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4.
Int J Radiat Oncol Biol Phys ; 108(2): 444-451, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32890529

RESUMO

PURPOSE: We evaluated the impact of a virtual radiation oncology clerkship. METHODS AND MATERIALS: We developed a 2-week virtual radiation oncology clerkship that launched on April 27, 2020. Clerkship components included a virtual clinic with radiation oncology faculty and residents, didactic lectures, student talks, and supplemental sessions such as tumor boards and chart rounds. Medical students completed pre- and post-clerkship self-assessments. Faculty and resident participants also completed surveys on their experience with virtual lectures and clinics. Pre- and post-clerkship results were compared using a 2-sided paired t test. An analysis of variance model was used to analyze the clerkship components. RESULTS: Twenty-six medical students, including 4 visiting students, enrolled over 2 clerkship periods (4 weeks). All students completed the pre- and post-clerkship self-assessments and agreed that the clerkship improved their understanding of radiation oncology. Compared with 3 (11.5%) students who agreed that they understood the daily responsibilities of a radiation oncologist before the clerkship, 22 (84.6%) students agreed and 3 (11.5%) strongly agreed that they understood the daily responsibilities of a radiation oncologist after the clerkship (P < .0001). Although 15 students (57.7%) reported an increased interest in radiation oncology because of the clerkship, the mean level of interest in radiation oncology as a career remained the same, with pre- and post-clerkship scores of 3.0 (±0.9) and 3.0 (±1.1) on a 5-point scale, respectively (P = .7). Students found virtual clinic and didactic lectures to be the most valuable components of the clerkship. Most respondents agreed (30.8%) or strongly agreed (65.4%) to recommend the clerkship to their classmates. CONCLUSIONS: Our virtual clerkship was effective in increasing medical student interest in and knowledge about radiation oncology. These data will help optimize a new paradigm of virtual radiation oncology education for medical students during COVID-19 and beyond.


Assuntos
Estágio Clínico/métodos , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Radioterapia (Especialidade)/educação , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Interface Usuário-Computador , Adulto Jovem
6.
Radiat Oncol ; 15(1): 74, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: covidwho-38291

RESUMO

The COVID-19 pandemic is challenging modern radiation oncology. At University Hospitals, we have a mandate to offer high-end treatments to all cancer patients. However, in times of crisis we must learn to prioritize resources, especially personnel. Compromising oncological outcome will blur all statistics, therefore all measures must be taken with great caution. Communication with our neighboring countries, within societies and between departments can help meet the challenge. Here, we report on our learning system and preparation measures to effectively tackle the COVID-19 challenge in University-Based Radiation Oncology Departments.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quimiorradioterapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Higiene , Idioma , Neoplasias/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Radioterapia (Especialidade)/educação , Universidades
8.
Bull Cancer ; 107(4): 417-427, 2020 Apr.
Artigo em Francês | MEDLINE | ID: mdl-32245605

RESUMO

INTRODUCTION: Medical oncology bad news consultation is a particularly stressful situation for both the patient and the physician. High-fidelity simulation is a learning option that has never been evaluated in France in this field. MATERIALS AND METHODS: This is a feedback from simulated announcement consultations carried out from January 2018 to May 2019. Residents from the medical oncology and radiotherapy departments performed high-fidelity simulations at the announcement consultation with an announcement nurse, a psychologist, a certified coach and an oncologist. A competency assessment was completed in pre-test, immediate post-test and after 5 months. RESULTS: Fourteen of the 16 eligible interns participated. The pre-test competency assessment showed that interns over 5 semesters reported being more comfortable at the consultation (P=0.04) and thought they were clearly explaining the disease (P=0.03). However, all residents, regardless of the semester, felt stressed before a consultation. The evolution of parameters skills after the simulation was positive for all criteria, particularly for adaptation to patient reactions, use of appropriate vocabulary and reduction of stress (P<0.05). This evolution was independent of the gender, curriculum, semester, or previous completion of a medical oncology internship. More than 80% of the students were ready to repeat this type of training. CONCLUSION: This training demonstrates the value of simulation training for medical oncology advertising consultation.


