Implementation of Standardized Lecture to Improve Radiation Oncology Knowledge in Multidisciplinary Lung Cancer Care Team: Initial Results of a Multi-Institutional Pilot Study

Abstract

<h3>Purpose/Objective(s)</h3> Most lung cancer (LC) providers have had no exposure to radiation oncology (RO) in training and may not know when a patient should have RO consultation. Despite this, there is paucity of literature describing RO interdisciplinary educational initiatives in LC. In 2019, ASTRO began developing disease-site specific slide decks, the first of which was designed to teach the specialists about RO in management of LC. The deck has been downloaded over 1000 times since it was made public. The authors examined the feasibility of an introductory lecture using the slide deck and its impact on the providers' knowledge and practice. By understanding treatment modalities outside one's own, it is hoped that the providers can present a full spectrum of options needed for patient-centered decision-making. <h3>Materials/Methods</h3> Between November 2019 and May 2021, a total of 7 radiation oncologists offered lectures to attendings and fellows in pulmonology, thoracic surgery, and medical oncology at 8 academic institutions. Due to the pandemic, lectures were given both in-person as well as virtually. The participants were invited to take an anonymized pre-test online, consisting of demographics and 13 multiple choice questions about RO for LC. After the lectures, the attendees were asked to take a post-test identical to the pre-test, with two additional questions about knowledge gained, and comfort level in making appropriate referrals to RO. <h3>Results</h3> A total of 76 individuals completed the pre-test, and 25 completed the post-test. The vast majority of the participants have never had a RO rotation (86%), lecture (75%), or seen a LINAC (82%). The mean pre-test score was 53.5% (SD 17.6%), and the mean post-test score was 75.1% (SD 3.6%), (p<0.001). On the post-test, 12 participants(48.0%) reported feeling much more knowledgeable about the role of RO in LC treatment and 13 (52.0%) felt a little more knowledgeable. A total of 9 participants (36.0%) felt much more comfortable making appropriate referrals to RO after the lecture, whereas 15 (60.0%) felt a little more comfortable, and 1 (4.0%) felt not any more comfortable. The improvement in score and reported knowledge and comfort levels were similarly observed across all subspecialties and between attendings and fellows. <h3>Conclusion</h3> Introductory lecture on RO for LC given using a standard slide deck resulted in a statistically significant improvement in relevant knowledge of RO. Nearly all participants also reported improved comfort level in making appropriate referrals to RO. The current study demonstrates feasibility of implementing such lectures to multiple providers across various institutions even during a pandemic. An organized effort to provide such lectures at more institutions may result in more appropriate management and RO referral for LC patients, especially in practice settings where tumor board is not readily available.