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Mendall J, Tolley A, Parisi V, Hornby S, Brown R, Nowak V. Confidence of Emergency Department doctors in managing ophthalmic emergencies: a systematic review. Eye (Lond) 2024; 38:2751-2760. [PMID: 38729998 PMCID: PMC11427453 DOI: 10.1038/s41433-024-03115-z] [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: 11/06/2023] [Revised: 04/10/2024] [Accepted: 04/24/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Eye emergencies constitute a significant portion of attendances to general Emergency Departments (EDs) in the UK, therefore it is important to assess the confidence of doctors who work in this setting in managing these potentially sight- and life-threatening presentations. This systematic review aims to assess the confidence of UK doctors working in general EDs in managing ophthalmic emergencies. METHODS MEDLINE (Ovid), EMBASE (Ovid), ProQuest Central and Web of Science databases and grey literature were searched from inception to 1 October 2022 for publications that (1) featured doctors working in UK general EDs, (2) assessed doctors' confidence in managing ophthalmic emergencies, (3) contained original data, (4) were full-text, and (5) written in English. Methodological quality was assessed using the AXIS tool. RESULTS 462 articles were screened, and 7 papers included for data extraction, which collectively assessed the confidence of 956 doctors working in EDs in managing ophthalmic emergencies. There was a widespread lack of confidence amongst foundation doctors, which has worsened over time. Most doctors lacked confidence in performing funduscopy and using the slit-lamp, and considered formal ophthalmology training received in EDs to be inadequate. CONCLUSIONS Evidence suggests a lack of confidence amongst foundation doctors in managing ophthalmic emergencies. High-quality evidence investigating the confidence amongst more experienced Emergency Medicine (EM) physicians was lacking. It is important to assess why foundation doctors feel so ill-prepared to manage eye emergencies and develop further ophthalmic training for doctors working in EDs. Further investigation exploring the confidence of EM trainees and consultants is required.
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Affiliation(s)
| | - Abraham Tolley
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | | | - Stella Hornby
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ruth Brown
- Imperial College Healthcare NHS Trust, London, UK
| | - Victoria Nowak
- The National Hospital for Neurology and Neurosurgery, London, UK
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2
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Jaibaji R, Irfan K, Choudry A, Pillaai M, Khan A, Mustafa H, Jawad H, Al-Maiyah F, Barnes SLA, Hussein AA, Alesmail A, Hassan-Dinif J, Khalil M, Albazooni M. Knowledge of head and neck cancer among medical students in the UK. Br J Oral Maxillofac Surg 2024; 62:171-176. [PMID: 38245454 DOI: 10.1016/j.bjoms.2023.11.015] [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: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 01/22/2024]
Abstract
Head and neck cancer (HNC) refers to malignancies found in mucosal surfaces anywhere from the paranasal sinuses to the larynx, including the various glands and cavities. Between the years 2016 and 2018, there were about 3900 new cases every year in women and 8600 in men, making it the thirteenth most common cancer in women and fourth most common in men. The aim of our study was to evaluate the amount and type of teaching United Kingdom (UK) medical students receive on HNC, and to assess their current knowledge of these cancers. An online survey distributed via university representatives was responded to by 311 final year medical students from 25 medical schools across the UK. Regarding HNC teaching, 72 students (23.2%) reported receiving no teaching at their medical school. Of the 239 who reported receiving teaching, 169 (54.3%) received it in the format of a non-interactive, large group lecture. A total of 271 respondents (87.1%) believed that medical students at their university would benefit from more teaching on HNC. Based on our sample, there appears to be an overall dissatisfaction and lack of confidence surrounding HNC in the undergraduate curriculum. With its increasing prevalence in the UK, it is vital that red-flag symptoms and referral criteria are understood by the future medical workforce.
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Affiliation(s)
- Raian Jaibaji
- UCL Medical School, 74 Huntley St, London WC1E 6DE, United Kingdom.
| | - Khansa Irfan
- University of Central Lancashire, 135A Adelphi St, Preston PR1 7BH, United Kingdom
| | - Anum Choudry
- University of Birmingham Medical School, Birmingham Medical School, Vincent Drive, Birmingham, B15 2TT, United Kingdom
| | - Medha Pillaai
- University of Dundee, Nethergate, Dundee DD1 4HN, United Kingdom
| | - Ayesha Khan
- University of Sheffield Medical School, Beech Hill Rd, Broomhall, Sheffield S10 2RX, United Kingdom
| | - Hassan Mustafa
- University College London Medical School, 74 Huntley St, London WC1E 6DE, United Kingdom
| | - Hadi Jawad
- Keele Medical School, Keele University, University Road, Staffordshire ST4 6QG, United Kingdom
| | - Faida Al-Maiyah
- Bart's and the London School of Medicine and Dentistry, Garrod Building, Turner Street, London E1 2AD, United Kingdom
| | | | - Ali Abdul Hussein
- Imperial College London, Exhibition Road, London SW7 2AZ, United Kingdom
| | - Ayah Alesmail
- Peninsula Medical School, Faculty of Health, The John Bull Building, Research Way Plymouth Science Park, Plymouth PL6 8BU, United Kingdom
| | - Jakob Hassan-Dinif
- St George's University of London, Cranmer Terrace SW17 0RE, United Kingdom
| | - Maryam Khalil
- Sunderland Medical School, Edinburgh Building, Chester Rd, Sunderland SR1 3SD, United Kingdom
| | - Mohammed Albazooni
- Aston Medical School, Aston University, Birmingham B4 7ET, United Kingdom
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3
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Fulton-Ward T, Bain R, Khoury EG, Keshwara SM, Joseph PJS, Selby P, Millward CP. Benefits of Mentoring in Oncology Education for Mentors and Mentees: Pre-Post Interventional Study of the British Oncology Network for Undergraduate Societies' National Oncology Mentorship Scheme. JMIR MEDICAL EDUCATION 2023; 9:e48263. [PMID: 37695662 PMCID: PMC10520773 DOI: 10.2196/48263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Formal education of oncology is lacking in many undergraduate medical curricula. Mentoring schemes can expose participants to specific areas of medicine and may address the shortfalls in oncology education. Few mentoring schemes have been designed within the United Kingdom, especially within oncology. There is a need to understand reasons for mentor and mentee participation in such schemes and to identify ways to minimize barriers to engagement. OBJECTIVE This study identifies motivations for participation in an oncology mentoring scheme and its benefits and limitations to both the mentee and the mentor. METHODS The British Oncology Network for Undergraduate Societies launched a National Oncology Mentorship Scheme (NOMS) on September 1, 2021. Mentees (medical student or foundation doctor) were paired with mentors (specialty registrar or consultant), for 6 months of mentoring. In total, 86 mentors and 112 mentees were recruited to the scheme. The mentees and mentors were asked to meet at least 3 times during this period and suggestions were provided on the content of mentoring. Mentees and mentors were invited to complete a prescheme questionnaire, exploring motivations for involvement in the scheme, current experiences within oncology, and knowledge and interests in the field. At the end of the scheme, mentors and mentees were asked to complete a postscheme questionnaire exploring experiences and benefits or limitations of participation. Paired analysis was performed using the Wilcoxon signed-rank test. For free text data, content analysis was applied to summarize the main themes in the data. RESULTS Of the 66 (59%) mentees who completed the prescheme questionnaire, 41 (62%) were clinical, 21 (32%) preclinical medical students, and the remainder were junior doctors. For mentees, networking was the primary reason for joining the scheme (n=25, 38%). Mentees ranked experience of oncology at medical school at 3 on 10 (IQR 2-5). In this, 46 (53%) mentors completed the prescheme questionnaire, 35 (76%) were registrar level, and the remainder were consultant level (n=11). The most common reason for mentor participation was to increase awareness and interest in the field (n=29, 63%). Of those who completed the prescheme questionnaire, 23 (35%) mentees and 25 (54%) mentors completed the postscheme questionnaire. Knowledge in all areas of oncology assessed significantly increased during the scheme (P<.001). Most mentees (n=21, 91%) and mentors (n=18, 72%) felt they had benefited from the scheme. Mentees cited gaining insights into oncology as most beneficial; and mentors, opportunities to develop professionally. Whilst mentees did not report any barriers to participating in the scheme, mentors stated lack of time as the greatest barrier to mentoring. CONCLUSIONS British Oncology Network for Undergraduate Societies' NOMS is expanding and is beneficial for mentees through increasing knowledge, providing exposure, and career advice in oncology. Mentors benefit from improving their mentoring skills and personal satisfaction.
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Affiliation(s)
- Taylor Fulton-Ward
- Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Robert Bain
- School of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma G Khoury
- Academic Cancer Sciences Unit, University Hospital Southampton, Southampton, United Kingdom
| | - Sumirat M Keshwara
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | | | - Peter Selby
- University of Leeds, Leeds, United Kingdom
- University of Lincoln, Lincoln, United Kingdom
| | - Christopher P Millward
- Institute of Systems, Molecular, & Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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Khamjan NA, Ahmed FA, Madkhali NM, Ayyoub LA, Dighriri RY, Kariri KA, Kamli H, Shubayr N. Evaluation of the Knowledge of the Most Common Cancers Among Health Students at Jazan University, Saudi Arabia: A Cross-Sectional Study. Cureus 2023; 15:e44871. [PMID: 37814764 PMCID: PMC10560132 DOI: 10.7759/cureus.44871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Cancer is a major public health problem worldwide, and medical students are expected to have adequate knowledge and awareness of the most common types of cancer. This study aimed to assess the cancer knowledge of medical students at Jazan University, Saudi Arabia, focusing on breast cancer (BC), prostate cancer (PC), cervical cancer (CC), and colorectal cancer (CRC). METHODS This study employed a self-administered survey to evaluate both general and specialized knowledge of cancer types. A total of 321 medical students from different academic years participated in the study. The questionnaire used a scoring system where each correct answer was given one point, and each incorrect answer or "I don't know" response was given zero points. RESULTS The overall knowledge scores were 18.75 ± 4.43 out of 28 (67%). The students had a good level of general knowledge about cancer (5.26 ± 1.44 out of 7, 75%) and breast cancer (5.47 ± 1.44 out of 7, 78%) and a moderate knowledge level of prostate cancer (2.83 ± 1.07 out of 4, 71%), cervical cancer (2.74 ± 1.53 out of 5, 55%), and colorectal cancer (2.55 ± 1.61 out of 5, 50%). There were significant differences in cancer knowledge by gender, academic year, and having a relative or friend with cancer. All types of cancer knowledge were positively and significantly correlated with each other. CONCLUSION This study revealed the strengths and weaknesses of cancer knowledge among medical students at Jazan University, Saudi Arabia. The overall score for knowledge indicated a moderate level. The students had some knowledge about cancer prevention, detection, and treatment, but some gaps and misconceptions need to be addressed. More education and awareness programs are necessary to improve cancer literacy among students and promote healthy behaviors that can reduce cancer risk.
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Affiliation(s)
| | | | | | - Lina A Ayyoub
- Medical Laboratory Technology, Jazan University, Jazan, SAU
| | | | | | - Hossam Kamli
- Clinical Laboratory Sciences, King Khalid University, Abha, SAU
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Moncaliano MC, Mahadevan A, Liu JC, Naik I, Pateva I. A Virtual Curriculum to Increase Exposure to Oncologic Subspecialties for Undergraduate Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:985-990. [PMID: 36151353 PMCID: PMC9510236 DOI: 10.1007/s13187-022-02220-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 06/02/2023]
Abstract
Medical student exposure to oncology is imperative given the prevalence of cancer, growing need for survivorship care, and ever-evolving therapies. Our institution offers a Cancer Care Elective for undergraduate medical students focused on clinical shadowing, but the COVID-19 pandemic necessitated completely redesigning a virtual alternative. In this study, we utilize a post-elective survey to 1) assess whether the novel virtual elective effectively promoted student learning and 2) identify which components were most impactful. We created an entirely virtual, semester-long course with structured mentorship, subspecialty panels, physician-led didactics, and patient exposure. Students attended multidisciplinary tumor boards and presented on oncologic topics. A post-elective survey assessed the course's impact on students' knowledge and the perceived value of each elective component. Of the 29 enrolled students, 12 responded to our survey (41%). Most students reported that the elective highly enhanced their understanding of medical (67%), surgical (75%), and pediatric (66%) oncology. The highest rated didactic involved patients discussing their cancer journeys, with 80% of students reporting that this session enhanced their understanding of patient-physician collaboration. Students reported that physician mentorship helped them better understand oncology (90%) and promoted interest in pursuing an oncologic career (100%). This study demonstrates that our virtual Cancer Care Elective was effective at increasing student understanding of oncology in practice. The results also suggest that patient exposure and physician mentorship are particularly educational and encouraging.
