Oncology Curriculum Research Articles

Redesigning Competency Assessment: A Blended Approach of Clinical Education for Oncology Nurses.

A train-the-trainer model of clinical education was redesigned in one National Cancer Institute-designated cancer center to introduce a blended model of learning. Program outcomes were for oncology nurse trainers to affirm program engagement; successfully complete a new, web-based specialized oncology curriculum, with 80% accuracy; complete one live 8-hour training event; acquire competency validation of required skills, with 100% accuracy; and communicate one strategy for training staff in their respective clinical settings.

Improving Care for Older Adults with Cancer in Canada: A Call to Action.

Most patients diagnosed with and dying from cancer in Canada are older adults, with aging contributing to the large projected growth in cancer incidence. Older adults with cancer have unique needs, and on a global scale increasing efforts have been made to address recognized gaps in their cancer care. However, in Canada, geriatric oncology remains a new and developing field. There is increasing recognition of the value of geriatric oncology and there is a growing number of healthcare providers interested in developing the field. While there is an increasing number of dedicated programs in geriatric oncology, they remain limited overall. Developing novel methods to delivery geriatric care in the oncology setting and improving visibility is important. Formal incorporation of a geriatric oncology curriculum into training is critical to both improve knowledge and demonstrate its value to healthcare providers. Although a robust group of dedicated researchers exist, increased collaboration is needed to capitalize on existing expertise. Dedicated funding is critical to promoting clinical programs, research, and training new clinicians and leaders in the field. By addressing challenges and capitalizing on opportunities for improvement, Canada can better meet the unique needs of its aging population with cancer and ultimately improve their outcomes.

Artful oncology: A comprehensive psychosocial oncology curriculum for hematology/oncology fellows.

9008 Background: Of patients with cancer, 46% experience significant psychosocial distress, a factor linked to higher morbidity, mortality and costs of care. Oncologists themselves face psychosocial distress, particularly during their fellowship training, with as many as 38% of hematology/oncology (H/O) fellows reporting burnout during training. The ACGME recognizes this risk and has recently included well-being skills in their professional milestones, in addition to milestones for assessing psychosocial issues and communication skills for addressing these complex patient needs, which are often a source of distress among clinicians. Very few published curricula are available to address these layered learning needs among H/O fellows. Methods: “Artful Oncology” is a multifaceted curriculum for H/O fellows focusing on four pillars: 1) monthly didactic lectures about psychosocial issues within cancer care; 2) bimonthly narrative medicine seminars reflecting on didactic themes; 3) quarterly communication skills training conducted with standardized patients; and 4) monthly cancer survivorship support group facilitation. This curriculum was instituted with the inaugural class of H/O fellows at Inova Schar Cancer Institute in 2021 (total 6 fellows to date) with iterative improvements. Outcomes were measured through self-assessed communication skills, scored feedback for each didactic, annual Physician Belief Scale (PBS) surveys, quarterly Professional Quality of Life (ProQOL)-Health and abbreviated Maslach Burnout Inventory (MBI) surveys. Results: Fellows rated didactics as being relevant to their work, prepared to implement the skills learned into clinical practice, and would recommend these sessions to others (average 4.58, 4.59, and 4.67 out of 5-point Likert scale). Among 19 evaluated didactic topics evaluated to date, the most highly rated sessions included Oncology Psychiatry, Integrative Approaches to Symptom Management, Hospice Behind the Scenes, and Moral Injury/Moral Distress (average 5.0); lowest rated included Mindfulness, Sexual Health, Recognizing Depression, Grief, and Adolescents/Young Adults (average 4.29). PBS scores numerically improved from 2022 to 2023 (78 to 68.8 out of 160, lower being associated with a more psychosocial approach to patient care). MBI and ProQOL Health scores were largely unchanged (<2 point difference on average). Self-assessed communication skills averaged across rising fellows increased from 4.38 to 7.44 out of 10 between 2022 and 2023. Conclusions: The Artful Oncology curriculum numerically improved self-assessed communication skills and attitudes regarding the physician role within psychosocial aspects of patient care. Didactic sessions were rated as highly relevant, actionable, and recommended by H/O fellows. Study of this curriculum over a longer timeframe with larger numbers of fellows is ongoing to better evaluate effects.

