An On-the-Go Platform for Continuing Medical Education in Radiation Oncology in Brazil

Abstract

Brazil faces a shortage of radiation oncologists, especially in underserved regions. In 2022, there were 751 active Radiation Oncologists. Moreover, there is a constant need for continuing education, as Radiation Oncology is a complex specialty with continuous updates and technological advancements. Training requires specialized centers that can provide highly skilled mentors and expose trainees to modern radiotherapy techniques, which is expensive and depends upon significant investments. However, other strategies can also contribute to improving training in the country. Active methodologies are highly effective learning tools; therefore, we created a free gamified mobile app based on evidence-based comments from the National Board Exam to provide exam preparation and theory review. We retrieved National Board Exams from 2018 to 2021. Radiation Oncologists created detailed answers to questions, including the evidence supporting the rationale and linked references for further reading. The answers were all in Portuguese. Gamification was implemented to increase adherence, motivation, and engagement with the material. We evaluated the app's metrics and usage rates across the 2022 Board Exam Cohort. Launched in June 2022, the app registered until December 2022 278 active users. The mean age was 34.5 years (range 21 - 61). Most users were physicians (70.2%), but there were also medical students (2.6%), radiotherapists (14.6%), and physicists (12.7%). Users were distributed across all Brazilian regions and 81.5% (22/27) of the Brazilian States (including the Federal District). Four out of the five States without users were in the North, and one in the Northeast. Two unrepresented states were those without radiotherapy centers (Roraima and Amapá). The Southeast region and São Paulo State concentrated the majority of users (57% and 37.7%, respectively). In 2022, 87 physicians applied to the Radiation Oncology Board Certification Exams, and 31 (35.6%) were certified. Most successful applicants were app users (25/31; 80.6%). Time spent in the app varied across users, ranging from 0 to 92.4 hours in one month (mean of 4.16 hours). Radioteraquiz demonstrated high engagement with its on-the-go platform, ensuring practical, accurate, evidence-based information. Overall, the gamified active method shows the potential to improve learning effectiveness and promote continuing education, helping professionals stay current with the latest advancements in the field. In addition, it reached radiation oncologists across the country, increasing access to high-quality information for those away from reference centers and who are not proficient in English. Ultimately, this can improve patient care and outcomes.