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Affiliation(s)
| | - Anita Mahadevan
- Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - Jessica C. Liu
- Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - Ilora Naik
- Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - Irina Pateva
- Case Western Reserve University School of Medicine, Cleveland, OH USA
- University Hospitals Rainbow Babies and Children’s Hospital, Division of Pediatric Hematology/Oncology, Cleveland, OH USA
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6
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Ingledew PA, Lalani N, Daly M, Campbell SR. Catalyzing the Next Generation: Interventions To Increase Medical Student Interest in Radiation Oncology. Int J Radiat Oncol Biol Phys 2023; 115:1017-1025. [PMID: 36922073 DOI: 10.1016/j.ijrobp.2022.11.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 03/14/2023]
Affiliation(s)
- Paris-Ann Ingledew
- Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, Canada
| | - Nafisha Lalani
- Department of Radiation Oncology, University of Ottawa, Ottawa, Canada
| | - Megan Daly
- Department of Radiation Oncology, University of California, Davis, Sacramento, California
| | - Shauna R Campbell
- Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
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Sherwood M, Giannopoulos E, Papadakos J, Martimianakis MA, Kulasegaram K, Giuliani M. Clinical Objectives of the Canadian Licensing Examination: Exploring the Representation of Oncology. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:255-259. [PMID: 34708392 DOI: 10.1007/s13187-021-02108-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 06/13/2023]
Abstract
Every physician should be comfortable caring for cancer patients, yet medical education in oncology is known as inadequate. Our study explored this issue from an assessment perspective, by determining the representation of oncology and other health priorities in the clinical learning objectives for the Medical Council of Canada Qualifying Examination Part 1 (MCCQE Part 1). The Medical Council of Canada lists objectives for the MCCQE Part 1, based on CanMEDS roles for medical graduate competency. These objectives guide exam question development and can be used as a study guide for learners. Our study focused on the Medical Expert role and mapped the clinical objectives for oncologic, cardiovascular, cerebrovascular and chronic lower respiratory disease. The clinical objectives contained 190 topics under the Medical Expert role. Oncology content was found in 57 (30%), cardiovascular disease in 56 (29.5%), cerebrovascular disease in 21 (11%) and chronic lower respiratory disease in 7 (3.7%). In objectives with oncology content, gastrointestinal cancer (16, 28%), non-specific indicators of cancer (7, 12%) and genitourinary/musculoskeletal cancers (6, 10.5%) were most frequent. Content coding had inter-rater agreement greater than 99%, with kappas from 0.73 to 1.00. Oncology was highly represented in the clinical objectives listed for the MCCQE Part 1. With existing research showing limited oncology content on examinations and in medical curricula, our results were unexpected. This finding could signal the efficacy of initiatives seeking to improve oncology education and emphasizes the importance of continuing improvements in oncology education to meet patient and healthcare system needs.
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Affiliation(s)
- Marissa Sherwood
- Department of Radiation Oncology, University of Toronto, Toronto, Canada.
- Radiation Medicine Program, Department of Radiation Oncology, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 1Z5, Canada.
| | - Eleni Giannopoulos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Maria A Martimianakis
- Wilson Centre for Research in Education, Toronto, Canada
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Kulamakan Kulasegaram
- Wilson Centre for Research in Education, Toronto, Canada
- Department of Family & Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Meredith Giuliani
- Department of Radiation Oncology, University of Toronto, Toronto, Canada
- Radiation Medicine Program, Department of Radiation Oncology, Princess Margaret Cancer Centre, 700 University Avenue, Toronto, ON, M5G 1Z5, Canada
- Cancer Education Program, Princess Margaret Cancer Centre, Toronto, Canada
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8
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Dutt H, Dean A, Kamal RS, Allan AL. Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231219394. [PMID: 38116493 PMCID: PMC10729629 DOI: 10.1177/23821205231219394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023]
Abstract
Background With the shift towards person-centered care (PCC) in oncology, there is a need for parallel evolution of oncology education programs to prepare the next generation of health professionals to deliver effective PCC. These programs should be designed utilizing perspectives from individuals who have lived experience with cancer to ensure that changes to education curricula translate to improved PCC in the clinic. Objectives Our goal was to identify existing literature describing such programs as well as identify gaps for further development. Methods Keywords were agreed upon and searched across Ovid Medline, Ovid Embase, ERIC, Google Scholar, and MedEdPORTAL databases. Duplicates were removed, unique articles were screened for relevance by title and abstract, and a full text review of each article was completed for validation. Included articles describe methods for involving people with cancer in developing and/or delivering oncology-focused education programs. Results In total, 15 articles describing 12 unique oncology education programs from 7 different countries were identified, reviewed, and summarized. These programs involved learners undertaking undergraduate medical education, postgraduate medical education, continuing medical education, or training as nurses or radiation therapists. Current literature indicates that classroom-based sessions, experiential or simulated learning modalities, and/or asynchronous online modules can all feasibly be created with the integration of perspectives/narratives of people with cancer. Furthermore, involving people with cancer directly in the design and/or delivery of these education programs may contribute to improved patient experiences. Conclusions Including the perspectives of people with cancer directly in oncology curriculum development and delivery can improve established pedagogical approaches and enhance learner confidence and competency in delivering PCC. We provide recommendations for stepwise implementation of patient perspectives into oncology education, with the hope that future programs will better prepare and motivate learners to provide PCC aimed at improving cancer care, quality of life, and disease outcomes.
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Affiliation(s)
- Hanna Dutt
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Arleigh Dean
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Rayyan Syed Kamal
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Interdisciplinary Medical Sciences Program, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Alison L. Allan
- London Regional Cancer Program, London Health Sciences Centre, London, Ontario, Canada
- Department of Anatomy & Cell Biology, and Department of Oncology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
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9
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Khoury EG, Heritage SR, Fulton-Ward T, Joseph PJS, Keshwara SM, Selby P. BONUS: the National Oncology Network for Students and Junior Doctors. Clin Oncol (R Coll Radiol) 2022; 34:678-682. [PMID: 35811271 DOI: 10.1016/j.clon.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 05/20/2022] [Accepted: 06/23/2022] [Indexed: 11/03/2022]
Affiliation(s)
- E G Khoury
- British Oncology Network for Undergraduate Societies, UK; University of Liverpool, Liverpool, UK.
| | - S R Heritage
- British Oncology Network for Undergraduate Societies, UK; University of Cambridge, Cambridge, UK
| | - T Fulton-Ward
- British Oncology Network for Undergraduate Societies, UK; University of Birmingham, Birmingham, UK
| | - P J S Joseph
- British Oncology Network for Undergraduate Societies, UK; University of Liverpool, Liverpool, UK
| | - S M Keshwara
- British Oncology Network for Undergraduate Societies, UK; Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
| | - P Selby
- British Oncology Network for Undergraduate Societies, UK; University of Leeds, Leeds, UK; University of Lincoln, Lincoln, UK
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10
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Heritage SR, Lynch-Kelly K, Kalvala J, Tulloch R, Devasar A, Harewood J, Khoury E, Abdelwahed A, Fung A, Bigogno CM, Gray R, Keshwara S, Joseph PJS, Selby P, Tharmalingam H. Medical Student Perspectives on Undergraduate Oncology Education in the UK. Clin Oncol (R Coll Radiol) 2022; 34:e355-e364. [PMID: 35595594 DOI: 10.1016/j.clon.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/31/2022] [Accepted: 04/27/2022] [Indexed: 11/03/2022]
Abstract
AIMS The British Oncology Network for Undergraduate Societies (BONUS) surveyed students who attended an oncology revision day to determine their views on the current quantity, quality and type of curriculum-based oncology teaching they have experienced. MATERIALS AND METHODS Students attending two BONUS revision days received a questionnaire assessing their experience of oncology teaching within the medical curriculum and interest in pursuing a future career in oncology using a 10-point Likert scale. Data were collected with informed consent to be anonymised and used for research. Student demographics and qualitative and quantitative data about experiences of oncology education were analysed. RESULTS In total, 451 students registered to attend the revision days. After removal of duplicates, non-responders and non-UK participants, responses from 153 students studying across years 1-6 at 22 UK medical schools were analysed. The mean quantity of oncology lectures students reported receiving was 8.9 hours and the mean quantity of clinic/ward-based oncology teaching was 7.5 hours. Ninety (62.1%) of the 145 students who responded to the relevant question reported that they had received dedicated teaching in oncology. Students who had received dedicated oncology teaching reported a statistically significantly higher mean quality 6.1 (95% confidence interval 5.6-6.5) versus 5.0 (95% confidence interval 4.3-5.5; P = 0.003) and quantity 5.2 (95% confidence interval 4.7-5.6) versus 4.3 (95% confidence interval 3.7-4.9; P = 0.03) of oncology teaching compared with those who had not received this. CONCLUSION Appropriate oncology education is essential for all medical students due to the high prevalence of cancer. All future doctors need the appropriate knowledge and communication skills to care for cancer patients. Our analysis provides quantitative evidence to support the value of specialist oncology teaching within the medical school curriculum in improving student-reported experience. National student-led revision days and events may widen interest in a future career in oncology and aid collaboration between oncology societies. It is important for the general undergraduate medical curriculum to integrate specialty content. An integrated curriculum should facilitate a holistic approach that spans prevention, screening, treatment and palliation rather than being split by subspeciality.
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Affiliation(s)
- S R Heritage
- School of Clinical Medicine, University of Cambridge, Cambridge, UK.
| | - K Lynch-Kelly
- GKT School of Medical Education, King's College London, London, UK
| | - J Kalvala
- School of Medicine, University of Nottingham, Nottingham, UK
| | - R Tulloch
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - A Devasar
- Edinburgh Medical School, The University of Edinburgh, Edinburgh, UK
| | - J Harewood
- School of Medical Education, Newcastle University, Newcastle, UK
| | - E Khoury
- School of Medicine, University of Liverpool, Liverpool, UK
| | - A Abdelwahed
- School of Medicine, Imperial College London, London, UK
| | - A Fung
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C M Bigogno
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - R Gray
- School of Medicine, University of Dundee, Dundee, UK
| | - S Keshwara
- Whiston Hospital, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
| | - P J S Joseph
- School of Medicine, University of Liverpool, Liverpool, UK
| | - P Selby
- University of Leeds, Leeds, UK; University of Lincoln, Lincoln, UK
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11
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Kanan D, Kanan T, Kalyenci N, Nanah AR, Tarbaghia M, Ekmekci B, Çelik S, Öven BB. A Successful Model for an Introductory Oncology Teaching Conference and Its Impact on Preclinical and Clinical Medical Students. JCO Oncol Pract 2022; 18:e907-e914. [PMID: 35157507 DOI: 10.1200/op.21.00463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Oncology education at medical schools is often fragmented, under-represented, and nonstandardized. Medical students lack essential knowledge, skills, and attitudes necessary for them to provide optimal primary care to patients with cancer upon graduation. METHODS In this study, we designed and assessed the impact of a compact oncology teaching conference on medical students. The conference covered topics in cancer biology, public health, diagnosis, patient management, treatment, and communication skills. Medical students completed voluntary presurveys and postsurveys regarding their perceived knowledge, attitudes, and perspectives. The event was promoted by student groups, particularly our ASCO Oncology Student Interest Group, and took place online. RESULTS A total of 228 responses from medical students representing 50 universities were analyzed. We revealed significant baseline confidence and perceived knowledge deficits especially in diagnosis and patient management, and treatment modalities. Our conference positively affected self-assessed knowledge acquisition among students, with the most pronounced differences seen in diagnosis and patient management (2.51 ± 1 v 3.87 ± 0.81) and treatment modalities (2.54 ± 0.96 v 3.79 ± 0.88), P < .001. Students believed the program was beneficial, felt more confident in applying their knowledge in the clinic and in delivering bad news, and were more interested in pursuing oncology-related fields, P < .001. CONCLUSION We demonstrated that a compact teaching conference resulted in significant improvements in students' confidence and perceived knowledge about oncology. Our successful teaching model can be adapted and implemented at medical schools globally. Development and evaluation of teaching programs are important to urgently reform undergraduate medical education in oncology.
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Affiliation(s)
- Duaa Kanan
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey
| | - Tarek Kanan
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey.,Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Nursena Kalyenci
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey.,Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Abdel Rahman Nanah
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey
| | - Marwa Tarbaghia
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey
| | - Betigul Ekmekci
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey.,Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Serkan Çelik
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey.,Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Turkey
| | - Bala Başak Öven
- 2020-2021 Education Committee of the American Society of Clinical Oncology-Sponsored Oncology Student Interest Group, Bahçeşehir University, Istanbul, Turkey.,Department of Medical Oncology, Yeditepe University Hospital, Istanbul, Turkey
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12
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Walls GM, Houlihan OA, Mooney C, Prince R, Spencer K, Lyons C, Cole AJ, McAleer JJ, Jones CM. Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey. Br J Radiol 2021; 94:20210614. [PMID: 34705530 PMCID: PMC8631035 DOI: 10.1259/bjr.20210614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/20/2021] [Accepted: 10/04/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic. METHODS A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19. RESULTS Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1-6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19. CONCLUSIONS RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors' already constrained exposure to radiotherapy. ADVANCES IN KNOWLEDGE This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.