Developing an educational “hub”: impact of a distance-learning curriculum in a multinational cohort

PurposeTo address a gap in radiation oncology education in low- and middle-income countries (LMICs), we sought to evaluate the effectiveness and generalizability of a refined curriculum on intensity modulated radiotherapy (IMRT) offered to existing radiation therapy (RT) clinics across Africa and Latin America (LATAM) at no cost.MethodsA curriculum was created based on prior needs assessments and adapted for participating medical physicists, radiation oncologists, radiation therapists, and trainees in LMICs. English-speaking and Spanish-speaking teams of volunteer educators delivered 27 hour-long sessions 1–2 times weekly for 4 months using video conferencing to African and LATAM cohorts, respectively. Pre- and post-course multiple-choice examinations were administered to LATAM participants, and pre- and post-course self-confidence (1–5 Likert-scale) and open-ended feedback were collected from all participants.ResultsTwenty-five centers across Africa (13) and LATAM (12) participated, yielding a total of 332 enrolled participants (128 African, 204 LATAM). Sessions were delivered with a mean of 44 (22.5) and 85 (25.4) participants in the African and LATAM programs, respectively. Paired pre and post-course data demonstrated significant (p < 0.001) improvement in knowledge from 47.9 to 89.6% and self-confidence across four domains including foundations (+ 1.1), commissioning (+ 1.3), contouring (+ 1.7), and treatment planning (+ 1.0). Attendance was a significant predictor of change in self-confidence in “high attendance” participants only, suggesting a threshold effect. Qualitative data demonstrates that participants look forward to applying their knowledge in the clinical setting.ConclusionA specialized radiation oncology curriculum adapted for LMIC audiences was effective for both African and LATAM participants. Participant feedback suggests that the refined IMRT course empowered clinics with knowledge and confidence to help train others. This feasible “Hub and Spokes” approach in which a distance-learning course establishes a hub to be leveraged by spokes (learners) may be generalizable to others aiming to reduce global health care disparities through training efforts.

The Association of Surgical Oncology (ACO) curriculum "Surgical oncology"-Prerequisites for participation, registration and course

For solid malignancies of the gastrointestinal tract, surgical removal is acentral pillar of treatment and often the only possibility to achieve a long-term cure. While there are additional qualifications for an oncological subspecialization in other surgical disciplines, such as gynecology or urology nothing comparable exists for visceral surgery in Germany, despite the fact that interdisciplinary cancer treatment strategies are becoming increasingly more complex. The Association of Surgical Oncology (ACO) in cooperation with the European Union of Medical Specialists (UEMS) has created the curriculum for surgical oncology, astructured further education concept, which concludes with the European Board of Surgical Qualification (EBSQ) examination. This results in a standardization and improvement in surgical and oncological treatment in Germany. Furthermore, successful graduates receive an ACO as well as aUEMS certificate and are Fellows of the European Board of Surgery (FEBS).

Undergraduate oncology education in Sudanese public medical schools; a national cross-sectional study

BackgroundCancer was the fifth leading cause of death in Sudan general hospitals in 2020, and its incidence is increasing. Medical students’ cancer education is key in cancer control. Evaluating the current education is the first step in optimizing it. The aim of this study was to assess undergraduate oncology education in Sudan public medical schools as reflected by the graduates of the year 2021–2022.MethodThis was a cross-sectional institution-based study. A validated online questionnaire was sent between 8 September and 11 November 2022 to graduates who were selected using a stratified random sampling technique from 17 Sudan public medical schools. The data were collected using Google Forms and analyzed using R software version 4.2.2 and Microsoft Excel 2022.ResultsA total of 707 graduates completed the questionnaire. They reported generally poor exposure to oncology. Palliative and radiation oncology in addition to chemotherapy daycare units were never attended by 76.0%, 72.0%, and 72.0% of graduates, respectively. The massed oncology curriculum was associated with increased hours of lectures dictated to medical (p = 0.005), radiation (p < 0.001), and palliative oncology (0.035). It was associated with an increased likelihood of assessment in breaking bad news (p < 0.001), counseling cancer patients (p = 0.015), and oncology-related knowledge (p < 0.001). The massed curriculum was associated with a decrease in interest in pursuing an oncology career (p = 0.037). Students were generally confident in their oncology competencies, and no difference was observed in relation to the curriculum approach (p > 0.05).ConclusionThis study reflected poor exposure to oncology at the undergraduate level in Sudanese public medical schools. The massed oncology curriculum was associated with formal assessment of oncology-related competencies and better exposure to some disciplines, such as radiation and palliative oncology. Nonetheless, it was associated with decreased interest in an oncology career. In spite of the poor exposure, graduates were confident in their skills in oncology-related competencies. Further objective analysis of competence is needed.

Physiotherapists' training in oncology rehabilitation from entry-level to advanced education: A qualitative study.

