Leading Change: Perceptions of Current Radiation Oncology Residents and Attending Physicians about the State of the Didactic Curriculum

Abstract

<h3>Purpose/Objective(s)</h3> Leading successful change efforts first requires assessment of the "before change" environment and culture. At our institution, the Radiation Oncology (RO) residents follow a longitudinal didactic learning program consisting of weekly one-hour lectures, case conferences, and journal clubs organized by disease site specialty. The resident didactic education series format has not changed since its inception over ten years ago. We evaluated the perceptions of current residents and faculty about the effectiveness of the curriculum in its present form. <h3>Materials/Methods</h3> Two parallel surveys were designed using a survey platform, one each for residents and attendings, to assess current attitudes regarding the effectiveness and need for change in the RO residency curriculum, specifically the traditional didactic lectures, the journal club sessions, and the case conferences. Online surveys were individually distributed in person or via video conference and took 5-10 minutes to complete. Attending faculty who practiced at the main campus or regional site and participated in the teaching program were eligible, with the senior author on this project excused. No identifiers were used to preserve anonymity of the respondents given the nature of this single institution cohort. Following completion of the survey, respondents were informally interviewed by the first author about the curriculum's strengths and weaknesses. <h3>Results</h3> Online surveys were individually distributed to 100% of residents (N=10) and 100% of eligible attendings (N=24). Compared to 46% of attendings, 80% of RO residents believe the current curriculum should be changed. Twenty percent of residents believe the traditional didactic lectures are effective in preparing them to manage patients in the clinic, compared to 74% of attendings. Similarly, 10% of residents feel that the journal club sessions are effective vs. 42% of attendings. Finally, 40% of residents believe the case conferences are effective vs. 67% of attendings. Overall, residents were less satisfied and more oriented towards change than faculty members. <h3>Conclusion</h3> Our results suggest that the perceptions of RO residents about the current didactic curriculum do not align with those of attending physicians. Main changes would be to increase the interactive nature of the course material, incorporate more ways to increase faculty engagement, and consider self-assessment questions to promote retention. The discrepancies between residents and faculty highlight the need of a dedicated change management effort to mitigate this gap. Pending approval from the residency program leadership, we will follow Kotter's "Eight steps to transforming your organization" to ensure the highest potential for faculty to transition to a new curriculum.