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Affiliation(s)
| | | | | | - Rebecca Prince
- Radiotherapy Research Group, Faculty of Medicine & Health, University of Leeds, Leeds, UK
| | | | - Ciara Lyons
- Department of Radiation Oncology, Cork University Hospital, Cork, Ireland
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13
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Chelvarajah R, Windsor A, Nicholls L, Bravery B, Shi K, Turner S, Tieu MT. Junior Doctor Evaluation of Radiation Oncology Education and Training in Medical Schools and Prevocational Training in Australia. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:646-651. [PMID: 31873855 DOI: 10.1007/s13187-019-01678-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The purpose of this study is to evaluate radiation oncology (RO)-specific education, confidence and knowledge of junior doctors in Australian teaching hospitals. A 38-item web-based survey was emailed to prevocational junior doctors working in Australian hospitals in New South Wales (NSW), Australian Capital Territory (ACT) and Queensland (QLD) between November 2017 and January 2018. The survey evaluated RO educational and clinical exposure of participants during medical school, and prevocational training and their confidence and knowledge of the specialty. A total of 183 respondents across 17 Australian hospital networks completed the survey. During medical school, 53.4% had RO incorporated into their formal curriculum, 19.5% had no formal lectures and 51.7% had never visited a RO department. As a junior doctor, 73.8% of respondents did not receive any formal RO education. When compared with other oncology specialties, fewer junior doctors were confident in consulting the RO team (21.0%) compared with medical oncology (42.0%), palliative care (75.2%) and haematology (40.1%). Majority of respondents (61.6%) showed limited understanding of radiation safety. On multivariate sub-group analysis, both confidence and knowledge in RO improved when RO was incorporated into the formal medical school curriculum. This survey highlights the current low confidence and poor knowledge standard amongst Australian junior doctors on RO due to inadequate teaching during medical school and prevocational training and suggests improvement through standardisation of formal RO curriculum teaching within medical school and prevocational training.
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Affiliation(s)
- Revadhi Chelvarajah
- Liverpool Cancer Therapy Centre, Liverpool Hospital, 1 Campbell Street, Liverpool, New South Wales, 2170, Australia.
| | - Apsara Windsor
- Central Coast Cancer Centre, Gosford, New South Wales, Australia
- School of Medicine, University of Newcastle, Callaghan, New South Wales, Australia
- Faculty of Radiation Oncology, Royal Australia and New Zealand College of Radiologists, Sydney, New South Wales, Australia
| | - Luke Nicholls
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Ben Bravery
- Blacktown Mount Druitt Hospital, Blacktown, New South Wales, Australia
| | - Kate Shi
- Westmead Hospital, Westmead, New South Wales, Australia
| | - Sandra Turner
- Faculty of Radiation Oncology, Royal Australia and New Zealand College of Radiologists, Sydney, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead, New South Wales, Australia
| | - Minh Thi Tieu
- School of Medicine, University of Newcastle, Callaghan, New South Wales, Australia
- Calvary Mater Hospital, Newcastle, New South Wales, Australia
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14
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Joseph AO, Balogun OD, Akinsete AM, Awofeso OM, Bashir AM, Salako O, Onitilo AA. Oncology Education in the Nigerian Medical Curriculum: A Cross-Sectional Review. Niger Med J 2021; 62:127-132. [PMID: 38505192 PMCID: PMC10937060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024] Open
Abstract
Background The quality of a physician is arguably related to the depth and quality of medical education received. As cancer devastates the health and economy of developing countries like Nigeria, it becomes increasingly important for physicians in these countries to be equipped with basic knowledge and skill to adequately detect, diagnose, refer and manage common cancers. This study reviewed exposure to oncology training as a component of the medical school's curriculum in Nigeria from the trainee's perspective. Methodology In a cross-sectional review of medical students and recent graduates of universities across Nigeria, data were collected using a predesigned tool. Results Entries from 228 participants were recorded and analysed. The mean age of study participants was 25.4 ± 2.9 years; 53.1% were female. Respondents were primarily in government-owned medical schools. Over half (55.7%) reported none to minimal oncology exposure during their preclinical classes, 38.6% reported oncology as a distinct clinical rotation in their medical schools and only 44.3% spent time in at least one oncology unit during clinical rotations. The mean duration spent in oncology units was 3.4 weeks. Conclusion Doubtless, Nigeria needs more oncology specialists but, it is just as important for even general practitioners to have basic oncology knowledge. This study shows slow exposure to oncology training for medical students, which has contributed to the lack of confidence in treating common cancers seen in Nigeria and low desire among medical students to specialize in oncology. As cancer incidence rises, the need for oncology knowledge in the general physician community is increasingly evident.
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Affiliation(s)
- Adedayo O. Joseph
- Radiation Oncology Unit, Lagos University Teaching Hospital, Lagos, Nigeria
| | | | - Adeseye M. Akinsete
- Paediatric Oncology Unit, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Opeyemi M. Awofeso
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Adebola M. Bashir
- Radiation Oncology Unit, Lagos University Teaching Hospital, Lagos Nigeria
| | - Omolola Salako
- Radiation Oncology Unit, Lagos University Teaching Hospital, Lagos Nigeria
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15
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Rallis KS, Wozniak AM, Hui S, Nicolaides M, Shah N, Subba B, Papalois A, Sideris M. Inspiring the future generation of oncologists: a UK-wide study of medical students' views towards oncology. BMC MEDICAL EDUCATION 2021; 21:82. [PMID: 33530974 PMCID: PMC7852146 DOI: 10.1186/s12909-021-02506-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/20/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND One in 2 people born in the UK after 1960 are expected to require oncology input in their lifetime. However, only 36% of UK medical schools provide dedicated oncology placements and teaching indicating a discordance between public health impact and training. We designed a UK-wide survey to capture medical students' views on current oncology teaching and the potential role of a national undergraduate oncology symposium as an educational, networking and motivational tool. METHODS We undertook a national cross-sectional survey of UK medical students' views in oncology and satisfaction with teaching using pre-designed questionnaires. We also distributed a dedicated survey (pre and post-conference) to compare medical students' motivation towards a career in oncology after attending the national symposium. This study was prospectively approved by QMUL Ethics Committee (Reference number QMREC2348). Statistical analysis included univariate inferential tests on SPSS and GraphPad software. RESULTS The national survey was completed by 166 students representing 22 UK medical schools. Students reported limited interest, knowledge and exposure to oncology, lack of confidence in skills, and teaching dissatisfaction. Oncology was perceived as a challenging specialty (mean 4.5/5 ± 0.7), yet most students estimate receiving only 1-2 weeks of dedicated oncology teaching. The national symposium generated a statically significant increase in students' interest, knowledge, and confidence in skills surrounding oncology, improving students' perceived ability to cope with the emotional challenges in this field. CONCLUSION Students' views towards oncology alongside their teaching dissatisfaction underpin the need to revisit and strive to improve current undergraduate oncology curricula. Increasing medical student oncology exposure by proposing outcome-based guidelines and adopting a standardised undergraduate oncology curriculum should be the foremost priority in inspiring future oncologists to ensure excellent cancer patient care.
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Affiliation(s)
- Kathrine S Rallis
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anna Maria Wozniak
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Sara Hui
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Marios Nicolaides
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Neha Shah
- Newham University Hospital, Barts Health NHS Trust, London, UK
| | - Beena Subba
- North Middlesex University Hospital NHS Trust, London, UK
| | | | - Michail Sideris
- Women's Health Research Unit, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK.
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16
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Bravery BD, Shi K, Nicholls L, Chelvarajah R, Tieu MT, Turner S, Windsor A. Oncology and Radiation Oncology Awareness in Final Year Medical Students in Australia and New Zealand. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1227-1236. [PMID: 31332623 DOI: 10.1007/s13187-019-01586-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to determine final year students' core oncology and radiation oncology knowledge and attitudes about the quality of teaching in medical programmes delivered in Australia and New Zealand. Does the modern medical programme provide core oncology skills in this leading global cause of mortality and morbidity? An online survey was distributed between April and June 2018 and completed by 316 final year students across all 21 medical schools with final year cohorts in Australia and New Zealand. The survey examined teaching and clinical exposure, attitudes and core knowledge for oncology and radiation oncology. Several questions from a survey done of graduates in 2001 were repeated for comparison. We found that clinical exposure to oncology and its disciplines is low. Students rated oncology and haematology the worst taught medical specialties at medical school. Students reported the most confidence identifying when surgical management of cancer may be indicated and much lower levels of confidence identifying when systemic therapy and radiation therapy may be helpful. The majority of students had no formal course content on radiation therapy and more than one third of final year students erroneously believed that external beam radiation therapy turned patients radioactive. Exposure to oncology practice and the teaching of core oncology knowledge remains low for medical students in Australia and New Zealand. Many areas of oncology teaching and knowledge have worsened for medical students in Australia and New Zealand over the past 20 years. Well-established gaps in the core oncology knowledge of medical graduates must be urgently addressed given the increasing incidence of cancer and ongoing underutilisation of radiation therapy in particular.
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Affiliation(s)
- Benjamin D Bravery
- School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia.
| | - Kate Shi
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Luke Nicholls
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | | | - Minh Thi Tieu
- Calvary Mater Newcastle Hospital, Waratah, New South Wales, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Sandra Turner
- University of Newcastle, Callaghan, New South Wales, Australia
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia
| | - Apsara Windsor
- University of Newcastle, Callaghan, New South Wales, Australia.
- Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.
- Central Coast Cancer Centre, Gosford, New South Wales, Australia.
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17
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Freed JA, Hale AJ, Rangachari D, Ricotta DN. Twelve tips for teaching oncology to non-oncologists. MEDICAL TEACHER 2020; 42:987-992. [PMID: 31663798 DOI: 10.1080/0142159x.2019.1682534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Teaching subspecialty care to trainees who are not pursuing that subspecialty poses many challenges. These challenges are amplified in the teaching of oncology to non-oncologists because there are more new therapies emerging in oncology than in any other discipline, and there are few oncologic issues managed by generalists without consultation. Concurrently, there is an increasing need for generalists to manage many aspects of care for patients with cancer.Aim: To provide 12 tips for oncologists to use to educate trainees on their oncology rotations.Method: The tips provided are based upon the available literature and the authors' own experience.Results: The 12 tips presented offer specific strategies for oncologists to enhance their teaching by selection of appropriate content and enhancing delivery. Focus is placed on aspects of oncology that trainees are likely to encounter as a generalist or non-cancer subspecialist. While oncology is used as the case study, these strategies are adaptable to any subspecialty area.Conclusion: Oncologists and other subspecialists can be core medical educators.
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Affiliation(s)
- Jason A Freed
- Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Andrew J Hale
- Division of Infectious Disease, University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Deepa Rangachari
- Division of Hematology/Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Daniel N Ricotta
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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18
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Rallis KS, Allen-Tejerina AM. Tele-oncology in the COVID-19 Era: Are Medical Students Left Behind? Trends Cancer 2020; 6:811-812. [PMID: 32863197 PMCID: PMC7450948 DOI: 10.1016/j.trecan.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 11/02/2022]
Affiliation(s)
- Kathrine S Rallis
- Barts Cancer Institute, Queen Mary University of London, London, UK; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Klufas A, Shin G, Raphael R, Sarfaty SC, Hirsch AE. A Thorough Analysis of the Current State of Cancer Education in Medical Schools and Application of Experimental Teaching Techniques and Their Efficacy. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:931-946. [PMID: 33293885 PMCID: PMC7719335 DOI: 10.2147/amep.s268382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 10/08/2020] [Indexed: 05/12/2023]
Abstract
Newly diagnosed cases of cancer are expected to double by the year 2040. Although many different oncology teaching initiatives have been implemented, many students continue to report uncertainty when dealing with patients with cancer. Through this review, we aim to find the most effective teaching methods to better prepare future physicians. Papers studying different methods of teaching oncology were identified through a thorough review of specific electronic databases. Each study was analyzed and sorted into one of ten unique categories created by the authors specifically for this review. If portions of the study fit into multiple categories, relevant results would be analyzed in all applicable areas. Additionally, papers were separated and analyzed by country of origin, preclinical or clinical interventional basis, and quantitative versus qualitative form of statistical analysis. A total of 115 papers from 26 different countries and regions were included in the final analysis. 91.4% of papers analyzing Lecture and Small Group Discussions indicated a positive impact. 97.1% of papers analyzing Clinical Practice and Simulation indicated a positive impact. 100% of papers analyzing Early Experience and Mentorship, Summer Programs and Voluntary Electives, use of Multidisciplinary Teams, and Role Play stated that these methods had a positive impact. 50% of papers analyzing Computer/Web Based Programs indicated a positive impact. Clinical Practice and Simulation, Role Play, Summer/Elective Programs and interventions involving Multidisciplinary Team Work all appeared to be most effective. Intensive Block Programs, Didactic Lectures/Small Group Discussions, and Computer/Web Based Education tools as a whole were variable. General Review papers showed continued variability in domestic and international oncology curricula. Incorporation of effective teaching interventions should be highly considered in the future creation of standardized oncology curricula in order to best prepare the next generation of physicians. Future studies could explore the differing efficacies of teaching interventions in the postgraduate versus graduate realms.
