Impact of an Interactive Contouring Module on Knowledge and Interest in Radiation Oncology Among Pre-Clinical Medical Students: A Randomized Trial

Abstract

Approximately 2 out of 3 patients with cancer are treated with radiation, and it is estimated that by 2030 there will be over 4 million survivors living at least 5 years after radiation treatment. Previous studies have reported significant gaps in knowledge of radiation therapy among medical students and primary care providers. The goal of this study was to evaluate the impact of an interactive contouring module on knowledge and interest in radiation oncology among pre-clinical medical students. Second-year medical students were recruited from the UC San Diego School of Medicine to engage in a 1-hour educational session. Students were randomized to a) watch a traditional didactic lecture or b) complete an interactive contouring module (trial educational materials can now be accessed at http://econtour.org/cervical). Both the lecture and contouring module described radiation in the context of a cervical cancer case, though only students in the contouring module completed a contouring exercise with access to eContour (http://econtour.org/cases/64). Upon completion of the educational session, students completed a short questionnaire regarding engagement, usefulness, and a multiple choice question (MCQ) test evaluating knowledge of patient experience of radiation including side effects and radiographic anatomy. Knowledge was tested again 3 months later for retention. Statistical analysis included Wilcoxon signed-rank test for pre- and post-test comparisons and Wilcoxon rank sum test for comparison between groups. Forty-three medical students completed this trial (21 in the didactic group and 22 in the contouring group). Baseline knowledge was similar in both groups (78% vs. 79%, NS). Students completing the contouring module scored as well as the traditional didactic group on general knowledge (86% vs. 86%, NS) but endorsed greater engagement on a 5-point likert-type scale (3.1 vs. 3.76, p=0.02). At 3 months, overall knowledge was similar (43% vs. 51%, p=0.10), but knowledge of side effects (51% vs. 75%, p=0.003) was improved in the contouring group. Interest in a clinical radiation oncology rotation was greater in the contouring group on a 5-point likert-type scale (2.5 vs. 3.3, p=0.01). Use of an interactive contouring module to teach pre-clinical medical students about radiation oncology was as effective as a traditional didactic lecture. However, higher engagement among students completing the contouring module led to improved retention of knowledge of side effects, and greater interest in radiation oncology. These data suggests that pre-clinical radiation oncology education, which impacts all physicians who will care for patients undergoing radiation and surviving after cancer treatment, may benefit from incorporation of interactive contouring modules.