Physiotherapy is gaining a central role in oncology. However, the training and competencies needed by physiotherapists in oncology rehabilitation are still unclear. This study aims to articulate the training trajectory of physiotherapists in oncology rehabilitation from entry-level education to advanced education degrees. Qualitative focus group study following a 'Reflexive Thematic Analysis' for data analysis. Participants were Italian physiotherapists with expertise in Oncology Rehabilitation (either clinically or academically) and Physiotherapy Bachelor of Science (BSc) course leaders, selected through purposive sampling. Two focus groups were conducted with 14 participants. Six themes were developed: 1. 'Entry-Level Education in Oncology Rehabilitation: Let's Have a Taste', as the BSc introduces oncology rehabilitation. 2. 'Basic Knowledge: Building up the Library' as students acquire basic knowledge on oncology rehabilitation during their BSc; 3. 'Learning by Experience: The Relevance of the Placement' to answer the question "Is this the right road for me?"; 4. 'Clinical Reasoning and Competencies in Oncology Rehabilitation Embedded in Uncertainty' because oncology physiotherapists need to deal with the uncertainty of their patients' status; 5. 'Advanced Education Degree Skills: from Appetiser to the Main Course', as advanced education degree courses allow for becoming an expert in the field; 6. 'A Call to Action for Physiotherapists: Prevention-Diagnosis-Survivorship & End of Life', to realise their critical role in all the phases of the oncology path. The BSc in Physiotherapy provides a foundation for future physiotherapists to understand oncology rehabilitation, but advanced education is necessary for expertise. The findings of this study have important implications for creating a shared physiotherapy curriculum in oncology rehabilitation. This study has significant implications for improving physiotherapy curricula in oncology rehabilitation, positively impacting the skills and competencies of practitioners in this paramount field.

Multimodality, online oncology learning resources: Meeting residents where they are—A pilot to create a new oncology curriculum.

11035 Background: The Accreditation Council for Graduate Medical Education (ACGME) requires internal medicine residents to have access to different medical subspecialties, including hematology/oncology. While inpatient rotations in hematology/oncology have been associated with a decreased interest in a career in oncology, dedicated educational sessions have been shown to improve residents’ interest in the field. In recognition of different learning styles and modalities and the need for asynchronous delivery, we aimed to build an effective curriculum for oncology learners using interactive, multimodality, online learning tools and resources. Methods: Using the Canvas online learning management system, individual learning modules covering major cancer types were created. Each learning module consisted of a pre-survey assessing the learners’ evaluation of their own knowledge and comfort with the topic, a brief audio or video file covering high-yield information about the cancer type, interactive case-based questions reviewing and reinforcing the information, and a post-survey assessing the change in the learners’ evaluation of their knowledge and comfort in clinical application of the information. The pre- and post-surveys were rated on a 5-point Likert scale. Median values and interquartile ranges are reported. A one-sided t-test was used to compare responses. Results: Two fully completed learning modules have been created. The lung cancer module included a high-yield, 10-minute voice-over PowerPoint presentation followed by interactive, case-based questions. The breast cancer module used a high-yield, 10-minute podcast with an accompanying handout for notes followed by case-based interactive questions. Seven learners have completed both pre- and post-survey responses for comparison. Two were completed by PGY1, 4 by PGY2, and 1 by a PGY3 resident. Median rating of the learners’ knowledge of the specific cancer type increased from 2- Fair (1.5) on the pre-survey to 3- Neutral (1) after completing the learning module (p = 0.001). 100% of learners agreed or strongly agreed that their knowledge increased after completing the module. All 7 residents felt more comfortable with their clinical application of the cancer topic material after completing the module, median 2(1) on pre-survey vs. 3(0.5) on post-survey; p = 0.0004. Conclusions: The creation of online, multimodality learning resources has resulted in improvements in learners’ perceived knowledge and comfort with clinical application of oncology topics. Using learning science principles, this pilot project serves as the foundation for further innovative and interactive educational resources and modules created for oncology learners.

Multi-institutional Expansion of a Longitudinal Radiation Oncology Curriculum for Medical Assistants and Allied Health Professionals (OnC MAP)