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Affiliation(s)
- Andrew Klufas
- Boston University School of Medicine, Boston, MA, USA
| | - Grace Shin
- Boston University School of Medicine, Boston, MA, USA
| | - Ryan Raphael
- Boston University School of Medicine, Boston, MA, USA
| | - Suzanne C Sarfaty
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Ariel E Hirsch
- Department of Radiation Oncology, Boston Medical Center, Boston, MA, USA
- Department of Radiation Oncology, Boston University School of Medicine, Boston, MA, USA
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20
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Patel H, Chiva Giurca B, Mukundu Nagesh N, Hibell I, Beattie M, Saint M, Lau G. Difficult Conversations in Cancer Care: Lessons from a Student-Led Initiative. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2019; 34:1242-1246. [PMID: 30798463 DOI: 10.1007/s13187-019-01498-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
With the rising global burden of cancer, healthcare professionals will inevitably be involved directly or indirectly in the care of cancer patients. Although medical education has recently evolved to emphasise the biopsychosocial model, current training regarding difficult communication skills and breaking bad news remains inadequate. Our aim was to utilise a novel method of teaching communication skills through public engagement. This was achieved by setting up a local network of cancer patients who were willing to share their stories to aid student learning. A group of medical students from years one to four interviewed a total of 48 cancer patients about their illness experiences. Student reflections were collated, producing three common themes: (1) knowing what to say, (2) seeing the person in the patient, and (3) understanding the consequences of poor communication. The experiences allowed students to develop their communication skills, learn from patient experiences, and reflect on their future practice. Patient stories, including art, drawings, and poems, were collated in the form of a book and disseminated to promote further learning. We hope our reflections and public engagement initiative will identify key areas of difficult communication, enhance learning, and prepare students for meaningful and often difficult conversation in cancer care. Similar principles could be used in other areas of medical education to allow students to develop safe and effective interpersonal skills.
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21
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Frearson S. EDUCATION AND TRAINING: Perceived educational impact, -challenges and opportunities of hospice placements for foundation year doctors: a qualitative study. Future Healthc J 2019; 6:56-60. [PMID: 31098588 PMCID: PMC6520090 DOI: 10.7861/futurehosp.6-1-56] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Foundation year one doctors (F1s) are expected to recognise and care for dying patients, but previous studies have found they can feel unprepared, stressed and unsupported when faced with such situations. Although hospice placements can provide good experiential learning for junior doctors, no studies to date have included F1s. This study used an interpretivist approach to explore educational opportunities and challenges in hospice placements from an F1's perspective. Six F1s who had recently completed hospice placements were interviewed individually. Data analysed qualitatively showed that F1s valued informal experiential learning and felt well supported by senior doctors. The most important learning outcome was the acquisition of enhanced communication skills and challenges included the risk of becoming medically deskilled. F1s felt their medical practice had changed as a result of hospice placement, most commonly in communication skills and recognition of the dying phase. The author recommends increased utilisation of hospice placements in foundation training programmes.
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22
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de Camargo CRS, Schoueri JHM, Neto FL, Segalla PB, Del Giglio A, Cubero DIG. Medical Student Oncology Congress: Designed and Implemented by Brazilian Medical Students. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:1151-1158. [PMID: 28361359 DOI: 10.1007/s13187-017-1215-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Oncology is an essential field of medicine; however, its teaching is occasionally underemphasized and uncoordinated during medical school. An alternative method of providing additional oncological information to medical students is through extracurricular activities, such as congresses and medical student associations. The aim of this paper is to describe a Medical Student Oncology Congress entirely designed and organized by medical students. Three medical students from oncology study and research groups identified the gap in oncology training at universities and decided to organize a congress for students. They selected representatives from 26 universities in Brazil for onsite registration and created a website for online registration and promotion of the congress. To determine the topics of the lectures, they searched the medical literature for the most commonly occurring cancers in adults and children. Extrapolating the academic content of oncology, they organized lectures by non-governmental organizations (NGOs), talks on career guidance and research in this field as well as a role-playing workshop to train future doctors on how to deliver news to patients. There were a total of 609 attendees, with 590 students from 26 different universities in Brazil. Approximately 82% were medical students, and among the participants there were also 15 medical educators. A total of 80.75% of the participants were extremely satisfied with the congress, and 99.17% would recommend it to a colleague. Most of the overall cost of the congress, 96%, was covered by registration fees. There was a 6% positive net balance, which was donated to the NGOs participating in the congress. This successful experience proves that it is possible to have a congress fully designed, organized and managed by students. It demonstrates how students can be active participants in their own education, as opposed to a classic approach through which only professors are responsible for instruction.
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Affiliation(s)
| | | | | | | | - Auro Del Giglio
- Oncology and Haematology Department, ABC School of Medicine, Santo Andre, SP, Brazil
| | - Daniel I G Cubero
- Oncology and Haematology Department, ABC School of Medicine, Santo Andre, SP, Brazil
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23
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Nicholls L, Bravery B, Chelvarajah R, Shi K, Tieu MT, Turner S, Windsor A. The status of radiation oncology teaching in Australian and New Zealand medical schools. J Med Imaging Radiat Oncol 2018; 62:828-834. [PMID: 30074292 DOI: 10.1111/1754-9485.12788] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 07/11/2018] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Radiation therapy is a core component of curative and palliative cancer treatment; however, its indications and benefits remain poorly understood across the medical profession. METHODS An electronic survey focussing on curriculum content, teaching and assessment in radiation oncology and plans for curriculum change was developed. The Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiology (RANZCR) distributed the survey to all 24 Australian and New Zealand medical schools. The survey was conducted from November 2017 to January 2018 following ethics approval. RESULTS Sixteen of the 24 (67%) medical Faculties in Australia and New Zealand responded. Ninety-four percent of Faculties had no formal radiation oncology curriculum. Most Faculties (87%) dedicated <15% of the total medical course to oncology, of which the majority (63%) dedicated <10% to radiation oncology. At least 50% of Faculties did not offer formal radiation oncology teaching to all students. When offered, students' exposure to radiation oncology was often <5 days over the entire course (44%). The majority of medical schools (73%) are planning curriculum changes in the next 5 years; however, most have no intention of changing radiation oncology teaching. CONCLUSION Radiation oncology continues to be underrepresented in medical curricula throughout Australia and New Zealand with no plans for improvement by Faculties. This study supports the need for formal advocacy for improving radiation oncology education in medical schools and will form the basis of new national recommendations for radiation oncology curriculum development.
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Affiliation(s)
- Luke Nicholls
- Princess Alexandra Hospital, Brisbane, Queensland, Australia.,School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Ben Bravery
- School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia
| | | | - Kate Shi
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Minh Thi Tieu
- University of Newcastle, Callaghan, New South Wales, Australia.,Radiation Oncology Department, Calvary Mater Hospital, Newcastle, New South Wales, Australia
| | - Sandra Turner
- Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia.,Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia
| | - Apsara Windsor
- University of Newcastle, Callaghan, New South Wales, Australia.,Faculty of Radiation Oncology, Royal Australian and New Zealand College of Radiologists, Sydney, New South Wales, Australia.,Central Coast Cancer Centre, Gosford, New South Wales, Australia
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24
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Ha FJ, Parakh S. Novel Approaches To Undergraduate Oncology Education. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:500-504. [PMID: 27581433 DOI: 10.1007/s13187-016-1109-z] [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] [Indexed: 05/26/2023]
Abstract
With the increasing incidence of cancer and related survival, junior doctors are more commonly involved the management of oncology patients. A comprehensive oncology curriculum has been developed and adopted across medi-cal schools in Australia. However, it was not designed to inform how medical students should be taught, and whether curriculum content translates to knowledge and competency can depend on its implementation. We have conducted a literature review of PubMed, Embase and Cochrane databases to identify and summarise the evidence for novel approaches to delivering the undergraduate oncology curriculum. Numerous effective approaches have been developed across areas of prevention, clinical examination through simulation, the multidisciplinary team, psycho-oncology, palliative care and even research. There is growing focus on a holistic and multidisciplinary approach to cancer education although direct clinical exposure and interactions with cancer patients is still crucial. Medical schools may also have an under-recognised role in promoting positive health behaviour if their graduates are to convey these preventative measures to their patients. Application of such methods relies upon clinicians and medical educators to consider the practicability and relevance of specific implementation in their local context.
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Affiliation(s)
- Francis J Ha
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Department of Medical Oncology, Olivia Newton-John Cancer and Wellness Centre, Austin Health, 145 Studley Road Heidelberg, Melbourne, Australia, 3084
| | - Sagun Parakh
- Department of Medical Oncology, Olivia Newton-John Cancer and Wellness Centre, Austin Health, 145 Studley Road Heidelberg, Melbourne, Australia, 3084.
- Tumour Targeting Laboratory, Olivia Newton-John Cancer Research Institute, Melbourne, Australia.
- School of Cancer Medicine, La Trobe University, Melbourne, Australia.
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Arenas M, Sabater S, Biete A, Lara P, Calvo F. Radiation Oncology Teaching Programmes as Part of the Undergraduate Degree in Medicine in Spanish Universities: the Need for an Update of the Contents and Structure. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:352-358. [PMID: 27595996 DOI: 10.1007/s13187-016-1106-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The relevance of radiation oncology (RO) teaching in the Faculty of Medicine Degree Plan is justified by the high number of cancer patients who will require it at some point in their evolution of radiotherapy (RT). About 40 % of the population who will suffer cancer will be cured by RT alone or other related treatment modalities. Therefore, cancer education and RT teaching needs to have an in depth impact in the undergraduate medicine programmes. This education component is highly variable, not only among countries but also within each country, in terms of content (theory and practical training), number of credits and departmental affiliation of the teachers. Our aim is to take a snapshot of the situation of the teaching of RO in undergraduate university education in Spain. We have analysed 40 Spanish universities about specific aspects related to the teaching of RT. Information was obtained by mail or telephone contact throughout 2015. We have analysed the elements involved in teaching performance. In universities with various instructional units, we have taken the average of them. Among the Universities consulted in Spain, during the period of the medical degree, the average time allocated to RT lectures is 12 h (range, 0-36), the mean time allocated to seminars is 4 h (range, 0-22), and the mean time assigned to practices is 11 h (range, 0-38). The subject is mainly taught by a radiation oncologist and 80 % of Spanish universities have at least one radiation oncologist on staff. Undergraduate radiation oncology teaching in Spain shows structural heterogeneity. The Spanish Society of Radiation Oncology (SEOR) University Forum has identified new opportunities and elaborated a proposal to improve undergraduate education in oncology.
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Affiliation(s)
- Meritxell Arenas
- Radiation Oncology Department, Hospital Universitari Sant Joan de Reus. School of Medicine, University of Rovira i Virgili, C/ Sant Joan, s/n, Reus, Tarragona, Spain.
| | - Sebastià Sabater
- Radiation Oncology Department, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Albert Biete
- Radiation Oncology Department, Hospital Clinic Universitari. School of Medicine, University of Barcelona, Barcelona, Spain
| | - Pedro Lara
- Radiation Oncology Department, Dr. Negrín University Hospital. School of Medicine, University of Las Palmas, Las Palmas, Spain
| | - Felipe Calvo
- Oncology Department, Hospital General Universitario Gregorio Marañón. School of Medicine, Complutense University of Madrid, Madrid, Spain
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Mayes J, Davies S, Harris A, Wray E, Dark GG. Impact of a 2-Week Oncology Placement on Medical Students' Perception of Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:174-179. [PMID: 27550294 DOI: 10.1007/s13187-016-1101-7] [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] [Indexed: 05/26/2023]
Abstract
Statistics show that more than one in two people born after 1960 in the UK will develop cancer during their lifetime. However, a 2013 study found that only 36 % of UK medical schools offer dedicated clinical teaching in oncology. The aim of this study was to assess the views of medical students on five domains of oncology before and after their first clinical placement, to assess the impact, and to obtain students' views on the oncology curriculum. A 28-item questionnaire was developed to compare responses before and after the students' first 2-week clinical placement, and impact was measured as a positive or negative deviation from a baseline response. Students were asked about their career intentions and to evaluate their received teaching. Thirty-six (80 %) students responded to the questionnaire. The largest areas of change were identified in students' confidence in breaking bad news, recognising red flag symptoms, and awareness of the complications of cancer management. Following their placement, 19 students said they would consider a career in oncology, 14 said they would not, and 2 were undecided. Students stated that Maggie's Centre, a patient support facility, was the most useful learning experience. The evidence demonstrates that all students should experience oncology in a variety of settings to aid their learning. Student feedback and perception can help to guide and shape medical teaching.
