Development and Implementation of a Simulation-Based Educational Workshop on Gynecological Brachytherapy: Pilot Study at a National Meeting

Singer, Lisa; Braunstein, Steve; Klopp, Ann H.; Joyner, Melissa

doi:10.1016/j.prro.2019.05.006

Cited by 24 publications

(23 citation statements)

References 19 publications

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“…Despite the larger group sizes compared with the U.S. deployment (5) and less individualized instruction as compared with the Virginia Commonwealth University workshop (4), the workshop was met with high satisfaction. The participant satisfaction identified in this study compares favorably with that seen in other similar workshops in the United States (4,6).…”

Section: Discussionsupporting

confidence: 65%

“…A recent review of SBE in radiation oncology showed that contouring training is the most common skill that is taught in this arena (17). However, several groups have developed BT SBE curricula for prostate, breast, and gynecologic BT, which have shown an improvement in learner confidence, similar to this workshop (4,6,8,18). Overall, the deployment of this curriculum in Israel demonstrates that the hands-on workshop and training are invaluable and can be broadly applied to a diverse audience.…”

Section: Discussionmentioning

confidence: 85%

“…In a gynecological BT workshop developed at Virginia Commonwealth University, model-based simulation improved participants' confidence, applicator placement, and efficiency (4). A gynecological BT workshop piloted at the American Brachytherapy Society annual meeting improved participants' confidence and familiarity with BT (6). SBE is beneficial because it allows for practice of technical skills in a nonclinical environment.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting

et al. 2020

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PURPOSE: A decline in brachytherapy (BT) use for cervical cancer has negatively affected cure rates in the United States and abroad. To improve trainee exposure to BT, a simulation-based educational curriculum incorporating a pelvic mannequin was developed and implemented at several U.S. residency programs. We sought to describe an initial experience with deployment of this curriculum to an international setting. METHODS AND MATERIALS: The setting was in Israel, a middle eastern country with cervical cancer incidence of 5e8 cases per 100,000 women. Israel was selected for this pilot because of its desire to increase exposure to trainees, lack of mandatory BT case requirements, and few residencies nationally. In determining the feasibility of deployment to this setting, a partnership was formed between a U.S. and Israeli brachytherapist to understand cultural context and institutional and logistical needs. Feasibility was defined as successful completion of the workshop. Trainee comfort and knowledge with BT was assessed with preworkshop and postworkshop surveys, with changes compared. RESULTS: The curriculum was incorporated into a 1-day course on gynecologic malignancies, with adaptation to local setting and routine. Among 15 attendees, eight were residents, from four programs. All completed the workshop. All domains assessed by the surveys improved and all respondents found the program to be helpful. CONCLUSIONS: International deployment of the simulation-based educational BT curriculum was feasible and well-received. Further collaboration is needed to deploy and adapt the curriculum to countries of high cervical cancer incidence that could benefit from increased education.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting

et al. 2020

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“…Simulation-based education (SBE) is an active area of research in radiation oncology [34]. SBE has been successfully applied to brachytherapy training [35][36][37] and training in on-call treatments [38], but to the authors' knowledge this is a novel use of SBE, and is well-suited to the nature of SMART. With the rise of MR-guided radiotherapy, healthy volunteer scans play a critical role in sequence and workflow optimization [39,40], as well as providing a non-clinical training environment.…”

Section: Discussionmentioning

confidence: 99%

Use of a healthy volunteer imaging program to optimize clinical implementation of stereotactic MR-guided adaptive radiotherapy