Background A single-institution longitudinal radiation oncology curriculum for medical assistants was shown to be sustainable over multiple years and increased job satisfaction.1 We aimed to assess the sustainability of a multi-institutional expansion of a monthly web-based longitudinal curriculum, and its impact on attendees' confidence and knowledge. Methods Four institutions were recruited, and non-physician staff participants were asked to participate. Between September 2022 and December 2022, participants completed 3 of 15 planned sessions including (1) radiation oncology clinical workflows, (2) medications and vital signs, and (3) prostate cancer. Before and after each session, participants completed surveys about their confidence in knowledge of session topics on a likert-5 point scale (1="very unconfident" to 5= "very confident") and completed knowledge tests. Results of confidence surveys were dichotomized (≥4 vs. ≤3). Surveys and tests were summarized using descriptive statistics and paired t-test. Results Twenty-four of thirty-five (69%) participants report clinical roles (4-7 per institution). Ten (42%) were medical assistants (MA), 8 (33%) were allied health professionals including registered nurses (RN), licensed vocational nurses (LVNs), or advanced practice providers (APP). In pre-session surveys, half of respondents were confident (Likert ≥4) in their understanding of consult notes or knowledge of common medications or abnormal vital signs. Less than half were confident in their ability to understand or use "one-liners" (∼32%) or knowledge of common systemic therapies (29%), medication side effects (41%), risk factors for prostate cancer (25%), or how prostate cancer is staged or managed (38%). On average, respondents were more likely to report confidence in their knowledge after session one (45% to 73%, p<0.01), two (52% to 83%, p<0.01), and three (40% to 95%, p<0.01). On pre-/post-knowledge tests, participants scored similarly for session one (84% vs. 79%, p=0.17) but tended to have increased scores after session two (62% to 74%, p=0.19) and three (38% to 60%, p=0.09), though these differences were not statistically significant. Most participants (85%) considered the amount and level of content appropriate despite the mixed clinical roles of participants. Discussion We report the feasibility of expanding a longitudinal interprofessional curriculum to four institutions, the successful integration of medical assistants, nurses, and advanced practice providers, and incorporation of objective knowledge tests. Participants reported increased confidence in their knowledge after each session and tended to score higher on post-assessments. Future directions include additional monthly disease-site based sessions, incorporation of online asynchronous learning, and incorporation of spaced-repetition of content into assessment to promote knowledge retention. A single-institution longitudinal radiation oncology curriculum for medical assistants was shown to be sustainable over multiple years and increased job satisfaction.1 We aimed to assess the sustainability of a multi-institutional expansion of a monthly web-based longitudinal curriculum, and its impact on attendees' confidence and knowledge. Four institutions were recruited, and non-physician staff participants were asked to participate. Between September 2022 and December 2022, participants completed 3 of 15 planned sessions including (1) radiation oncology clinical workflows, (2) medications and vital signs, and (3) prostate cancer. Before and after each session, participants completed surveys about their confidence in knowledge of session topics on a likert-5 point scale (1="very unconfident" to 5= "very confident") and completed knowledge tests. Results of confidence surveys were dichotomized (≥4 vs. ≤3). Surveys and tests were summarized using descriptive statistics and paired t-test. Twenty-four of thirty-five (69%) participants report clinical roles (4-7 per institution). Ten (42%) were medical assistants (MA), 8 (33%) were allied health professionals including registered nurses (RN), licensed vocational nurses (LVNs), or advanced practice providers (APP). In pre-session surveys, half of respondents were confident (Likert ≥4) in their understanding of consult notes or knowledge of common medications or abnormal vital signs. Less than half were confident in their ability to understand or use "one-liners" (∼32%) or knowledge of common systemic therapies (29%), medication side effects (41%), risk factors for prostate cancer (25%), or how prostate cancer is staged or managed (38%). On average, respondents were more likely to report confidence in their knowledge after session one (45% to 73%, p<0.01), two (52% to 83%, p<0.01), and three (40% to 95%, p<0.01). On pre-/post-knowledge tests, participants scored similarly for session one (84% vs. 79%, p=0.17) but tended to have increased scores after session two (62% to 74%, p=0.19) and three (38% to 60%, p=0.09), though these differences were not statistically significant. Most participants (85%) considered the amount and level of content appropriate despite the mixed clinical roles of participants. We report the feasibility of expanding a longitudinal interprofessional curriculum to four institutions, the successful integration of medical assistants, nurses, and advanced practice providers, and incorporation of objective knowledge tests. Participants reported increased confidence in their knowledge after each session and tended to score higher on post-assessments. Future directions include additional monthly disease-site based sessions, incorporation of online asynchronous learning, and incorporation of spaced-repetition of content into assessment to promote knowledge retention.

European Cancer Summit 2022 submission for Workforce NetworkWhat is it valuable for trainees in Interprofessional education in cancer care: a qualitative approach