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Affiliation(s)
| | | | | | - Emma Wray
- Newcastle University, Newcastle upon Tyne, UK
| | - Graham G Dark
- Newcastle University, Newcastle upon Tyne, UK.
- Medical Oncology and Cancer Education, Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK.
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Neppala P, Sherer MV, Larson G, Bryant AK, Panjwani N, Murphy JD, Gillespie EF. An interactive contouring module improves engagement and interest in radiation oncology among preclinical medical students: Results of a randomized trial. Pract Radiat Oncol 2018; 8:e190-e198. [PMID: 29571974 DOI: 10.1016/j.prro.2018.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/28/2017] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Studies have shown significant gaps in knowledge of radiation therapy among medical students and primary care providers. The goal of this study was to evaluate the effect of an interactive contouring module on knowledge and interest in radiation oncology among preclinical medical students. METHODS AND MATERIALS Second-year medical students at the University of California, San Diego were randomized to participate in an interactive contouring exercise or watch a traditional didactic lecture on radiation oncology. Participants completed knowledge tests and surveys at baseline, immediately following the exercise, and 3 months later. Statistical analysis included Wilcoxon signed-rank test for pre- and posttest comparisons and Wilcoxon rank sum test for comparison between groups. RESULTS Forty-three medical students participated in the trial (21 in the didactic group; 22 in the contouring group). Students completing the contouring module demonstrated similar overall knowledge improvement compared with the traditional didactic group (+8.6% vs +6.6%, not significant) but endorsed greater engagement on a 5-point Likert-type scale (3.10 vs 3.76, P = .02). At 3-month follow-up, there was a nonsignificant trend toward improved overall knowledge in the contouring group (43% vs 51%, P = .10), with a significance difference in a subset of questions on knowledge of the process of radiation therapy as well as side effects (51% vs 75%, P = .002). Students in the contouring group demonstrated more interest in pursuing a clinical radiation oncology rotation (2.52 vs 3.27, P = .01). CONCLUSIONS Use of an interactive contouring module was an effective method to teach preclinical medical students about radiation oncology, with no significant difference in knowledge gained compared with a traditional didactic lecture; however, higher engagement among students completing the contouring module led to improved retention of knowledge of radiation side effects and greater interest in radiation oncology. These data suggest a potential benefit of integrating an interactive radiation oncology module into the preclinical medical school curriculum.
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Affiliation(s)
- Pushpa Neppala
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Michael V Sherer
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Grant Larson
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Alex K Bryant
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Neil Panjwani
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - James D Murphy
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California
| | - Erin F Gillespie
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California; Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York.
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George M, Mandaliya H, Prawira A. A Survey of Medical Oncology Training in Australian Medical Schools: Pilot Study. JMIR MEDICAL EDUCATION 2017; 3:e23. [PMID: 29233799 PMCID: PMC5743919 DOI: 10.2196/mededu.7903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/08/2017] [Accepted: 10/30/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND Oncology is a rapidly evolving field with continuous advancements in the diagnosis and treatment of cancer. Therefore, it is important that medical students are provided with the knowledge and experience required to care for oncology patients and enable them to diagnose and manage toxicities of novel therapeutic agents. OBJECTIVE This study was performed to understand the medical students' perspective of the oncology education provided in universities across Australia and identify areas of education that could potentially be modified or improved to ultimately attract more students to a career in oncology. METHODS This pilot cross-sectional study consisted of an 18-question survey that was submitted online to medical students in their final year and interns rotating to the Tamworth Hospital. RESULTS The survey was completed by 94 fifth-year medical students and interns. Oncology was taught both theoretically and clinically for 68% (63/93) of participants, and 48% (44/92) had an exclusive oncology rotation. Both theoretical and clinical oncology assessments were conducted for only 21% (19/92) of participants. Overall, 42% (38/91) of participants were satisfied with their oncology education, and 78% (40/51) were dissatisfied with the number of oncology teaching hours. The importance of a career in oncology was rated as low by 46% (41/90) of participants. CONCLUSIONS This pilot study indicates that there are potential areas to improve oncology teaching in Australian universities. The majority of surveyed students were dissatisfied with the number of teaching hours they receive in oncology. More global assessment of students and/or interns from other Australian institutes may yield further useful information.
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Affiliation(s)
- Mathew George
- Medical Oncology, North West Cancer Centre, Tamworth, Australia
| | - Hiren Mandaliya
- Medical Oncology, North West Cancer Centre, Tamworth, Australia
| | - Amy Prawira
- Medical Oncology, North West Cancer Centre, Tamworth, Australia
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Pinho-Gomes AC, Taylor D, Riley S. Influence of Student Selected Components on Medical Career Choice. MEDEDPUBLISH 2017; 6:191. [PMID: 38406467 PMCID: PMC10885311 DOI: 10.15694/mep.2017.000191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background and aims: Student selected components (SSC) offer a privileged opportunity for students to gain a deeper insight into areas of their personal interest, including potential careers. How different SSC programmes influence future career choice remains uncertain. The aims of this study were to investigate (1) how SSC programmes in British medical schools offer career exploration and (2) whether the experience of SSCs during medical school influences medical career choice. Methods: Two online surveys were sent to SSC leads in medical schools and to Foundation Year 2 doctors in the UK. This information was complemented with data available on medical school websites. Results and conclusions: A wide diversity of SSCs programmes is provided by medical schools across the UK, with variable compliance with GMC recommendations regarding career exploration. SSCs seem to play a paramount role in shaping career preferences during medical school and to exert a powerful influence on future career decisions. Therefore, it is imperative to design SSC programmes that allow students to explore several career pathways, including both medical and alternative careers, so that they can make informed decisions and hence avoid the detrimental consequences of inadequate career choices.
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Lütgendorf-Caucig C, Kaiser PA, Machacek A, Waldstein C, Pötter R, Löffler-Stastka H. Vienna Summer School on Oncology: how to teach clinical decision making in a multidisciplinary environment. BMC MEDICAL EDUCATION 2017; 17:100. [PMID: 28587603 PMCID: PMC5461756 DOI: 10.1186/s12909-017-0922-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 04/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Clinical decision making in oncology is based on both inter- and multidisciplinary approach. Hence teaching future doctors involved in oncology or general health practice is crucial. The aim of the Vienna Summer School on Oncology (VSSO) as an international, integrated, undergraduate oncology course is to teach medical students interdisciplinary team communication and application of treatment concepts/algorithms in a multidisciplinary setting. METHOD The teaching is based on an inter- and multidisciplinary faculty and a multimodal education approach to address different learning styles. The participants rated their satisfaction of the program voluntarily after finishing the course according to a grading scale from one (not good) to five (very good). The learning success was assessed by a compulsory pre-VSSO and post-VSSO single choice questionnaire. RESULTS Program organisation was rated with a mean score of 4.47 out of 5.0 (SD 0.51), composition of the program and range of topics with a mean score of 4.68 (SD 0.58) and all teachers with a mean score of 4.36 (SD 0.40) points. Student evaluation at the beginning and end of the program indicated significant knowledge acquisition -i.e., general aspects of cancer: median 8.75 points (IQR 7.5-9.4) vs.10.0 points (IQR 9.4-10.0) p = 0.005; specific aspects of cancer: median 4.87 points (IQR 3.33-5.71) vs. 8.72 points (IQR 6.78-9.49) p ≤ 0.001, respectively. CONCLUSION Even though the participants represent a selection of students with special interest in cancer, the results of the VSSO indicate the benefit of an inter- and multidisciplinary teaching approach within an oncology module.
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Affiliation(s)
- Carola Lütgendorf-Caucig
- Department of Radiation Oncology, Comprehensive Cancer Center, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University of Vienna/General Hospital of Vienna, Vienna, Austria
| | - Philipp A. Kaiser
- 0000 0000 9259 8492grid.22937.3dInternational Students Office, Medical Students Association, Medical University Vienna, Vienna, Austria
| | - Alexandra Machacek
- Department of Radiation Oncology, Comprehensive Cancer Center, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University of Vienna/General Hospital of Vienna, Vienna, Austria
| | - Cora Waldstein
- Department of Radiation Oncology, Comprehensive Cancer Center, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University of Vienna/General Hospital of Vienna, Vienna, Austria
| | - Richard Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center, Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology; Medical University of Vienna/General Hospital of Vienna, Vienna, Austria
| | - Henriette Löffler-Stastka
- Department of Psychoanalysis and Psychotherapy, and Teaching Center, Medical University of Vienna/General Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
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Wang J, He B, Miao X, Huang X, Lu Y, Chen J. The reliability and validity of a new professionalism assessment scale for young health care workers. Medicine (Baltimore) 2017. [PMID: 28640082 PMCID: PMC5484190 DOI: 10.1097/md.0000000000007058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
With the development of medical technique, many medical challenges have been solved. This cross-sectional study was aimed to assess the reliability and validity of a new developed scale for assessing the professionalism of young health care workers.This cross-sectional population-based study was conducted based on cluster sampling method in 2015. The participants were from 2 medical centers of Nantong city of Jiangsu province in China. The internal consistency reliability was assessed using Cronbach's alpha and split-half reliability coefficients. Construct validity was analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Content, convergent, and discriminant validities were also assessed in this study.Total 749 individuals aged 29.09 ± 3.91 years old participated in this investigation. There were 745 valid questionnaires and 730 were complete. Cronbach's alpha value (0.944) and the split-half reliability coefficient (0.873) reflected satisfactory internal consistency reliability of this new professionalism assessment scale. EFA extracted a 7-factor model. About 63.4% of the total variance was explained by these factors. However, CFA showed a good model fit after excluding the items with factor loading lower than 0.5. Good discriminant validity of this new developed professionalism assessment scale was also shown (P < .05). However, the evidences for content and convergent validity were not enough in this study.The results showed the satisfactory reliability of this new developed professionalism assessment scale. However, this scale should be modified to improve the validity in further studies.
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Affiliation(s)
| | | | | | - Xiaoqin Huang
- Department of Scientific Research and Teaching, The Second Affiliated Hospital of Nantong University
| | - Yihua Lu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
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Tam VC, Ingledew PA, Berry S, Verma S, Giuliani ME. Developing Canadian oncology education goals and objectives for medical students: a national modified Delphi study. CMAJ Open 2016; 4:E359-E364. [PMID: 27730100 PMCID: PMC5047803 DOI: 10.9778/cmajo.20150127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Studies have shown that there is a deficiency in focused oncology teaching during medical school in Canada. This study aimed to develop oncology education goals and objectives for medical students through consensus of oncology educators from across Canada. METHODS In 2014 we created a comprehensive list of oncology education objectives using existing resources. Experts in oncology education and undergraduate medical education from all 17 Canadian medical schools were invited to participate in a 3-round modified Delphi process. In round 1, the participants scored the objectives on a 9-point Likert scale according to the degree to which they agreed an objective should be taught to medical students. Objectives with a mean score of 7.0 or greater were retained, those with a mean score of 1.0-3.9 were excluded, and those with a mean score of 4.0-6.9 were discussed at a round 2 Web meeting. In round 3, the participants voted on inclusion and exclusion of the round 2 objectives. RESULTS Thirty-four (92%) of the 37 invited oncology educators, representing 14 medical schools, participated in the study. They included oncologists, family physicians, members of undergraduate medical education curriculum committees and a psychologist. Of the 214 objectives reviewed in round 1, 146 received a mean score of 7.0 or greater, and 68 were scored 4.0-6.9; no objective received a mean score below 4.0. Nine new objectives were suggested. The main themes of participants' comments were to minimize the number of objectives and to aim objectives at the knowledge level required for family physicians. In round 2, the participants were able to combine 28 of the objectives with other existing objectives. In round 3, 7 of the 49 objectives received consensus of at least 75% for inclusion. The final Canadian Oncology Goals and Objectives for Medical Students contained 10 goals and 153 objectives. INTERPRETATION Through a systematic process, we created a comprehensive, consensus-based set of oncology goals and objectives to facilitate the design of undergraduate medical education curricula and improve oncology education for medical students.
