Corona virus disease 2019 (COVID-19) affected medical student clerkships and education around the country. A virtual medical student clerkship was created to integrate didactic education with disease specific lectures for medical students, contouring, and hands on learning with telehealth. Twelve medical students in their 3rd and 4th year were enrolled in this 2 week elective from April 27, 2020 to June 5, 2020. There was significant improvement of overall knowledge about the field of radiation oncology from pre elective to post elective (P < .001). Feedback included enjoying direct exposure to contouring, telehealth, and time with residents. Overall this 2 week rotation was successful in integrating radiation oncology virtually for medical students. This is now being expanded to multiple institutions as an educational resource and future rotations for medical students.
No abstract
Purpose/Objective(s): Much focus has been placed on describing the serious and disproportionate exclusion of black physicians in radiation oncology. As a result, many programs have recently emerged to introduce historically-excluded minority medical students from radiation oncology. However, according to annual Association of American Medical Colleges data, black applicants, let alone black medical school matriculants, are among the lowest of any racial/ethnic group. With the starting black population in medical school already significantly and concerningly low, the utility of early radiation oncology exposure initiatives are arguably limited in their ultimate objectives. Thus, to improve the exposure and ultimate inclusion of black physicians as part of the healthcare (generally) or radiation oncology (specifically) workforce, the systemic and institutionalized racist barriers to entry into medicine need to be adequately addressed. To this end, we describe and analyze programs designed to help black premedical students in their pursuit for a medical career. Materials/Methods: We conducted a review of the indexed literature and content analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Studies describing programs and initiatives designed to ultimately increase the volume of black American applicants and matriculants into medical school were included. These studies further analyzed for common themes, successes, and challenges. Results: The search identified 7608 results. Following title, abstract, then full-text review, 10 articles detailing 11 initiatives were included. Programs ranged from three weeks to four years. The primary targets of these initiatives were undergraduate premedical students from underrepresented and economically disadvantaged backgrounds. Themes emerging from these initiatives included mentorship, rigorous academic preparation, test taking strategies, and professional development training. Challenges included sustainable funding, maintaining student interest, and ultimately the need to identify which features specifically lend to programs' success. Conclusion: While programs designed to expose black medical students to radiation oncology are important, they unfortunately do not address the supply/demand problem. Initiatives supporting black premedical students within the larger medical system designed to exclude them and restrict their access offer an opportunity for radiation oncology programs to collaborate with undergraduate institutions to offer practical support of black premedical students. Given the uniqueness and breadth of the clinical components of radiation oncology (e.g., imaging, clinical interactions, procedures, inpatient consults, etc.), we can learn from the successes and challenges of current programs to design and improve future initiatives to introduce and support black undergraduates through the medical career pipeline.
Medical student education in radiation oncology traditionally takes place in-person during 3 rd or 4 th year of medical school. Due to the COVID-19 pandemic, onsite clerkships were placed on hold, leading to virtual medical student clerkships in radiation oncology which incorporated didactics and hands-on learning. We sought to implement this virtual medical student clerkship in radiation oncology at multiple institutions and analyze the impact and utility of this platform. Materials/Methods: An IRB-approved virtual clerkship was created and implemented at 7 institutions. Students enrolled in home or away rotations. Clerkships offered general and disease subsite-specific oncology topics through recorded didactics geared towards medical students on www. radoncvirtual.com, as well as clinical vignettes, telehealth visits, chart rounds, contouring, and capstone presentations. Surveys were given preand post-clerkship to assess baseline comfort and knowledge. At the end of each clerkship, a course exam was given consisting of 48 questions. Clerkship directors were given a survey to assess comfort and ease of implementing the virtual clerkship. Surveys and course exams were analyzed using Wilcoxon Signed rank test and t-test, 2-sided. Results: Seventy-two (72) students enrolled at 7 institutions between 4/ 2020 and 2/2021. Survey response rates were 100% pre-and post-clerkship as well as from course directors. The majority of students were MS4 (57%) and MS3 (33%) with equal distribution in gender. Each institution's median number of total medical students doing an away rotation was 4 (range 3-9) and home rotation number of students 2 (range 0-36). The median length of each virtual rotation was 2.5 weeks (range: 1-4 week). 71% (n = 51) of medical students had never previously enrolled in a radiation oncology elective. Improvements in the overall knowledge of radiation oncology, as well as specific knowledge in the scope of radiation oncology, roles of radiation physicist, dosimetrist and therapist, contouring, treatment planning, and training path to the field (all P < 0.001). There was no significant difference in course final exam scores between students who had attended a radiation oncology elective before enrollment and those who had not (P = 0.27). Course directors reported spending an additional 5-10 hours per week with students. The survey revealed 100% were satisfied with content and delivery of this virtual elective, and 83% (n = 6) indicated they would utilize the material for future rotations. Conclusion: Implementation of a multi-institutional virtual radiation oncology elective was successful at improving knowledge for medical students at all levels, even those that had exposure previously. This virtual elective platform can be utilized to improve access to multiple institutions, resources, mentors, and networking opportunities. Resources in the virtual rotation platform can also be integrated into traditional educational paradigms to increase exposure in the field.
Purpose/Objective(s): There is no standard simulation training geared towards interstitial brachytherapy (IS BT) for gynecologic malignancies. Most residents perform few IS cases during residency. However, IS BT is an integral part of care for locally advanced gynecologic malignancies. We developed and implemented a workshop curriculum for IS BT with: 1) lecture on equipment, workflow, and guidelines, 2) hands-on ultrasound-guided IS BT workshop, and 3) treatment planning workshop. Materials/Methods: The cost of each gynecologic phantom was approximately $70; phantoms were composed of an acrylic vase cube, rigid PETG tubes, modeling clay, agar, glass microspheres, a custom molded cervix/ uterus structure, and a water-filled condom to mimic the bladder. A handson ultrasound-guided IS BT workshop was performed with residents in two small groups, where they imaged the gynecologic phantom using a transabdominal ultrasound probe. Participants alternated roles of sonographer or brachytherapist, implanting the phantom using custom stainlesssteel needles machined in-house. A second workshop with hands-on treatment planning was performed in planning software using a L-Q spreadsheet with the following objectives: coverage goal of D90, meeting D2cc constraints of bladder and rectum, and minimizing V200 to qualitatively involve a small volume. All residents filled out a pre-and post-survey with subjective (4 demographics; 12 Likert-style) and objective knowledgebased (13) questions about GYN IS-BT. Paired subjective data were compared with the Wilcoxon signed ranks test. Paired objective data were compared with the McNemar's test of paired proportions. All statistical analysis was performed with a 2-sided P-value at the 0.05 significance level. Results: Four residents had prior IS BT experience. After the workshop, residents reported significantly improved comfort with skills and knowledge regarding GYN IS BT equipment and procedure, evaluating GYN anatomy using ultrasound, and CT Simulation, contouring, and plan review (median pre-session Likert score 2 [1-3] vs post session 3 [3-4], P < 0.05). The overall rate of percent correct items assessing objective radiation oncology knowledge at baseline was 44%, Following completion of the curriculum, the overall percent correct items was 88% (P < 0.0001). All residents "Agree" (2/7) and "Strongly Agree" (5/7) the session was an effective learning experience. Qualitative feedback primarily asked for more time with treatment planning and educational content beforehand. Conclusion: Residents participating in phantom training with an ultrasound curriculum and a treatment planning session is both feasible and effective. Similar strategies should be considered to enhance and standardize radiation oncology education initiatives for gynecologic IS BT training.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.