BackgroundThe INTERACT Europe project is developing an inter-specialty oncology curriculum. As part of this project the team wanted to explore, “What is it valuable for trainees to learn in order to work more effectively with different specialties and professions to deliver better care and to provide psychosocial and nutritional support for cancer patients?”.To answer some of the concerns a learning needs analysis with a questionnaire was distributed to develop the curriculum on what health care professionals require to care for people affected by cancer and their family. This study reports the qualitative aspects of this questionnaire. MethodsThe qualitative data which consisted of eight questions and was transcribed verbatim using thematic analysis1. The transcripts were read until the project team were familiar with the content and analysed to identify emerging themes. The themes were compared, and any discrepancies discussed in more detail with all the participants from the INTERACT working package. The team then conducted a cross analysis and mapped the themes to derive overlapping concepts which then informed the curriculum. Results115 respondents from the 219 participants answered some or all the qualitative survey questions. Respondents were from all around Europe and had representation from different professions including doctors, nurses and patient advocates and from a large range of clinical experience (from newly qualified to more than 15 years of experience).Fifteen themes were initially identified during initial coding. After comparison and discussion with all the co-investigators they were merged into 5 themes that included: “Unsure of Interprofessional education meaning”, “Barriers and challenges”, “open channels of communication and respect”, “support throughout the cancer journey “and “new way of working” ConclusionsThe results of the survey alongside the quantitative part will serve to build the curriculum of interprofessional training in cancer care. Participants identified many obstacles in their actual practices to use interprofessional training, but the value to improve teamwork, communication and to improve patient experience and treatment was also captured.

Importance of Incorporating the Perspectives of People with Cancer into Oncology Education: A Scoping Review.

With the shift towards person-centered care (PCC) in oncology, there is a need for parallel evolution of oncology education programs to prepare the next generation of health professionals to deliver effective PCC. These programs should be designed utilizing perspectives from individuals who have lived experience with cancer to ensure that changes to education curricula translate to improved PCC in the clinic. Our goal was to identify existing literature describing such programs as well as identify gaps for further development. Keywords were agreed upon and searched across Ovid Medline, Ovid Embase, ERIC, Google Scholar, and MedEdPORTAL databases. Duplicates were removed, unique articles were screened for relevance by title and abstract, and a full text review of each article was completed for validation. Included articles describe methods for involving people with cancer in developing and/or delivering oncology-focused education programs. In total, 15 articles describing 12 unique oncology education programs from 7 different countries were identified, reviewed, and summarized. These programs involved learners undertaking undergraduate medical education, postgraduate medical education, continuing medical education, or training as nurses or radiation therapists. Current literature indicates that classroom-based sessions, experiential or simulated learning modalities, and/or asynchronous online modules can all feasibly be created with the integration of perspectives/narratives of people with cancer. Furthermore, involving people with cancer directly in the design and/or delivery of these education programs may contribute to improved patient experiences. Including the perspectives of people with cancer directly in oncology curriculum development and delivery can improve established pedagogical approaches and enhance learner confidence and competency in delivering PCC. We provide recommendations for stepwise implementation of patient perspectives into oncology education, with the hope that future programs will better prepare and motivate learners to provide PCC aimed at improving cancer care, quality of life, and disease outcomes.

Development of a United States Radiation Oncology Curricular Framework: A Stakeholder Delphi Consensus

A United States (US) radiation oncology curriculum, developed using best practices for curriculum inquiry, is needed to guide residency education and qualifying examinations. Competency-based training, including entrustable professional activities (EPAs), provides an outcomes-based approach to modern graduate medical education. This study aimed to define US radiation oncology EPAs and curricular content domains using a deliberative process with input from multiple stakeholder groups. The Radiation Oncology Education Collaborative Study Group Core Curriculum Project Leadership Committee developed initial content domains and EPAs. Following recruitment of stakeholders, a Delphi process was used to achieve consensus. In the first round, content domains and EPAs were reviewed for inclusion and exclusion, clarity, time allocation (content domains), and level of training (EPAs). Participants submitted additional content domains and EPAs for consideration. Any content domains or EPAs 1 standard deviation below the median for inclusion and exclusion underwent Leadership Committee review. All participants completing the first Delphi round were invited to the second round. Percent curriculum time allocated for content domains and a single subdomain were finalized. New EPAs or EPAs undergoing major revisions were reviewed. A total of 186 participants representing diverse stakeholder groups participated. One hundred fourteen completed the first Delphi round (61.3%). Of 114 invited, 77 participants completed the second round of the Delphi process (67.5%). Overall, 6 of 9 content domains met consensus, 1 content domain was removed, and 2 content domains were combined. Four subdomains of a single content domain were reviewed and met consensus. Consensus on percent time allocated per content domain and subdomain was reached. Of 55 initial EPAs, 52 final EPAs met consensus. Deliberative curriculum inquiry was successfully used to develop a consensus on US radiation oncology content domains and EPAs. These data can guide the allocation of educational time in training programs, help inform weighting for qualifying examinations, and help guide clinical training and resident assessment.

An educational initiative to develop radiotherapy-specific teaching following the introduction of the oncology common stem year

Background: Following the GMC’s Excellence by Design report on postgraduate curricula, the clinical oncology (CO) curriculum has been rewritten and includes a shared first year of training – the oncology common stem (OCS) – where medical oncology (MO) and CO trainees have the same curriculum including radiotherapy (RT) skills evidenced with DORPS (direct observation of radiotherapy planning skills) and acute oncology. Radiotherapy planning experience had suffered during the COVID-19 pandemic, with more planning happening remotely.

