Assessment of Program Director and Resident Needs for a Structured Introductory Radiation Oncology Curriculum and Boot Camp

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.