students pursuing radiation oncology (RO) research and RO as a career. This study is an evaluation of the effect of this national research and mentorship award on medical students, resident mentors, and research supervisors over 3 iterations.

METHODS AND MATERIALS

Three separate surveys were created for medical student mentees, RO resident mentors, and attending research supervisors. These surveys were developed using best practice strategies for medical education surveys and circulated for peer review among experts in oncology medical education. The surveys were sent to the 52 individuals (18 students, 18 residents, 16 supervisors) who participated in 3 cycles of Canadian Association of Radiation Oncology ASM MSRMA (2020-21, 2021-22, 2022-23). After anonymization, quantitative answers were analyzed using descriptive statistics, and narrative responses were evaluated using a grounded theory approach.

RESULTS

There was a 90% survey response rate. For medical student mentees, the award maintained (71%) or increased (24%) interest in pursuing an RO career. Students reported receiving helpful tips for residency applications and insight into RO residency, research, and career planning advice. Only the first student cohort currently has matching results for residency, with approximately 50% matching to RO. All resident mentor respondents felt the program either maintained or increased motivation to mentor students in RO. Research project supervisors unanimously enjoyed their role in this program and would recommend and participate in this program again.

CONCLUSIONS

A national research and mentorship award for medical students has shown a positive effect on participants. Medical students felt this award program motivated them to continue pursuing oncology research and a potential career in RO. The program also enhanced mentorship skills in residents and research supervisors, which encourages further RO mentorship, teaching, and exposure for future generations of students.

An Antidote to Decreasing Interest in Radiation Oncology: Earlier Engagement

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.

Mentor communication skills training: development, feasibility, and preliminary efficacy

BACKGROUND

Mentoring is vital to career development in academic medicine, and communication underlies all aspects of the mentoring relationship. Although training research mentors has been shown to be effective, few academic medicine faculties have received training in how to mentor. The investigators developed a novel intervention, the Mentor Communication Skills Training for Oncology Faculty ("Comskil Mentor Training") and examined feasibility and preliminary efficacy.

METHODS

The study was a single arm pre-post intervention design. The intervention (Comskil Mentor Training) was offered in one virtual 3-hour session and included a didactic lecture with exemplary skill demonstration videos, facilitator-led small group role plays with trained actors, and evaluation. 19 faculty members from 12 departments participated in the training.

RESULTS

All participants completed the training. Overall, the training was rated favorably, with more than 80% of participants indicating that they "agreed" or "strongly agreed" with training evaluation. From pre- to post-training, significant improvement was seen in participants' overall self-efficacy to communicate with mentees, as well as participants' overall use of communication skills and mentoring-specific language.

CONCLUSIONS

Our findings support the feasibility and preliminary efficacy of a virtually delivered experiential mentor communication skills training program for multidisciplinary clinical and research faculty in oncology.

Professional development through mentoring: Final evaluation of the pilot mentoring programme of the European society of radiotherapy and oncology

The European SocieTy for Radiotherapy and Oncology (ESTRO) organized a one-year pilot mentoring programme. At evaluation after one year, both mentors and mentees scored the programme with a median score of 9 on a scale of 10. All of the mentors indicated that they wanted to participate again as mentors.

Current situation in radiation oncology residency-Results of a national survey performed by the working group Young DEGRO of the German Society of Radiation Oncology

BACKGROUND

The aim of this study was to assess the current status of the radiation oncology (RO) residency programs in Germany. For this, RO residents and RO specialists were surveyed regarding the current situation of the RO residency training and the working conditions in Germany.

METHODS

The Continuing Education Section of the Young DEGRO (yDEGRO) Working Group of the German Society of Radiation Oncology (DEGRO) developed a survey to assess (1) the overall satisfaction, learning objectives, and teaching methods used during training; and (2) the perception of the importance of specific disease patterns in RO training. Open-ended questions were also asked to elicit opinions on areas for improvement. From 21 November to 27 December 2022, RO residents registered with DEGRO and/or in the working group yDEGRO were invited to participate anonymously in an online questionnaire.

RESULTS

Overall, 97 participants completed the survey, including 65 RO residents (67%) and 32 RO specialists (33%); 66 (68%) of the respondents reported being employed in the university setting, 23 (23.7%) in the non-university setting, and 8 (8.3%) in private practice. Within the training, heterogeneity was found in the teaching methods used. In terms of knowledge transfer, the greatest importance was accorded to annual continuing education discussions with the head of the residency training (92.8%), participation in tumor boards (85.6%), written training concepts (81.4%), and evaluations at the beginning (76.3%) and end of a rotation (80.4%). The arithmetic mean of satisfaction with specialist training was 6/10 points (SD: 1.99); 88.7% of respondents would like to see a nationally uniform and mandatory curriculum in RO residency training.