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Affiliation(s)
- Vincent C Tam
- Department of Oncology (Tam, Verma), Tom Baker Cancer Centre, University of Calgary, Calgary, Alta.; Department of Radiation Oncology (Ingledew), Fraser Valley Cancer Centre, University of British Columbia, Vancouver, BC; Division of Medical Oncology and Hematology (Berry), Sunnybrook Odette Cancer Centre, University of Toronto; Department of Radiation Oncology (Giuliani), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont
| | - Paris-Ann Ingledew
- Department of Oncology (Tam, Verma), Tom Baker Cancer Centre, University of Calgary, Calgary, Alta.; Department of Radiation Oncology (Ingledew), Fraser Valley Cancer Centre, University of British Columbia, Vancouver, BC; Division of Medical Oncology and Hematology (Berry), Sunnybrook Odette Cancer Centre, University of Toronto; Department of Radiation Oncology (Giuliani), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont
| | - Scott Berry
- Department of Oncology (Tam, Verma), Tom Baker Cancer Centre, University of Calgary, Calgary, Alta.; Department of Radiation Oncology (Ingledew), Fraser Valley Cancer Centre, University of British Columbia, Vancouver, BC; Division of Medical Oncology and Hematology (Berry), Sunnybrook Odette Cancer Centre, University of Toronto; Department of Radiation Oncology (Giuliani), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont
| | - Sunil Verma
- Department of Oncology (Tam, Verma), Tom Baker Cancer Centre, University of Calgary, Calgary, Alta.; Department of Radiation Oncology (Ingledew), Fraser Valley Cancer Centre, University of British Columbia, Vancouver, BC; Division of Medical Oncology and Hematology (Berry), Sunnybrook Odette Cancer Centre, University of Toronto; Department of Radiation Oncology (Giuliani), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont
| | - Meredith E Giuliani
- Department of Oncology (Tam, Verma), Tom Baker Cancer Centre, University of Calgary, Calgary, Alta.; Department of Radiation Oncology (Ingledew), Fraser Valley Cancer Centre, University of British Columbia, Vancouver, BC; Division of Medical Oncology and Hematology (Berry), Sunnybrook Odette Cancer Centre, University of Toronto; Department of Radiation Oncology (Giuliani), Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont
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Abstract
Oncologists should contribute to the undergraduate curriculum whenever they can, and should teach communication skills, acute oncology, prescribing, and other transferable skills. Newly qualified doctors will care for many patients with cancer in their first years of work, and all doctors need to know when an urgent oncology referral is required and to be aware of the pace of change in oncology. Oncologists should involve their patients in teaching whenever it is appropriate. We should aim to inspire junior doctors to consider a career in oncology. The oncology education community should adopt new teaching methods, for example simulation, mock MDTs and student led clinics. CPD provided by honorable organisations, including online learning, is becoming more important for oncologists to keep up to date.
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Affiliation(s)
- Judith Cave
- Dept of Medical Oncology, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
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Hawkins A, Tredgett K. Use of high-fidelity simulation to improve communication skills regarding death and dying: a qualitative study. BMJ Support Palliat Care 2016; 6:474-478. [PMID: 27316636 DOI: 10.1136/bmjspcare-2015-001081] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 04/12/2016] [Accepted: 05/31/2016] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The objectives of this study were to explore medical students' experiences of communicating with patients and their carers about death and dying, and to assess whether using high-fidelity simulation improved students' confidence in discussing cardiopulmonary resuscitation. METHODS This qualitative study was carried out at a hospital in the south of England. Participants were 7 final-year medical students. Tutorials were developed using high-fidelity simulation to teach communication skills regarding discussion of cardiopulmonary resuscitation with patients and carers. Scenarios involved a simulated ward environment, a high-fidelity simulation mannequin and actor playing the role of a carer. Data were collected through joint interviews carried out by one researcher which were audio recorded and transcribed verbatim. The same researcher analysed the data using framework analysis. RESULTS Students reported a lack of experience observing conversations with patients and carers about death and dying. They also reported a lack of opportunities to interact with dying patients during their training. Barriers reported by students included healthcare professionals' and patients' attitudes. Students reported a lack of confidence and preparedness to have consultations with patients and carers about death, dying and cardiopulmonary resuscitation as junior doctors. They perceived role-play scenarios observed by their peers to be stressful, and this detracted from the learning experience. Students reported that the high-fidelity simulation scenarios were more realistic than low-fidelity ('role-play') scenarios. This improved the learning gained from the sessions and improved confidence among some students. CONCLUSIONS This study has suggested that high-fidelity simulation may be a useful adjunct for undergraduate communication skills training in palliative medicine. Further research is required to assess whether improvements in confidence described by students in this study translate to discernible improvements in competence, and whether using high-fidelity simulation in this setting is cost-effective.
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Affiliation(s)
- A Hawkins
- Woking and Sam Beare Hospices, Woking, UK
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Shou J, Ren L, Wang H, Yan F, Cao X, Wang H, Wang Z, Zhu S, Liu Y. Reliability and validity of 12-item Short-Form health survey (SF-12) for the health status of Chinese community elderly population in Xujiahui district of Shanghai. Aging Clin Exp Res 2016; 28:339-46. [PMID: 26142623 DOI: 10.1007/s40520-015-0401-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/12/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND The 12-item Short-Form Health Survey (SF-12) is the abridged practical version of SF-36. AIMS This cross-sectional study was aimed to assess the reliability and validity of SF-12 for the health status of Chinese community elderly population. METHODS The Chinese community elderly people in Xujiahui district of Shanghai were investigated. The internal consistency reliability was assessed using Cronbach's alpha and split-half reliability coefficients. Construct validity was analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Spearman's correlation coefficient (ρ) was used for the evaluation of criterion, convergent, and discriminant validity with Spearman's ρ ≥ 0.4 as satisfactory. Comparisons of the SF-12 summary scores among populations that differed in demographics were performed for discriminant validity. RESULTS Total 1343 individuals aged ≥60 and <85 years old (response rate: 91.3 %) were analyzed. The Cronbach's α value (0.910) and the split-half reliability coefficient (0.812) reflected satisfactory internal consistency reliability of SF-12. EFA extracted a two-factor model (physical and mental health). About 60.7 % of the total variance was explained by the two factors. CFA showed that the two-factor solution provided a good fit to the data. Good convergent validity and discriminant validity of SF-12 were proved by the correction analyses (Spearman's ρ > 0.4) and the comparisons of the SF-12 summary scores among populations (P < 0.05). SF-12 summary scores were significantly correlated with the SF-36 summary scores (Spearman's ρ > 0.4, P < 0.05). CONCLUSIONS In conclusion, SF-12 had satisfactory reliability and validity in measuring health status of Chinese community elderly population in Xujiahui district of Shanghai.
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Baird R, Banks I, Cameron D, Chester J, Earl H, Flannagan M, Januszewski A, Kennedy R, Payne S, Samuel E, Taylor H, Agarwal R, Ahmed S, Archer C, Board R, Carser J, Copson E, Cunningham D, Coleman R, Dangoor A, Dark G, Eccles D, Gallagher C, Glaser A, Griffiths R, Hall G, Hall M, Harari D, Hawkins M, Hill M, Johnson P, Jones A, Kalsi T, Karapanagiotou E, Kemp Z, Mansi J, Marshall E, Mitchell A, Moe M, Michie C, Neal R, Newsom-Davis T, Norton A, Osborne R, Patel G, Radford J, Ring A, Shaw E, Skinner R, Stark D, Turnbull S, Velikova G, White J, Young A, Joffe J, Selby P. An Association of Cancer Physicians' strategy for improving services and outcomes for cancer patients. Ecancermedicalscience 2016; 10:608. [PMID: 26913066 PMCID: PMC4762575 DOI: 10.3332/ecancer.2016.608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Indexed: 12/02/2022] Open
Abstract
The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.
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Affiliation(s)
- Richard Baird
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Ian Banks
- ACP Strategy Drafting Group
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - David Cameron
- ACP Executive Member
- ACP Strategy Drafting Group
- Edinburgh Cancer Research Centre, UK
| | - John Chester
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Wales Cancer Research Centre, Cardiff, UK
| | - Helena Earl
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Addenbrooke’s Hospital, Cambridge, UK
| | - Mark Flannagan
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Beating Bowel Cancer, Harlequin House, 7 High St, Teddington, Middlesex TW11 8EE, UK
| | - Adam Januszewski
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- London Deanery, Stewart House, 32 Russell Square, London WC1B 5DN, UK
| | | | - Sarah Payne
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Guy’s and St Thomas’s Hospital, London, UK and Medical Affairs Manager, Pfizer
| | - Emlyn Samuel
- ACP Strategy Drafting Group
- Cancer Research UK, Angel Building, 407 St John Street, London EC1V 4AD, UK
| | - Hannah Taylor
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Severn Deanery, Vantage Office Park Old Gloucester Road, Hambrook, Avon, Bristol BS16 1GW, UK
| | - Roshan Agarwal
- ACP Executive Member
- Northampton General Hospital, Cliftonville, Northampton NN1 5BD, UK
| | - Samreen Ahmed
- ACP Executive Member
- University Hospitals of Leicester, Infirmary Square, Leicester LE1 5WW, UK
| | - Caroline Archer
- ACP Executive Member
- Queen Alexandra Hospital, Portsmouth, UK
| | - Ruth Board
- ACP Executive Member
- Lancashire Teaching Hospitals, UK
| | - Judith Carser
- ACP Executive Member
- Southern Health and Social Care Trust, Southern College of Nursing, Craigavon Area Hospital, 68 Lurgan Road, Portadown, BT63 5QQ, UK
| | - Ellen Copson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - David Cunningham
- ACP Executive Member
- Supporting Chapter Author
- NIHR Biomedical Research Centre, Royal Marsden Hospital, London, UK
| | - Rob Coleman
- ACP Executive Member
- Weston Park Hospital, Sheffield, UK
| | - Adam Dangoor
- ACP Executive Member
- Supporting Chapter Author
- University Hospitals Bristol, Bristol, UK
| | - Graham Dark
- Supporting Chapter Author
- Freeman Hospital, Newcastle, UK
| | - Diana Eccles
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | | | - Adam Glaser
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Richard Griffiths
- ACP Executive Member
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Geoff Hall
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Marcia Hall
- ACP Executive Member
- Mount Vernon Cancer Centre, Northwood, UK
| | - Danielle Harari
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Michael Hawkins
- Supporting Chapter Author
- University of Birmingham, Edgbaston, Birmingham, West Midlands B15 2TT, UK
| | - Mark Hill
- ACP Executive Member
- Kent Oncology Centre, Maidstone, Kent, UK
| | - Peter Johnson
- Supporting Chapter Author
- University of Southampton, University Rd, Southampton SO17 1BJ, UK
| | - Alison Jones
- ACP Executive Member
- Royal Free and University College Hospital, London, UK
| | - Tania Kalsi
- Supporting Chapter Author
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | | | - Zoe Kemp
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Janine Mansi
- ACP Executive Member
- Supporting Chapter Author
- Guy’s and St Thomas’ Hospitals, London, UK
| | - Ernie Marshall
- Supporting Chapter Author
- Clatterbridge Cancer Centre, Clatterbridge Health Park, Clatterbridge Rd, Wirral, Merseyside CH63 4JY, UK
| | - Alex Mitchell
- Supporting Chapter Author
- University of Leicester, University Rd, Leicester LE1 7RH, UK
| | - Maung Moe
- ACP Executive Member
- North Middlesex University Hospital, UK
| | | | - Richard Neal
- Supporting Chapter Author
- University of Bangor, Bangor, Gwynedd LL57 2DG , Wales, UK
| | - Tom Newsom-Davis
- Supporting Chapter Author
- Chelsea and Westminster Hospital, London, UK
| | | | - Richard Osborne
- Supporting Chapter Author
- Poole Hospital, Longfleet Rd, Poole, Dorset BH15 2JB, UK
| | - Gargi Patel
- ACP Executive Member
- Brighton and Sussex University Hospitals, UK
| | - John Radford
- Supporting Chapter Author
- University of Manchester, Oxford Rd, Manchester M13 9PL, UK
| | - Alistair Ring
- Supporting Chapter Author
- Royal Marsden Hospital, London, UK
| | - Emily Shaw
- Supporting Chapter Author
- Southampton General Hospital, Tremona Rd, Southampton, Hampshire SO16 6YD, UK
| | - Rod Skinner
- Supporting Chapter Author
- Royal Victoria Infirmary, Newcastle, UK
| | - Dan Stark
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Sam Turnbull
- ACP Executive Member
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Galina Velikova
- Supporting Chapter Author
- University of Leeds, Leeds LS2 9JT, UK
| | - Jeff White
- Supporting Chapter Author
- Beatson West of Scotland Cancer Centre, Glasgow, Scotland, UK
| | - Alison Young
- ACP Executive Member
- Supporting Chapter Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
| | - Johnathan Joffe
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Huddersfield Royal Infirmary, Acre St, Huddersfield, West Yorkshire HD3 3EA, UK
| | - Peter Selby
- ACP Executive Member
- ACP Strategy Drafting Group
- Supporting Chapter Author
- Senior Author
- Leeds Cancer Centre, St James’s University Hospital, Leeds, UK
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Zaorsky NG, Shaikh T, Handorf E, Eastwick G, Hesney A, Scher ED, Jones RT, Showalter TN, Avkshtol V, Rice SR, Horwitz EM, Meyer JE. What Are Medical Students in the United States Learning About Radiation Oncology? Results of a Multi-Institutional Survey. Int J Radiat Oncol Biol Phys 2015; 94:235-42. [PMID: 26684409 DOI: 10.1016/j.ijrobp.2015.10.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 08/21/2015] [Accepted: 10/01/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE The purposes of this study were to assess the exposure that medical students (MSs) have to radiation oncology (RO) during the course of their medical school career, as evidenced by 2 time points in current medical training (ie, first vs fourth year; MS1s and MS4s, respectively) and to assess the knowledge of MS1s, MS4s, and primary care physicians (PCPs) about the appropriateness of RT in cancer management in comparison with RO attendings. METHODS We developed and beta tested an electronic survey divided into 3 parts: RO job descriptions, appropriateness of RT, and toxicities of RT. The surveys were distributed to 7 medical schools in the United States. A concordance of >90% (either yes or no) among RO attendings in an answer was necessary to determine the correct answer and to compare with other subgroups using a χ(2) test (P<.05 was significant). RESULTS The overall response rate for ROs, MS1s, MS4s, and PCPs was 26%; n (22 + 315 + 404 + 43)/3004. RT misconceptions decreased with increasing level of training. More than 1 of 10 MSs did not believe that RT alone could cure cancer. Emergent oncologic conditions for RT (eg, spinal cord compression, superior vena cava syndrome) could not be identified by >1 of 5 respondents. Multiple nontoxicities of RT (eg, emitting low-level radiation from the treatment site) were incorrectly identified as toxicities by >1 of 5 respondents. MS4s/PCPs with an RO rotation in medical school had improved scores in all prompts. CONCLUSIONS Although MS knowledge of general RT principles improves from the first to the fourth year, a large knowledge gap still exists between MSs, current PCPs, and ROs. Some basic misconceptions of RT persist among a minority of MSs and PCPs. We recommend implementing formal education in RO fundamentals during the core curriculum of medical school.