What do hematology residents know about caring for older adults with cancer? A national survey of Canadian hematology residents' knowledge and interests

IntroductionAs the Canadian population ages, older adults comprise an increasing proportion of those diagnosed and treated for hematologic malignancies. A geriatric oncology curriculum has been recognized as a top priority in the care of older patients with cancer. It is not clear, however, whether hematology trainees receive training in geriatric oncology. We sought to understand residents' views and needs for a geriatric oncology curriculum during hematology residency in Canada. Materials and MethodsWe conducted a cross-sectional needs assessment of hematology trainees enrolled in a Canadian residency or advanced fellowship training program within hematology. The survey, which was piloted with three non-hematology residents to ensure user-friendliness, used a combination of Likert scale, multiple-choice, and open-ended questions. The survey comprised three sections: (1) demographic data, (2) current state of geriatric oncology training (amount, content) and (3) attitudes towards learning about geriatric oncology and preferred curriculum components and identified needs. The survey was administered by the study team and distributed electronically to program directors in June 2020. The program directors were asked to forward the survey to trainees registered within their Division of Hematology. Data were analyzed descriptively. ResultsTwenty-nine hematology residents participated (41.4% estimated response rate). Most respondents had not received geriatric oncology teaching (58.6%, n = 17) and have never been taught about geriatric oncology assessment tools (72.4%, n = 21) during hematology residency. Most respondents felt that their program should deliver a geriatric oncology curriculum (96.6%, n = 28). Respondents were most interested in learning about use of geriatric assessment tools for pre-treatment chemotherapy decision-making (86.2%, n = 25), prediction of chemotherapy toxicity (82.8%, n = 24), and to facilitate conversations regarding treatment initiation, continuation, or termination (79.3%, n = 23). DiscussionOur study highlights the paucity of geriatric oncology training in hematology residency training programs. Our results highlight both the need and interest for a future dedicated geriatric oncology curriculum integrated into hematology training and provide guidance about which topics are most valued by trainees.

Integrating Radiation Plan Review into Radiation Oncology Curriculum: Single-Institution Experience

Background Lack of residents' dedicated training and satisfaction with regard to radiation plan review was one of the major issues detected in our needs assessment at Indiana University. Therefore, a monthly session focusing on dosimetry and plan review for residents was added to our didactics. Methods This session was designed based on Kolb's cycle of experiential learning. All residents have been exposed to radiation plan review in clinic and during peer review (concrete experience). However, this session will emphasize on reflective observation and abstract conceptualization. Each month, we cover a specific disease site for the resident plan review session. Residents pick 3-4 radiation plans in advance. Each session begins by presenting the patient followed by plan review based on CB-CHOP acronym. Faculty are present to highlight the important aspects of plan review. Dosimetrists are sometimes present to explain the steps needed to design the plan. If there is a plan that was not approved by faculty, that plan will also be reviewed to highlight the issues and familiarize residents with less optimal plans. This session gives residents the opportunity to actively participate and ask questions, a factor that can be missing in departmental peer review sessions. Results This curriculum change was implemented in January 2021 at Indiana University and is in effect. There are 7 residents in our program and our evaluation has shown than all believe that this addition to the curriculum has improved their understanding of different steps of plan review and has increased their confidence to evaluate plans independently. It has been highlighted that the presence of dosimetrists and their detailed explanation of plan design has also helped them understand the process better. They all agree that this session should be continued in the future. Discussion Integrating plan review in our curriculum has resulted in increased confidence and satisfaction of residents regarding radiation plan review. We are currently working on the fourth part of Kolb's cycle which is active experimentation to actively involve residents and will ask our faculty and dosimetrists to provide feedback about residents' ability to review plans. As our next step, we would like to collaborate with other institutes to design a plan review curriculum. We also look forward to collaboration with dosimetrists and physicists to help us design scenarios and plans that require improvements. Lack of residents' dedicated training and satisfaction with regard to radiation plan review was one of the major issues detected in our needs assessment at Indiana University. Therefore, a monthly session focusing on dosimetry and plan review for residents was added to our didactics. This session was designed based on Kolb's cycle of experiential learning. All residents have been exposed to radiation plan review in clinic and during peer review (concrete experience). However, this session will emphasize on reflective observation and abstract conceptualization. Each month, we cover a specific disease site for the resident plan review session. Residents pick 3-4 radiation plans in advance. Each session begins by presenting the patient followed by plan review based on CB-CHOP acronym. Faculty are present to highlight the important aspects of plan review. Dosimetrists are sometimes present to explain the steps needed to design the plan. If there is a plan that was not approved by faculty, that plan will also be reviewed to highlight the issues and familiarize residents with less optimal plans. This session gives residents the opportunity to actively participate and ask questions, a factor that can be missing in departmental peer review sessions. This curriculum change was implemented in January 2021 at Indiana University and is in effect. There are 7 residents in our program and our evaluation has shown than all believe that this addition to the curriculum has improved their understanding of different steps of plan review and has increased their confidence to evaluate plans independently. It has been highlighted that the presence of dosimetrists and their detailed explanation of plan design has also helped them understand the process better. They all agree that this session should be continued in the future. Integrating plan review in our curriculum has resulted in increased confidence and satisfaction of residents regarding radiation plan review. We are currently working on the fourth part of Kolb's cycle which is active experimentation to actively involve residents and will ask our faculty and dosimetrists to provide feedback about residents' ability to review plans. As our next step, we would like to collaborate with other institutes to design a plan review curriculum. We also look forward to collaboration with dosimetrists and physicists to help us design scenarios and plans that require improvements.