CONCLUSION

The study provides suggestions for improving RO medical training in Germany: further development of accompanying education and training programs in cooperation with professional associations, e.g., the DEGRO, structured feedback, and supervision.

Challenges in the transition to independent radiation oncology practice and targeted interventions for improvement

Numerous radiation oncology residents and junior attendings have identified common weaknesses in residency training that hinder the transition from training to independent practice. Recurrent themes include not only general autonomy but also proficiency in technical skills, such as treatment plan review and image verification, and nontechnical skills, such as leadership, mentorship, and education. While multiple strategies to address these deficiencies have been investigated, many are not widely available or may be difficult to implement. We aim to summarize the frequently cited challenges in the transition to independent radiation oncology practice as well as the pertinent interventions that have been explored.

Radiation Oncology AcaDemic Mentorship Program (ROADMAP) for Junior Faculty: One-Year Results of a Prospective Single Institution Initiative

PURPOSE

Although mentorship has been associated with promotion, job satisfaction, and retention, data are limited on the mentorship experience of clinical- versus research-track physicians as well as feasibility and relative priority of formal program components.

METHODS AND MATERIALS

Within a single-institution, multi-site, academic network, we implemented a Radiation Oncology AcaDemic Mentorship Program (ROADMAP) for junior faculty. Validated surveys assessing mentee satisfaction were distributed at baseline and 1 year. The statistical analysis included Wilcoxon rank sum and signed tests. Mentees assessed the likelihood to recommend each program component (10-point Likert-type scale), and means with standard error (SE) are reported.

RESULTS

Among 42 eligible junior faculty, 36 (86%) opted into the program. The median time since residency was 2.5 years (interquartile range, 1.75-5.25) on the clinical track (n = 12) and 3 years (interquartile range, 2.75-5.00) on the research track (n = 24). At baseline, research-track physicians reported higher satisfaction with mentoring than physicians on the clinical track (2.92 vs 2.16; P = .02). Among 32 physicians completing 1 year, overall satisfaction with mentoring increased compared with baseline (2.72 vs 3.87; P < .001), which persisted on subset analysis for both clinical- (2.16 vs 4.03; P < .001) and research-track physicians (2.99 vs 3.77; P = .005). At 1 year, 28 mentees (88%) opted to continue the program. Program components were rated 8.25 (SE, 0.37) for mentor-mentee pairings, 7.22 (SE, 0.39) for goal setting, 6.84 (SE, 0.47) for administrative support, 6.69 (SE, 0.44) for peer mentoring, and 6.53 (SE, 0.45) for steering committee oversight. Ratings of peer mentoring were not associated with track (P = .59) or years in practice (P = .29).

CONCLUSIONS

Clinical-track physicians may be less satisfied with mentorship than research-track faculty. However, all junior faculty, regardless of track, appeared to benefit from formalizing dyadic mentor-mentee relationships, goal setting, and peer mentoring. Further work is needed to determine the role of mentorship in addressing physician burnout.

Strategies for Achieving Gender Equity and Work-Life Integration in Physician-Scientist Training

Substantial gender inequities persist across academic medicine. These issues are not new: Recent evidence still points to a chilly climate for women in academic medicine, including those in physician-scientist training. The discussion for how to address gender equity and issues of work-life integration typically centers around faculty and rarely includes trainees. The authors delineate specific strategies to address gender inequity in physician-scientist training by identifying key stakeholders for implementation and proposing areas to integrate these strategies with current training timelines. Strategies discussed include multiple-role mentoring, allyship training for trainees and faculty, early implementation of professional development sessions, incorporation of childcare and family-friendly policies, and additional policies for funding bodies to prioritize gender equity practices. The goal of this article is to equip trainees and the academic community with proactive strategies to create a more equitable environment for future generations of trainees in academic medicine.

Education in Radiation Oncology-Current Challenges and Difficulties

The evolution and development of radiotherapy in the last two decades has meant that postgraduate medical training has not kept up with this rapid progress both in terms of multidisciplinary clinical approaches and especially in terms of technological advances. Education in radiation oncology is a major priority in the context of the rapid development of radiotherapy, including advanced knowledge of radiobiology, radiation physics and clinical oncology, anatomy, tumor biology and advanced medical imaging. In this context, the lack of training in radiation oncology in the curricula of medical faculties may have detrimental consequences for the training of residents in radiotherapy but also in their choice of specialty after completing their university studies. There is a clear gap between resident physicians’ actual and required knowledge of radiotherapy, and this requires urgent remediation. In the context of technical advances in imaging-guided radiotherapy (IGRT) and new radiobiology data, a balanced approach divided equally between general oncology, clinical radiation oncology, radiation oncology technology, medical physics and radiobiology, anatomy and multimodal imaging, including mentorship could bring educational and career choice benefits for students of radiation oncology.

Education in gynecological brachytherapy

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.

A Scoping Review of Radiation Oncology Educational and Career-Planning Interventions in Undergraduate Medical Education

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.