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Affiliation(s)
- Nicholas G Zaorsky
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
| | - Talha Shaikh
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Elizabeth Handorf
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Gary Eastwick
- Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Adam Hesney
- Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Eli D Scher
- Rowan University School of Osteopathic Medicine, Stratford, New Jersey
| | - Ryan T Jones
- Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Timothy N Showalter
- Department of Radiation Oncology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Vladimir Avkshtol
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania; University of Toledo College of Medicine, Toledo, Ohio
| | | | - Eric M Horwitz
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Joshua E Meyer
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
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Rubin G, Berendsen A, Crawford SM, Dommett R, Earle C, Emery J, Fahey T, Grassi L, Grunfeld E, Gupta S, Hamilton W, Hiom S, Hunter D, Lyratzopoulos G, Macleod U, Mason R, Mitchell G, Neal RD, Peake M, Roland M, Seifert B, Sisler J, Sussman J, Taplin S, Vedsted P, Voruganti T, Walter F, Wardle J, Watson E, Weller D, Wender R, Whelan J, Whitlock J, Wilkinson C, de Wit N, Zimmermann C. The expanding role of primary care in cancer control. Lancet Oncol 2015; 16:1231-72. [PMID: 26431866 DOI: 10.1016/s1470-2045(15)00205-3] [Citation(s) in RCA: 355] [Impact Index Per Article: 39.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 07/25/2015] [Accepted: 07/27/2015] [Indexed: 12/21/2022]
Abstract
The nature of cancer control is changing, with an increasing emphasis, fuelled by public and political demand, on prevention, early diagnosis, and patient experience during and after treatment. At the same time, primary care is increasingly promoted, by governments and health funders worldwide, as the preferred setting for most health care for reasons of increasing need, to stabilise health-care costs, and to accommodate patient preference for care close to home. It is timely, then, to consider how this expanding role for primary care can work for cancer control, which has long been dominated by highly technical interventions centred on treatment, and in which the contribution of primary care has been largely perceived as marginal. In this Commission, expert opinion from primary care and public health professionals with academic and clinical cancer expertise—from epidemiologists, psychologists, policy makers, and cancer specialists—has contributed to a detailed consideration of the evidence for cancer control provided in primary care and community care settings. Ranging from primary prevention to end-of-life care, the scope for new models of care is explored, and the actions needed to effect change are outlined. The strengths of primary care—its continuous, coordinated, and comprehensive care for individuals and families—are particularly evident in prevention and diagnosis, in shared follow-up and survivorship care, and in end-of-life care. A strong theme of integration of care runs throughout, and its elements (clinical, vertical, and functional) and the tools needed for integrated working are described in detail. All of this change, as it evolves, will need to be underpinned by new research and by continuing and shared multiprofessional development.
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Affiliation(s)
- Greg Rubin
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK.
| | - Annette Berendsen
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | | | - Rachel Dommett
- School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Craig Earle
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Jon Emery
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Tom Fahey
- Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Luigi Grassi
- Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - Eva Grunfeld
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Sumit Gupta
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - David Hunter
- School of Medicine, Pharmacy and Health, Durham University, Stockton on Tees, UK
| | | | - Una Macleod
- Hull-York Medical School, University of Hull, Hull, UK
| | - Robert Mason
- Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Geoffrey Mitchell
- Faculty of Medicine and Biomedical Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Richard D Neal
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | | | - Martin Roland
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Bohumil Seifert
- Department of General Practice, Charles University, Prague, Czech Republic
| | - Jeff Sisler
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Stephen Taplin
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA
| | - Peter Vedsted
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Teja Voruganti
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Fiona Walter
- Department of General Practice, University of Groningen, Groningen, Netherlands
| | - Jane Wardle
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Eila Watson
- Department of Clinical Health Care, Oxford Brookes University, Oxford, UK
| | - David Weller
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Jeremy Whelan
- Research Department of Oncology, University College London, London, UK
| | - James Whitlock
- Department of Paediatrics, University of Toronto, Toronto, ON, Canada
| | - Clare Wilkinson
- North Wales Centre for Primary Care Research, Bangor University, Bangor, Wales
| | - Niek de Wit
- Department of General Practice, University Medical Center Utrecht, Utrecht, Netherlands
| | - Camilla Zimmermann
- Division of Medical Oncology and Haematology, Department of Medicine, University of Toronto, Toronto, ON, Canada
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Agarwal A, Koottappillil B, Shah B, Ahuja D, Hirsch AE. Medical Student--Reported Outcomes of a Radiation Oncologist--Led Preclinical Course in Oncology: A Five-Year Analysis. Int J Radiat Oncol Biol Phys 2015; 92:735-9. [PMID: 26104929 DOI: 10.1016/j.ijrobp.2015.03.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 02/23/2015] [Accepted: 03/09/2015] [Indexed: 12/19/2022]
Abstract
PURPOSE There is a recognized need for more robust training in oncology for medical students. At our institution, we have offered a core dedicated oncology block, led by a radiation oncologist course director, during the second year of the medical school curriculum since the 2008-2009 academic year. Herein, we report the outcomes of the oncology block over the past 5 years through an analysis of student perceptions of the course, both immediately after completion of the block and in the third year. METHODS AND MATERIALS We analyzed 2 separate surveys. The first assessed student impressions of how well the course met each of the course's learning objectives through a survey that was administered to students immediately after the oncology block in 2012. The second was administered after students completed the oncology block during the required radiology clerkship in the third year. All questions used a 5-level Likert scale and were analyzed by use of a Wilcoxon signed-rank test. RESULTS Of the 169 students who took the oncology course in 2012, 127 (75.1%) completed the course feedback survey. Over 73% of students agreed or strongly agreed that the course met its 3 learning objectives. Of the 699 medical students who took the required radiology clerkship between 2010 and 2013, 538 participated in the second survey, for a total response rate of 77%. Of these students, 368 (68.4%) agreed or strongly agreed that the course was effective in contributing to their overall medical education. CONCLUSION Student perceptions of the oncology block are favorable and have improved across multiple categories since the inception of the course. Students self-reported that a dedicated preclinical oncology block was effective in helping identify the basics of cancer therapy and laying the foundation for clinical electives in oncology, including radiation oncology.
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Affiliation(s)
- Ankit Agarwal
- Boston University School of Medicine, Boston, Massachusetts
| | | | - Bhartesh Shah
- Boston University School of Medicine, Boston, Massachusetts
| | - Divya Ahuja
- Boston University School of Medicine, Boston, Massachusetts
| | - Ariel E Hirsch
- Boston University School of Medicine, Boston, Massachusetts.
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Barclay S, Whyte R, Thiemann P, Benson J, Wood DF, Parker RA, Quince T. An important but stressful part of their future work: medical students' attitudes to palliative care throughout their course. J Pain Symptom Manage 2015; 49:231-42. [PMID: 24975433 DOI: 10.1016/j.jpainsymman.2014.06.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 05/29/2014] [Accepted: 06/12/2014] [Indexed: 10/25/2022]
Abstract
CONTEXT Palliative care (PC) education for medical students is important. Knowledge concerning drugs and services can be readily taught, and skills of communicating with terminally ill patients and their families are increasingly being addressed. Developing positive attitudes toward caring for patients near the end of life is more challenging. OBJECTIVES To examine medical students' attitudes toward PC in each year of their course, investigate changes in these attitudes over time during their course, and identify gender differences in attitudes and attitudinal change. METHODS Questionnaires administered to four cohorts of preclinical core science and clinical medical students at the University of Cambridge Medical School from 2007 to 2010, with annual longitudinal follow-up in subsequent years; 1027 participants in total. RESULTS Students started their medical course with broadly positive attitudes toward PC, which largely persisted into the final years. During the core science component, some attitudes became more negative, whereas during the clinical component, some attitudes became more positive. Over the whole course, there was evidence of increasingly positive attitudes. No significant effect of gender on attitudes or attitudinal change was found. Although statistically significant, all these changes were small. CONCLUSION Medical students' attitudes toward their future role in caring for people with PC needs were broadly positive. Core science was associated with increasingly negative attitudes and clinical studies with increasingly positive attitudes. For teaching faculty, the challenge remains to address negative and foster positive attitudes toward PC during medical school.
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Affiliation(s)
- Stephen Barclay
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
| | - Rebecca Whyte
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Pia Thiemann
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - John Benson
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Diana F Wood
- School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Richard A Parker
- Centre for Applied Medical Statistics, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
| | - Thelma Quince
- Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom
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Kwan JYY, Nyhof-Young J, Catton P, Giuliani ME. Mapping the future: towards oncology curriculum reform in undergraduate medical education at a Canadian medical school. Int J Radiat Oncol Biol Phys 2015; 91:669-77. [PMID: 25583687 DOI: 10.1016/j.ijrobp.2014.11.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 10/16/2014] [Accepted: 11/11/2014] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate (1) the quantity and quality of current undergraduate oncology teaching at a major Canadian medical school; and (2) curricular changes over the past decade, to enhance local oncology education and provide insight for other educators. METHODS AND MATERIALS Relevant 2011-2012 undergraduate curricular sessions were extracted from the University of Toronto curriculum mapping database using keywords and database identifiers. Educational sessions were analyzed according to Medical Council of Canada objectives, discussion topics, instructor qualifications, teaching format, program year, and course subject. Course-related oncology research projects performed by students during 2000 to 2012 were extracted from another internal database. Elective choices of clerks during 2008-2014 were retrieved from the institution. The 2011-2012 and 2000-2001 curricula were compared using common criteria. RESULTS The 2011-2012 curriculum covers 5 major themes (public health, cancer biology, diagnosis, principles of care, and therapy), which highlight 286 oncology teaching topics within 80 sessions. Genitourinary (10, 12.5%), gynecologic (8, 10.0%), and gastrointestinal cancers (7.9, 9.8%) were the most commonly taught cancers. A minority of sessions were taught by surgical oncologists (6.5, 8.1%), medical oncologists (2.5, 3.1%), and radiation oncologists (1, 1.2%). During 2000-2012, 9.0% of students (233 of 2578) opted to complete an oncology research project. During 2008-2014, oncology electives constituted 2.2% of all clerkship elective choices (209 of 9596). Compared with pre-2001 curricula, the 2012 oncology curriculum shows notable expansion in the coverage of epidemiology (6:1 increase), prevention (4:1), screening (3:1), and molecular biology (6:1). CONCLUSIONS The scope of the oncology curriculum has grown over the past decade. Nevertheless, further work is needed to improve medical student knowledge of cancers, particularly those relevant to public health needs. Defining minimum curricular content, emphasizing content based on population needs, and ensuring educational delivery with the support and expertise of oncologists and non-oncologists will be essential next steps.