Improving resident education on the inpatient solid tumor oncology rotation through development of an asynchronous video curriculum.

e23014 Background: As the oncology patient population grows, continued recruitment of talented individuals is essential. Meaningful and highly educational clinical exposures play a crucial role in a resident’s decision to pursue fellowship in oncology. Currently, the majority of oncology exposure occurs in the inpatient setting, where trainees are confronted with many competing clinical demands, leaving minimal time for teaching. Prior work has demonstrated that dedicated time for teaching supplemented with high-yield educational material improves trainee satisfaction and interest in a particular field. We hypothesize that implementing an asynchronous inpatient video oncology curriculum will improve resident clinical competency and satisfaction. Methods: This is an ongoing, single institution educational intervention using the Kern method for curriculum development in the Johns Hopkins Osler Internal Medicine Residency (IRB00307077). A targeted needs assessment has been developed to identify gaps in medical knowledge, assess preparedness in managing common solid tumor inpatient diagnoses, and explore satisfaction with prior educational experiences on this service. Based on these results, ten educational videos will be created by content experts and aligned with the learning objectives of the Osler residency program and ABIM blueprint. Trainees will have dedicated time to watch the videos during their solid tumor rotation. We plan to evaluate effectiveness of our curriculum by measuring completion rates and pre- and post-video multiple choice responses. We will also assess knowledge retention and resident satisfaction at three and six months post-rotation with online questionnaires. Results: Annual Osler program ACGME survey data review revealed a high level of resident dissatisfaction with the oncology clinical experience compared with other rotations. While 83.3% of residents rated their general internal medicine experience as “excellent,” only 52.4% rated their oncology experience as “excellent.” Needs assessment data collection has been delayed by the COVID-19 pandemic but is ongoing. Following topic selection, videos will be created in April 2022 with plans for video curriculum implementation in July 2022. Conclusions: In order to attract and retain trainees in the field of oncology, it is imperative that educational curricula adapts to meet learners’ needs. Efficient, evidence-based instructional strategies designed to promote clinical competency for internal medicine residents on an inpatient solid tumor service may foster engagement and rotation satisfaction. We are currently evaluating how an asynchronous video inpatient oncology curriculum may significantly improve the inpatient internal medicine trainee experience. If successful, this curriculum can be adapted for other trainees and practitioners new to the field of oncology.

An International Expert Delphi Consensus to Develop Dedicated Geriatric Radiation Oncology Curriculum Learning Outcomes

The management of older adults with cancer is rapidly becoming a significant challenge in radiation oncology (RO) practice. The education of future radiation oncologists in geriatric oncology is fundamental to ensuring that older adults receive high-quality care. Currently RO trainees receive little training and education in geriatric oncology. The objective of this study was to define core geriatric RO curriculum learning outcomes relevant to RO trainees worldwide. A 2-stage modified Delphi consensus was conducted. Stage 1 involved the formation of an expert reference panel (ERP) of multiprofessional experts in geriatric oncology and/or RO and the compilation of a potential geriatric RO learning outcomes set. Stage 2 involved 3 iterative rounds: round 1 and round 2 (both online surveys), and an intervening ERP round. These aimed at identifying and refining ideal geriatric RO learning outcomes. Invited participants for round 1 and 2 included oncology health care professionals with expertise across RO, geriatric oncology, and/or education and consumers. Predefined Delphi consensus definitions were applied to the results of rounds 1 and 2. An ERP of 11 experts in geriatric oncology and/or RO was formed. Seventy potential knowledge- and skill-based learning outcomes were identified. In round 1, 103 of 179 invited eligible Delphi participants completed the survey (58% response rate). The ERP round was conducted, resulting in the exclusion of 28 learning outcomes. In round 2, 54 of 103 completed the survey (52% response rate). This identified a final total of 33 geriatric RO learning outcomes. The geriatric RO learning outcomes described in this study form an international consensus that can inform RO training bodies worldwide. This represents the first fundamental step in developing a global educational framework aimed at improving RO trainee knowledge and skills in geriatric oncology.