Assuntos
Treinamento com Simulação de Alta Fidelidade/métodos , Internato e Residência , Oncologia/educação , Neoplasias/diagnóstico , Simulação de Paciente , Revelação da Verdade , Adulto , Competência Clínica , Feminino , França , Treinamento com Simulação de Alta Fidelidade/organização & administração , Humanos , Masculino , Neoplasias/psicologia , Enfermagem Oncológica , Psicologia , Radioterapia (Especialidade)/educação , Radioterapia , Autoavaliação , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Inquéritos e Questionários , Fatores de Tempo
9.
Radiat Oncol ; 15(1): 74, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32264908

RESUMO

The COVID-19 pandemic is challenging modern radiation oncology. At University Hospitals, we have a mandate to offer high-end treatments to all cancer patients. However, in times of crisis we must learn to prioritize resources, especially personnel. Compromising oncological outcome will blur all statistics, therefore all measures must be taken with great caution. Communication with our neighboring countries, within societies and between departments can help meet the challenge. Here, we report on our learning system and preparation measures to effectively tackle the COVID-19 challenge in University-Based Radiation Oncology Departments.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quimiorradioterapia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Higiene , Idioma , Neoplasias/terapia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Radioterapia (Especialidade)/educação , Universidades
11.
Int J Radiat Oncol Biol Phys ; 106(4): 683-689, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-32092341

RESUMO

PURPOSE: Data regarding the amount and use of nonclinical time (NCT) in radiation oncology residency programs are scarce. We surveyed every U.S. radiation oncology residency program to obtain benchmark data to inform decisions about optimal program structure. METHODS AND MATERIALS: An anonymous, web-based survey was distributed to postgraduate year 5 residents at Accreditation Council for Graduate Medical Education-accredited radiation oncology training programs. The survey included 33 yes/no, Likert-scale, and free-response questions. Program data were analyzed for all programs, including those considered "top 10" per Doximity and those "not top 10." Likert-scale responses were dichotomized as "not as satisfied" (1, 2, 3) or "very satisfied" (4, 5). RESULTS: One hundred twenty-six residents (69%) completed the survey. Program-specific data were obtained for 100% of programs (n = 82). Almost all training programs (98%) provide residents with protected NCT. Including programs with no NCT, the median NCT is 10 months in all programs. The median NCT is 12 months in "top 10" programs and 9 months in "not top 10" programs (P < .01). Most programs (68%) reported >6 months of NCT. The proportion of residents wanting more NCT decreased as the amount of NCT increased (73%, 52%, and 19% for 4-6, 7-9, and 10-12 months, respectively; P < .01). The proportion of residents who were very satisfied with NCT flexibility increased with more NCT (64%, 79%, and 94% for 4-6, 7-9, and 10-12 months, respectively; P < .01), as did the proportion of residents who were very satisfied with accomplishments during NCT (35%, 53%, and 72% for 4-6, 7-9, and 10-12 months, respectively; P < .01). When asked whether residents would theoretically give up some NCT to shorten residency, the proportion of residents willing to shorten their residencies decreased as the amount of NCT increased (65%, 47%, and 33% for 4-6, 7-9, and 10-12 months respectively; P = .04). CONCLUSIONS: Programs should maintain an emphasis on NCT and implement measures to ensure meaningful resident experiences.


Assuntos
Internato e Residência/estatística & dados numéricos , Radioterapia (Especialidade)/educação , Inquéritos e Questionários , Humanos , Satisfação Pessoal , Estados Unidos
12.
Int J Radiat Oncol Biol Phys ; 107(1): 27-32, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31987964

RESUMO

PURPOSE: The impact that early clinical exposure to radiation oncology has on medical students' understanding of oncology and career choice is understudied. This study aims to review the experience and outcomes of medical students who participated in the Canadian Association of Radiation Oncology-Canadian Radiation Oncology Foundation 6-week summer studentship. METHODS AND MATERIALS: Medical students who participated in the nationally funded studentship from 2014 to 2018 were asked to fill out a survey after completing the program. The survey asked about student experience related to radiation oncology before the studentship, student satisfaction with the studentship (scale of 1-5; 5 = outstanding, 3 = meets expectations, 1 = unsatisfactory), and student willingness to recommend it to other students (scale of 1-10; 1 = strongly disagree, 5 = neutral, 10 = strongly agree). The effect of studentship on interest in the specialty was assessed (scale of 1-10; 1 = strongly disagree, 5 = neutral, 10 = strongly agree), including intent to direct their career toward radiation oncology. Match rates to radiation oncology residency are reported for students who participated in the studentship from 2013 to 2016. RESULTS: All 31 students responded to the survey. Overall, the program was highly rated: inclusion of a broad range of clinical problems (mean = 4.6/5); opportunity to learn assessment, investigation, and management (mean = 4.2/5); and overall educational value (mean = 4.8/5). Poststudentship, most students reported an increased interest in oncology (76%, n = 22/29), and specifically radiation oncology (83%, n = 24/29). They would highly recommend this program to another medical student (mean = 9.8/10). The average percentage of these students entering a radiation oncology career (30.5%) each year was higher than national residency match rates in radiation oncology (0.7%). CONCLUSIONS: Clinical exposure to radiation oncology through a nationally funded Canadian Association of Radiation Oncology-Canadian Radiation Oncology Foundation summer studentship positively affected medical student interest in oncology. This study suggests a potential effect of the studentship program on career selection of radiation oncology.