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Affiliation(s)
- Jennifer Y Y Kwan
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Joyce Nyhof-Young
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Pamela Catton
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Meredith E Giuliani
- Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
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Matkowski R, Szelachowska J, Szewczyk K, Staszek-Szewczyk U, Kornafel J. Improvements in undergraduate oncology education introduced at Polish medical universities between 2004 and 2010 under Poland's "National Program for Combating Neoplastic Diseases". JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:428-33. [PMID: 24627083 PMCID: PMC4129232 DOI: 10.1007/s13187-014-0633-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Cancer patient treatment in Poland remains unsatisfactory when compared to that in other countries. In 2005, this alarming situation prompted the Polish government to launch the "National Program for Combating Neoplastic Diseases" (NPCND). One part of this project was to improve the quality of oncology instruction at the undergraduate level over the years 2006 and 2007 (subsequently extended until 2010 thanks to promising results and the relatively small financial outlay). The program's main aims were to improve existing oncology therapy and to ameliorate the quality of undergraduate oncology education. To evaluate the changes in the quality of undergraduate education as a result of the NPCND program, medical universities were asked to fill out a questionnaire. Responses indicate that the program had a major positive impact on the quality of cancer education mainly as a result of the introduction of a uniform program of training and an increase in the number of classes devoted to oncology. The main unresolved problem is that university hospitals seldom have integrated units catering in-house for surgery, radiotherapy, chemotherapy, etc., and most such "hands-on" teaching still has to be done externally.
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Affiliation(s)
- Rafał Matkowski
- Department of Oncology and Division of Oncological Surgery, Wroclaw Medical University, Plac Hirszfelda 12, 53-413, Wroclaw, Poland,
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Harris DG, Coles B, Willoughby HM. Should we involve terminally ill patients in teaching medical students? A systematic review of patient's views. BMJ Support Palliat Care 2014; 5:522-30. [PMID: 24644203 DOI: 10.1136/bmjspcare-2013-000535] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 01/19/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To review available published research that has explored how terminally ill patients feel about being involved in undergraduate medical teaching. METHODS A systematic review using narrative synthesis. Qualitative or quantitative publications were included if they directly explored the views of adult patients, with a terminal diagnosis, about their involvement in undergraduate clinical teaching. RESULTS Seven publications met the inclusion criteria: one case report, one qualitative study and five questionnaire-based studies. A total of 269 patients were included across all studies. Patients were predominantly studied in a hospice or hospice day care setting. Both patients who had, and who had not, previously been involved in student teaching were captured by the included publications. In general, the views of patients were highly positive: overall 85%-100% were in favour of involvement in teaching. There were also some negative aspects, such as: concerns about being physically examined by a student; finding involvement in teaching tiring; feeling unable to decline consent to participate. CONCLUSIONS An assumption that clinical undergraduate medical teaching involving terminally ill patients may be too burdensome is not reflected overall in studies that have sought the views of the patients themselves. Understanding the patient's perspective provides a number of practical points in relation to how clinical teaching should be adapted in this patient group; for example, using smaller student group sizes; direct supervision if physical examination performed; short encounters with multiple patients rather than a longer encounter with one patient; adequate informed consent beforehand and without the students automatically being present.
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Affiliation(s)
| | - Bernadette Coles
- Department of Information Services, Cardiff University, Velindre Hospital, Cardiff, UK
| | - Hannah May Willoughby
- Department of Postgraduate General Practice Education, Cardiff University School of Medicine, Cardiff, UK
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44
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Gilson D, Young A. Training and Acute Oncology Services. Clin Oncol (R Coll Radiol) 2014; 26:130-1. [DOI: 10.1016/j.clon.2013.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 11/21/2013] [Indexed: 10/25/2022]
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45
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Tam VC, Berry S, Hsu T, North S, Neville A, Chan K, Verma S. Oncology education in Canadian undergraduate and postgraduate medical programs: a survey of educators and learners. ACTA ACUST UNITED AC 2014; 21:e75-88. [PMID: 24523624 DOI: 10.3747/co.21.1667] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The oncology education framework currently in use in Canadian medical training programs is unknown, and the needs of learners have not been fully assessed to determine whether they are adequately prepared to manage patients with cancer. METHODS To assess the oncology education framework currently in use at Canadian medical schools and residency training programs for family (fm) and internal medicine (im), and to evaluate opinions about the content and utility of standard oncology education objectives, a Web survey was designed and sent to educators and learners. The survey recipients included undergraduate medical education curriculum committee members (umeccms), directors of fm and im programs, oncologists, medical students, and fm and im residents. RESULTS Survey responses were received from 677 educators and learners. Oncology education was felt to be inadequate in their respective programs by 58% of umeccms, 57% of fm program directors, and 50% of im program directors. For learners, oncology education was thought to be inadequate by 67% of medical students, 86% of fm residents, and 63% of im residents. When comparing teaching of medical subspecialty-related diseases, all groups agreed that their trainees were least prepared to manage patients with cancer. A standard set of oncology objectives was thought to be possibly or definitely useful for undergraduate learners by 59% of respondents overall and by 61% of postgraduate learners. CONCLUSIONS Oncology education in Canadian undergraduate and postgraduate fm and im training programs are currently thought to be inadequate by a majority of educators and learners. Developing a standard set of oncology objectives might address the needs of learners.
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Affiliation(s)
- V C Tam
- Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, AB
| | - S Berry
- Division of Hematology and Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
| | - T Hsu
- Division of Medical Oncology, University of Toronto, Toronto, ON
| | - S North
- Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, AB
| | - A Neville
- Department of Oncology, McMaster University, Hamilton, ON
| | - K Chan
- Division of Hematology and Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON. ; Division of Medical Oncology and Hematology, Princess Margaret Hospital, University of Toronto, Toronto, ON
| | - S Verma
- Division of Hematology and Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON
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Bandyopadhyay A, Das A, Ghosh A, Giri R, Biswas N. Oncology knowledge gap among freshly passed interns in a Government Medical College of Eastern India. South Asian J Cancer 2014; 2:62-5. [PMID: 24455554 PMCID: PMC3876660 DOI: 10.4103/2278-330x.110488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objectives: A survey was conducted among freshly passed undergraduate doctors of a medical college in Eastern India with the aim to investigate their exposure to oncology patients, their knowledge about various aspects of oncology patient management and their confidence in managing patients with cancer. Materials and Methods: One hundred and twelve newly passed interns of a Government Medical College in Kolkata were interviewed using semi-structured partly open ended and partly closed end questionnaire. The questionnaire dealt with the qualitative and quantitative aspects of knowledge and perception of the interns about the problem of cancer and its management. Results: A total of 82 interns responded to the questionnaire, with a response rate of 73.2%. About 53% of the respondents have seen less than five patients during their undergraduate ward/clinical postings. Among the respondents, 71% felt they were confident in diagnosing cancer, and about 56% were confident in counseling of patient and their relatives about cancer. About 63% were aware about the role of surgery; however, only 32% and 37.5% were aware about the role of radiotherapy and chemotherapy, respectively. A dismal 12.5% were confident of care of terminal and late stage patients. Preparedness was correlated with exposure to patients with cancer (P = 0.03). Majority (87%) felt the need for incorporating oncology training at the undergraduate level and the most frequent method (67%) suggested for doing so was having separate posting in radiotherapy department/oncology wards. Conclusion: There is glaring knowledge gap among newly passed doctors and integrated oncology postings during undergraduate training and during internship may help seal this gap.
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Affiliation(s)
- Anis Bandyopadhyay
- Department of Radiotherapy, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Anuradha Das
- Department of Radiotherapy, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Ashok Ghosh
- Department of Gynecology and Obstetrics, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Rajsekhar Giri
- Department of Medicine, Calcutta National Medical College, Kolkata, West Bengal, India
| | - Nilay Biswas
- Department of Surgery, Calcutta National Medical College, Kolkata, West Bengal, India
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Lara P, Calvo FA, Guedea F, Bilbao P, Biete A. Undergraduate cancer education in Spain: The debate, the opportunities and the initiatives of the University Forum of the Spanish Society of Radiation Oncology (SEOR). Rep Pract Oncol Radiother 2013; 18:405-13. [PMID: 24416587 DOI: 10.1016/j.rpor.2013.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/27/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022] Open
Abstract
Most medical schools in Spain (80%) offer undergraduate training in oncology. This education is highly variable in terms of content (theory and practical training), number of credits, and the medical specialty and departmental affiliation of the professors. Much of this variability is due to university traditions in the configuration of credits and programmes, and also to the structure of the hospital-based practical training. Undergraduate medical students deserve a more coherent and modern approach to education with a strong emphasis on clinical practice. Oncology is an interdisciplinary science that requires the input of professors from multiple specialties to provide the primary body of knowledge and skills needed to obtain both a theoretical and clinical understanding of cancer. Clinical skills should be a key focus due to their importance in the current model of integrated medical management and care. Clinical radiation oncology is a traditional and comprehensive hospital-based platform for undergraduate education in oncology. In Spain, a significant number (n = 80) of radiation oncology specialists have a contractual relationship to teach university courses. Most Spanish universities (80%) have a radiation oncologist on staff, some of whom are department chairs and many others are full professors who have been hired and promoted under competitive conditions of evaluation as established by the National Agency for Quality Evaluation. The Spanish Society of Radiation Oncology (SEOR) has identified new opportunities to improve undergraduate education in oncology. In this article, we discuss proposals related to theoretical (20 items) and practical clinical training (9 items). We also describe the SEOR University Forum, which is an initiative to develop a strategic plan to implement and organize cancer education at the undergraduate level in an interdisciplinary teaching spirit and with a strong contribution from radiation oncologists.
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Affiliation(s)
- Pedro Lara
- Universidad de Las Palmas, Canary Islands, Spain
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Payne S, Burke D, Mansi J, Jones A, Norton A, Joffe J, Cunningham D, McVie G, Agarwal R. Discordance between cancer prevalence and training: a need for an increase in oncology education. Clin Med (Lond) 2013; 13:50-6. [PMID: 23472496 PMCID: PMC5873708 DOI: 10.7861/clinmedicine.13-1-50] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The impact of cancer on healthcare is increasing. Therefore, it is key that all doctors receive oncology training. This study surveyed UK undergraduate medical schools to determine the extent of oncology training provided by their curricula. Data on foundation year (FY) and core medical training (CMT) programmes were obtained and analysed for the proportion of oncology posts. Of the responding medical schools, five (36%) had a defined period dedicated to oncology (mean 2 weeks). Four foundation schools were in London, with 10,094 FY posts in 1699 programmes. Of these, 1.5% of post and 8.7% of programmes were in oncology. For CMT offered by the London deanery specialty schools, 11% of CMT post and 48% of programmes included oncology. Oncology was included in 11% posts and 48% programmes offered by the London Deanery specialty schools. Our results show that < 50% of junior doctors receive dedicated undergraduate or postgraduate oncology training. An increase in oncology training is therefore urgently required.
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Affiliation(s)
- Sarah Payne
- Department of Oncology, St Bartholomew's Hospital
| | | | | | - Alison Jones
- Department of Medical Oncology, Royal Free Hospital
| | | | - Johnathan Joffe
- Department of Medical Oncology, Huddersfield Royal Infirmary
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Assessing the value of an optional radiation oncology clinical rotation during the core clerkships in medical school. Int J Radiat Oncol Biol Phys 2012; 83:e465-9. [PMID: 22704704 DOI: 10.1016/j.ijrobp.2012.01.058] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/14/2012] [Accepted: 01/18/2012] [Indexed: 11/23/2022]
Abstract
PURPOSE Few medical students are given proper clinical training in oncology, much less radiation oncology. We attempted to assess the value of adding a radiation oncology clinical rotation to the medical school curriculum. METHODS AND MATERIALS In July 2010, Jefferson Medical College began to offer a 3-week radiation oncology rotation as an elective course for third-year medical students during the core surgical clerkship. During 2010 to 2012, 52 medical students chose to enroll in this rotation. The rotation included outpatient clinics, inpatient consults, didactic sessions, and case-based presentations by the students. Tests of students' knowledge of radiation oncology were administered anonymously before and after the rotation to evaluate the educational effectiveness of the rotation. Students and radiation oncology faculty were given surveys to assess feedback about the rotation. RESULTS The students' prerotation test scores had an average of 64% (95% confidence interval [CI], 61-66%). The postrotation test scores improved to an average of 82% (95% CI, 80-83%; 18% absolute improvement). In examination question analysis, scores improved in clinical oncology from 63% to 79%, in radiobiology from 70% to 77%, and in medical physics from 62% to 88%. Improvements in all sections but radiobiology were statistically significant. Students rated the usefulness of the rotation as 8.1 (scale 1-9; 95% CI, 7.3-9.0), their understanding of radiation oncology as a result of the rotation as 8.8 (95% CI, 8.5-9.1), and their recommendation of the rotation to a classmate as 8.2 (95% CI, 7.6-9.0). CONCLUSIONS Integrating a radiation oncology clinical rotation into the medical school curriculum improves student knowledge of radiation oncology, including aspects of clinical oncology, radiobiology, and medical physics. The rotation is appreciated by both students and faculty.
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Hughes-Davies L, Barrett J. Training the oncologists of the future. Clin Oncol (R Coll Radiol) 2011; 23:565-8. [PMID: 21924879 DOI: 10.1016/j.clon.2011.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2011] [Accepted: 07/18/2011] [Indexed: 11/18/2022]
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