Improving Palliative Radiotherapy Training: A Multi-professional, Combined Clinical and Training Improvement Project

Background: Palliative radiotherapy (RT) is an essential component of oncology training. A survey of South Wales oncology trainees identified a need for further RT training opportunities. With the new oncology curriculum (August 2021), medical (MO) and clinical oncology (CO) trainees will need experience in palliative RT. A new consultant/radiographer led palliative RT service at Velindre Cancer Centre providing rapid access to RT was used to improve training in palliative RT planning.

Target Volume Delineation Training in Radiation Oncology in India : A Survey Evaluating Its Status, the Need for Educational Programs and the Utility of Virtual Teaching.

Introduction:The complexity of modern-day radiotherapy techniques calls for greater accuracy in target volume delineation which requires intensive training and expert guidance. In this study, we intend to evaluate the status of training in target delineation across radiation oncology curriculums in India and utility of webinars in teaching it. Methodology:We organized daily webinars on the topics of radiological anatomy and target volume delineation in common sites of cancer over a period of 2 weeks. At the end of the program, a 35 item survey questionnaire was shared with the participants. The responses were analysed and are reported here. Results:Out of the 797 participants that registered for the course, 356 radiation oncologists responded to the survey questionnaire. Majority (96%) of our respondents believe that there is a need for additional training in target volume delineation. Ninety percent of the participants felt that radiation oncology curriculum requires a formal radiology training but only 6.7% reported that their training consisted of a dedicated rotation and regular lectures in radiological anatomy. Majority (97%) responded that they were likely to incorporate the points learnt from the webinar sessions in their daily practice. Forty eight percent of respondents opted for attending a webinar to an in-person event in the future while 34% would like to have the option to choose between the two. Ninety four percent agreed that online webinars should be conducted routinely even after the pandemic ends. Conclusion:Our survey results suggest that target volume delineation training in India is deficient and virtual teaching programs can be a practical and effective way to improve it.

Development of a United States Radiation Oncology Curricular Framework: A Stakeholder Delphi Consensus

<h3>Purpose/Objective(s)</h3> A United States (US) radiation oncology (RO) curriculum, developed by key stakeholders using best practices for curriculum inquiry, is needed to guide residency education and qualifying examinations. Competency-based training, including entrustable professional activities (EPAs), provides an outcomes-based approach to modern graduate medical education. This study developed the first list of US RO EPAs and curricular content domains (CDs) to guide resident training and assessment in the modern era. <h3>Materials/Methods</h3> The Radiation Oncology Education Collaborative Study Group (ROECSG) Core Curriculum Project Leadership Committee (LC) developed initial EPAs and CDs. Following recruitment of stakeholders, a Delphi process was used for consensus. In the first Delphi, EPAs and CDs were reviewed for inclusion/exclusion, clarity, level of training (EPAs only), and time allocation (CDs only). Participants submitted additional EPAs/CDs for consideration. Any EPA or CD one standard deviation below the median underwent LC review. All participants completing the first Delphi were invited to the second. New EPAs or EPAs undergoing major revisions were re-reviewed. Percent allocated curriculum time was finalized for CDs and for a single subdomain (SD). <h3>Results</h3> 186 participants representing diverse RO stakeholder groups volunteered to participate. 114 completed the first Delphi (61.3%): 6/9 CDs met consensus, 1 CD was removed, 2 CDs were combined (Table 1). Of 114 invited, 77 participants completed the second Delphi (67.5%). Of 55 initial EPAs, 52 final EPAs met consensus. 4 SDs of a single CD (Applied Sciences) were reviewed and met consensus. Consensus on percent time allocated per CD and SD was reached (Table 1). <h3>Conclusion</h3> Deliberative curriculum inquiry was successfully used to develop a consensus on US RO CDs/SDs and EPAs. These data can guide educational time in training programs and help inform weighting for qualifying examinations. CDs are not exclusive; educators must ensure all CDs are considered when delivering curriculum content, regardless of the primary CD. RO-specific EPAs can guide clinical training and resident assessment. The Delphi should be used to reach consensus recommendations for SD content breakdown. Given the evolving nature of RO and the need for curriculum renewal, the Delphi process will be repeated on an interval basis.