Assuntos
Escolha da Profissão , Radioterapia (Especialidade)/educação , Estudantes de Medicina/estatística & dados numéricos , Canadá , Feminino , Humanos , Masculino
15.
Int J Radiat Oncol Biol Phys ; 106(4): 677-682, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31786277

RESUMO

PURPOSE: Prior surveys suggest almost one-third of chief residents report insufficient exposure to treatment planning. We evaluated the state of treatment planning education among United States residents. METHODS AND MATERIALS: A web-based survey was sent to current residents identified using the Association of Residents in Radiation Oncology directory. RESULTS: The response rate was 33%. Twenty-six percent of residents reported a mandatory treatment planning rotation. Seventy-one percent of residents reported reviewing ≤50% of plans with an attending. Twenty-three percent of respondents were not at all or only slightly comfortable (1 or 2 on a 1-5 scale) evaluating treatment plans. Residents with mandatory treatment planning rotations were more comfortable evaluating plans compared with those without mandatory rotations (P = .045). Overall, 60% reported insufficient exposure to treatment planning. Among postgraduate year 5 residents, this rate was 52%. Ninety-two percent of residents expressed interest in free supplemental treatment planning resources. CONCLUSIONS: A significant proportion of residents surveyed report insufficient exposure to treatment planning. Development of a practical treatment planning curriculum would offer the opportunity to improve resident education, and ultimately quality of care, at the national level.


Assuntos
Internato e Residência/estatística & dados numéricos , Determinação de Necessidades de Cuidados de Saúde , Radioterapia (Especialidade)/educação , Planejamento da Radioterapia Assistida por Computador
16.
Br J Radiol ; 93(1107): 20190873, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31860337

RESUMO

The UK has an important role in the evaluation of proton beam therapy (PBT) and takes its place on the world stage with the opening of the first National Health Service (NHS) PBT centre in Manchester in 2018, and the second in London coming in 2020. Systematic evaluation of the role of PBT is a key objective. By September 2019, 108 patients had started treatment, 60 paediatric, 19 teenagers and young adults and 29 adults. Obtaining robust outcome data is vital, if we are to understand the strengths and weaknesses of current treatment approaches. This is important in demonstrating when PBT will provide an advantage and when it will not, and in quantifying the magnitude of benefit.The UK also has an important part to play in translational PBT research, and building a research capability has always been the vision. We are perfectly placed to perform translational pre-clinical biological and physical experiments in the dedicated research room in Manchester. The nature of DNA damage from proton irradiation is considerably different from X-rays and this needs to be more fully explored. A better understanding is needed of the relative biological effectiveness (RBE) of protons, especially at the end of the Bragg peak, and of the effects on tumour and normal tissue of PBT combined with conventional chemotherapy, targeted drugs and immunomodulatory agents. These experiments can be enhanced by deterministic mathematical models of the molecular and cellular processes of DNA damage response. The fashion of ultra-high dose rate FLASH irradiation also needs to be explored.


Assuntos
Institutos de Câncer/estatística & dados numéricos , Terapia com Prótons/estatística & dados numéricos , Medicina Estatal/estatística & dados numéricos , Adolescente , Adulto , Institutos de Câncer/provisão & distribução , Fortalecimento Institucional , Criança , Ensaios Clínicos como Assunto , Terapia Combinada/métodos , Dano ao DNA , Inglaterra , Humanos , Modelos Teóricos , Neoplasias/radioterapia , Órgãos em Risco/efeitos da radiação , Avaliação de Programas e Projetos de Saúde , Terapia com Prótons/efeitos adversos , Radioterapia (Especialidade)/educação , Planejamento da Radioterapia Assistida por Computador , Eficiência Biológica Relativa , Pesquisa , Pesquisa Médica Translacional , Resultado do Tratamento , Incerteza , Adulto Jovem
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