Development of an Educational Workshop on the Practical Application of Respiratory Motion Management Techniques for Radiation Oncology Trainees

Abstract

<h3>Background</h3> Respiratory motion management (RMM) is an important tool that is increasingly utilized in the era of image-guided radiation therapy. There are several different techniques available to limit tumor motion during respiration with the goal of allowing for effective dose escalation to the target, while limiting toxicity to nearby organs at risk. Selection of the appropriate RMM tool depends on the clinical scenario and requires input from the treating physician and/or residents and medical physics staff, however, there is a paucity in trainee education on the various RMM methods. The purpose of this initiative was to develop a formal didactic and hands on experience for our trainees that described the RMM tools available and the appropriate clinical scenarios in which to best implement these specific techniques. <h3>Methods</h3> Trainees (medical and physics residents as well as medical students) participated in a two-phase educational workshop: a 45 minute didactic session followed by a hands-on demonstration of RMM modalities and pertinent software for motion evaluation. Each participant completed pre- and post-workshop surveys assessing their confidence on RMM (based on a 5-point Likert scale) and knowledge based quizzes to assess their understanding of the various RMM techniques. Participant scores were paired for statistical analysis using Wilcoxon-Rank Sum and student T-tests. <h3>Results</h3> This educational workshop was held annually in 2021 and 2022. There were 7 participants (5 medical and 2 physics residents) in 2021 and 9 (2 medical students, 6 medical, and 1 physics resident) that participated in 2022. For all participants, there was a significant increase in self-reported post-workshop confidence in RMM techniques (median 3.625 pre- vs 4.634 post-workshop, p=0.018 in 2021 and median 1.125 vs 3.750, p=0.008 in 2022). There was also a significant increase in the participants' scores in the post-workshop knowledge based quizzes (mean 85.71% vs 92.86%, p=0.03 in 2021 and mean 48.60% vs 87.50%, p=0.008 in 2022). <h3>Discussion</h3> In order to optimize patient care, it is essential that RO trainees understand and are able to implement RMM techniques appropriately when treating intrathoracic and abdominal cavity tumors. This initiative showed that a dedicated educational workshop on RMM techniques significantly improved RO trainee's knowledge and confidence on the use of these important tools. Future aims of this project include continuing to offers this workshop annually to trainees to assess information retention and creation of a shared resource for trainees at other institutions.