Abstract
Many subspecialties have implemented courses to teach fundamental skills and knowledge to trainees entering residency with excellent subjective and objective outcomes (PMID 22015813). This study assessed the need for a 1-2 day off-site “boot camp” (BC) and the optimal structure/components of an introductory curriculum (IC) for beginning radiation oncology (RO) residents. A contact list of program directors (PDs) from 89 accredited RO residency programs was compiled from the AMA FREIDA website as of 9/2015. Resident e-mails were compiled informally via contact of program directors (PDs), program coordinators, and residents. A web-based survey of binary (yes/no) or Likert-type responses (1=not at all, 5=extremely) was sent to 89 PDs and 697 residents. Likert-type scores are reported as median [interquartile range]. 47/89 (53%) PDs and 165/697 (24%) residents responded. 37 (79%) PDs reported having a formal IC at their training program. 22 (47%) of these provided instruction while residents were in clinic, most frequently over 1 month (13, 59%). For programs with an IC administered prior to clinic, this was most often over a 1 week period (8, 44%). PDs reported resident preparation for clinic as “moderate” 3[2-3] upon entering residency and “moderate” 3[3-4] after IC completion (p=0.03). PDs felt a centralized off-site BC would be of “moderate” utility 3[3-4]. Most would allow residents to miss one clinic day to attend an off-site BC (38, 82%), but funding would limit participation (27, 57%). 83 (50%) residents reported having a formal IC at their training program. Residents felt “slightly” prepared 2[1-2] for clinic upon entering residency. Residents with an IC felt “moderately” prepared 3[2-3] after IC completion and reported a “moderate” benefit from the IC 3[2-4]. Of those without IC, 82 (45%) felt that having IC would be extremely beneficial 4[3-5]. 81 residents (49%) preferred IC prior to any clinical duties and 66 (40%) preferred IC over a 1 week period. 92 (56%) residents reported that travel costs would most limit participation in a centralized off-site BC and, without departmental funding, 126 (76%) residents would only travel <50 miles. PDs and residents rated the following IC components most highly (out of 100): lecture on radiation emergencies (76/83.5) and simulation/patient setup (69/83). PDs rated lectures on treatment planning/dosimetry (65) and monitor unit calculations (65) highly. Residents rated hands-on workshops highly (contouring target volumes (79.5), normal structures (77.5)). Beginning RO residents lack structured IC and desire formalized instruction prior to clinic, specifically with a focus on emergency management and contouring. PDs recognize moderate effectiveness/value of a centralized off-site BC, but the majority cite funding as a barrier to participation. A virtual BC or IC could provide structured curricula at reduced cost. The effectiveness of any implemented BC and/or IC must be carefully evaluated.
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