Evaluation of high-fidelity simulation training in radiation oncology using an outcomes logic model

Abstract

PurposeTo evaluate the feasibility and educational value of high-fidelity, interprofessional team-based simulation in radiation oncology.MethodsThe simulation event was conducted in a radiation oncology department during a non-clinical day. It involved 5 simulation scenarios that were run over three 105 minute timeslots in a single day. High-acuity, low-frequency clinical situations were selected and included HDR brachytherapy emergency, 4D CT artifact management, pediatric emergency clinical mark-up, electron scalp trial set-up and a cone beam CT misregistration incident. A purposive sample of a minimum of 20 trainees was required to assess recruitment feasibility. A faculty radiation oncologist (RO), medical physicist (MP) or radiation therapist (RTT), facilitated each case. Participants completed a pre event survey of demographic data and motivation for participation. A post event survey collected perceptions of familiarity with the clinical content, comfort with interprofessional practice, and event satisfaction, scored on a 1–10 scale in terms of clinical knowledge, clinical decision making, clinical skills, exposure to other trainees and interprofessional communication. Means and standard deviations were calculated.ResultsTwenty-one trainees participated including 6 ROs (29%), 6 MPs (29%), and 9 RTTs (43%). All 12 cases (100%) were completed within the allocated 105 minutes. Nine faculty facilitators, (3MP, 2 RO, 4 RTTs) were required for 405 minutes each. Additional costs associated with this event were 154 hours to build the high fidelity scenarios, 2 standardized patients (SPs) for a total of 15.5 hours, and consumables.The mean (±SD) educational value score reported by participants with respect to clinical knowledge was 8.9 (1.1), clinical decision making 8.9 (1.3), clinical skills 8.9 (1.1), exposure to other trainees 9.1 (2.3) and interprofessional communication 9.1 (1.0). Fifteen (71%) participants reported the cases were of an appropriate complexity. The importance of further simulation events was rated highly at 9.1/10.ConclusionsHigh-fidelity simulation training is feasible and effective in a radiation oncology context. However, such educational activities require significant resources, including personnel and equipment.

Assessing the performance and satisfaction of medical residents utilizing standardized patient versus mannequin-simulated training

“…Moreover, IM residents must be ready to treat catastrophic medical events, some of which they read about, but may never physically encounter during the course of their residency training. To achieve this goal, SBT is a safe and effective method for teaching crisis resource management for a variety of medical and surgical learners, as well as practicing physicians and other medical personnel 11–13. Regular participation in simulated deteriorating patients’ scenarios translates into earlier recognition and treatment of such emergencies in the hospital setting 14.…”

Team-based clinical simulation in radiation medicine: value to attitudes and perceptions of interprofessional collaboration

“…Twenty-one pre-event and post-event evaluations were returned (100%), as well as 21 post-case evaluations (100%) for each case. Insight regarding the development of the event, including resource requirements and programmatic outputs, is reported elsewhere 28 …”

“…One of the major limitations of this study was how research-intensive it was, and its reliance on a clinic closure. While feasible in the context of an academic research investigation, an analysis of what might be required to run such an event in a non-research context is discussed by Giuliani et al 28 Other limitations to this study were the broad range of training year of the participants, and thus the variability in clinical experience. Future efforts will attempt to determine the most appropriate time in training to hold such an event.…”

“…Insight regarding the development of the event, including resource requirements and programmatic outputs, is reported elsewhere. 28 Pre-event perceptions Participants perceived themselves as having limited interaction with trainees and staff of the other professional groups before RM SLICE. Half of the ROs (3/6) and MPs (3/6) believed they interacted frequently with RTT staff, and there was some interaction with RO staff and trainees reported by MPs and RTTs (see Table 1).…”

Learning radiotherapy: the state of the art

“…'Emerging Pedagogical Themes' collects the educational paradigms on the horizon that seek to enhance training experience. Given the interprofessional collaboration involved in the patient radiotherapy journey, the feasibility and effectiveness of training doctors alongside Physicists and Radiation Therapist could be deemed unsurprising [4,[49][50][51][52]. Statistical techniques were used to create a competency checklist for gynaecological brachytherapy [53] and advanced qualitative methodologies produced consensus target volumes for assessment of contours [54].…”