Development of a Radiation Oncology Resident Continuity Clinic to Improve Clinical Competency and Patient Compliance

Abstract

Purpose To assess the impact of a radiation oncology resident continuity clinic (RCC) on patient compliance and residency education. Methods and Materials This is a retrospective review of all follow-up visits at a public safety net hospital in the 2016 calendar year. Previously, follow-up care was assigned to teams based on the disease sites treated by a single attending with the resident on a 1:1 rotation in the traditional apprenticeship model (TAM). On July 1, 2016, the department was restructured to a RCC model where patients were scheduled to be seen by the resident physician who performed the planning simulation of their radiation treatment. The number of no-show visits was compared before and after the restructuring. All residents completed a survey regarding their satisfaction on 20 aspects of faculty supervision, clinical environment, resident perception, and educational experience. Results A total of 1,896 follow-up visits were included in the analysis. The TAM had 907 follow-up visits, while the RCC model had 991 visits. The TAM had a no-show rate of 25.6% compared to the RCC model’s 16.4%. To estimate the impact of RCC on compliance, we employed a segmented linear regression with robust standard errors, which showed that the RCC improved clinic adherence by an absolute amount of 9.4% (p<0.02). Survey participants reported statistically significant improvement (p<0.05) in 8 areas, which include relationship with patients, confidence as a physician, and learning management of toxicities and treatment outcomes. Conclusion The RCC model is a feasible approach for follow-up care in a radiation oncology department in a safety net hospital setting. This model may improve patient compliance with appointments, strengthen the education of toxicity management, and promote the emotional well-being of trainees.