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Boyle

et al. 2020

Technical Innovations & Patient Support in Radiation Oncolo

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Purpose: MR-linacs (MRLs) have enabled the use of stereotactic magnetic resonance (MR) guided online adaptive radiotherapy (SMART) across many cancers. As data emerges to support SMART, uncertainty remains regarding optimal technical parameters, such as optimal patient positioning, immobilization, image quality, and contouring protocols. Prior to clinical implementation of SMART, we conducted a prospective study in healthy volunteers (HVs) to determine optimal technical parameters and to develop and practice a multidisciplinary SMART workflow. Methods: HVs 18 years or older were eligible to participate in this IRB-approved study. Using a 0.35 T MRL, simulated adaptive treatments were performed by a multidisciplinary treatment team in HVs. For each scan, image quality parameters were assessed on a 5-point scale (5 = extremely high, 1 = extremely poor). Adaptive recontouring times were compared between HVs and subsequent clinical cases with a t-test. Results: 18 simulated treatments were performed in HVs on MRL. Mean parameters for visibility of target, visibility of nearby organs, and overall image quality were 4.58, 4.62, and 4.62, respectively (range of 4-5 for all measures). In HVs, mean ART was 15.7 min (range 4-35), comparable to mean of 16.1 (range 7-33) in the clinical cases (p = 0.8963). Using HV cases, optimal simulation and contouring guidelines were developed across a range of disease sites and have since been implemented clinically. Conclusions: Prior to clinical implementation of SMART, scans of HVs on an MRL resulted in acceptable image quality and target visibility across a range of organs with similar ARTs to clinical SMART. We continue to utilize HV scans prior to clinical implementation of SMART in new disease sites and to further optimize target tracking and immobilization. Further study is needed to determine the optimal duration of HV scanning prior to clinical implementation.

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“…They found that both resident procedural skill and confidence improved and greater improvement was seen in residents with less experience. This experience, and the experience from another workshop performed by Singer et al at a national meeting, demonstrated that most respondents reported increased confidence and familiarity with procedures by the end of the workshop (23). Therefore, we conducted an institutional pilot brachytherapy workshop to evaluate the impact of simulation-based radiation oncology resident training on domain-specific resident knowledge, procedural confidence, and gynecologic brachytherapy interest using a combination of didactic lectures and brachytherapy simulation laboratory using a specialized pelvic phantom.…”

Section: Introductionmentioning

confidence: 99%

Simulation-based learning for enhanced gynecologic brachytherapy training among radiation oncology residents

et al. 2021

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PURPOSE: Brachytherapy is an irreplaceable component of gynecologic cancer treatment. Resident training has declined, and procedural exposure is variable. We evaluated whether simulationbased gynecologic brachytherapy training among radiation oncology residents could improve knowledge, confidence, and interest. METHODS AND MATERIALS: Before a brachytherapy workshop, radiation oncology residents without prior gynecologic brachytherapy experience completed a survey on brachytherapy knowledge, procedural confidence, plan evaluation, and quality/safety. Residents then participated in a gynecologic brachytherapy workshop. Lectures covered brachytherapy imaging and physics principles/quality assurance, followed by hands-on and individualized feedback regarding applicator selection and placement, target segmentation, and physics quality assurance. Afterward, preworkshop questions were recollected. Descriptive statistics and Fisher's exact tests were used for data analysis. RESULTS: After the workshop, resident responses regarding the learning environment and baseline knowledge questions improved overall. There was a 30% improvement in favorable responses to the learning environment statement ''My residency has a formal process/curriculum to teach brachytherapy'' and for baseline knowledge the greatest improvement was seen for ''I am familiar with the anatomy and placement of the applicators in relation to the anatomy''. ''Lack of didactic or procedural training exposure'' was identified as the main reason for declining brachytherapy use. Initially, 1/8 residents correctly completed the knowledge questions, and after the workshop, 6/7 ( p ! 0.001) residents correctly completed the questions. CONCLUSIONS: Domain-specific knowledge, procedural confidence, and brachytherapy interest improved after a gynecologic brachytherapy workshop. Integrated didactic and simulation-based brachytherapy training may serve as a valuable learning tool to augment resident knowledge, introduce practical skills, and spark resident interest in brachytherapy. Published by Elsevier Inc. on behalf of American Brachytherapy Society.

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Development and Implementation of a Simulation-Based Educational Workshop on Gynecological Brachytherapy: Pilot Study at a National Meeting

Cited by 24 publications

References 19 publications

Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting

Feasibility of deploying a U.S. simulation-based gynecological brachytherapy educational workshop to an international setting

Use of a healthy volunteer imaging program to optimize clinical implementation of stereotactic MR-guided adaptive radiotherapy

Simulation-based learning for enhanced gynecologic brachytherapy training among radiation oncology residents

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