Educational Impact of a Structured Radiation Oncology Clerkship Curriculum: An Interinstitutional Comparison

Abstract

Purpose Many medical school clerkships have structured curricula, however most radiation oncology clerkships do not. The Radiation Oncology Education Collaborative Group (ROECSG) implemented a curriculum for fourth-year radiation oncology clerkships at 14 institutions. We hypothesized that students completing clerkships with the curriculum would report greater subjective knowledge and comfort to function as a radiation oncology resident compared with students completing clerkships without the curriculum. Methods and Materials The ROECSG curriculum included three 1-hour lectures and a 1-hour hands-on radiation treatment planning workshop. Applicants to a single radiation oncology residency program in the 2014–2015 academic year were sent an anonymous, validated clerkship experience survey. Students indicated if clerkships were completed at a curriculum site. Likert-type data (1=not at all, 5=extremely) are reported as median(interquartile range). Results Respondents described 276 clerkship experiences of which 64(23.2%) were completed at a curriculum site. Students whose first clerkship was at a curriculum site perceived greater post-clerkship confidence in knowledge of radiation biology (3 (3–4) vs 2(2–3), p<0.01), treatment set-up/positioning (3(2–3) vs. 2(2–3), p<0.05), treatment planning (3(2–3) vs. 2(2–3), p<0.01), and ability to integrate evidence-based medicine into treatment (4(2–4) vs. 3(2–4), p<0.05). Students who completed any clerkship with the curriculum had greater post-clerkship confidence to function as a radiation oncology resident (3(3–4) vs. 3(2–3), p<0.05). Conclusions These results support the curriculum’s ability to increase student knowledge in radiation oncology, especially in the students’ first clerkship. Further, these findings suggest that expanded implementation of such curricula may ensure a rewarding educational experience during radiation oncology clerkships.

Objective Evaluation of a Didactic Curriculum for the Radiation Oncology Medical Student Clerkship

“…For phase 2, a total of 220 applicants to the University of Chicago/University of Illinois at Chicago radiation oncology residency program were invited to complete the 2017 annual clerkship experience survey (7, 8, 19). A total of 77 complete responses were returned for a response rate of 35.0%.…”

“…The traditional radiation oncology medical student clerkship is an audition elective (23), with a majority of students reporting limited didactic education (7, 8, 19). Although prior studies have shown an improvement in students’ subjective perceptions of preparedness for residency training (8) and subjective radiation oncology knowledge (19), this study demonstrates improved short-and long-term objective knowledge of radiation oncology topics. These results suggest that a structured didactic curriculum should be a standard component of any radiation oncology clerkship elective.…”

“…For phase 2 of the study, to assess long-term (approximately 6-month) knowledge retention, the same objective knowledge assessment was administered during the annual clerkship survey conducted since 2012 by investigators in the Department of Radiation and Cellular Oncology at the University of Chicago (<dummy_Appendix E3>; available online at www.redjournal.org) (7, 8, 19). The phase 2 long-term knowledge assessment study population included all students applying to the University of Chicago Radiation Oncology residency in the 2016 to 2017 National Resident Matching Program.…”

“…Upon completion of a clerkship at a participating institution, each student voluntarily and anonymously evaluated the ROECSG curriculum. Subjective evaluations from students were positive (14, 17, 18), and students who completed at least 1 clerkship at an institution that had instituted the ROECSG curriculum reported greater post-clerkship confidence in their radiation oncology knowledge and their ability to function as a radiation oncology resident (19). However, these initial reports did not evaluate the efficacy of the curriculum using an objective measure such as a knowledge assessment.…”

Tumor Board Shadowing: A Unique Approach for Integrating Radiation Oncologists Into General Medical Student Education

“…Multidisciplinary cancer management ("tumor board") conferences are common at academic centers but are infrequently used for the purpose of teaching medical students, although they would expose students to a real-world collaborative process among physicians and give perspective on the multidisciplinary aspects of clinical oncology, experiences that are often lacking in US and Canadian medical curricula. [1][2][3][4] Such an activity may also be particularly valuable to radiation oncologists, given the relative dearth of other opportunities to expose the average student to radiation oncology in most curricula [2][3][4][5] and the American Society for Radiation Oncology's goal of elevating the profile of the field 6 . However, whether a mentored "tumor board shadowing" activity that is primarily observational and lacks direct patient contact is a valuable educational activity is unclear.…”