The nuances of brachytherapy taught by teachers from beyond: Questionnaire-based assessment of the first cadaveric hands-on brachytherapy workshop in India

Alva, Ram Charith; Sreenivasa, Kirthi Koushik Agrahara; Gururajachar, Janaki Manur; Raju, Arul Ponni Thiru; Kumar, Mohan; Bilimagga, Ramesh S; Kilara, G.; Harish, K; Satish, Chetan

doi:10.1016/j.brachy.2016.05.005

Cited by 15 publications

(11 citation statements)

References 7 publications

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“…For even more reality, and a chance to practice interstitial applications, cadaveric models have been used both by the Northwestern Radiation Oncology Department as well as the MS Ramaiah Medical College in India 27 28. The trainees at Northwestern had a curriculum that included didactics and self-study, hands-on applicator insertions on cadaveric pelvic models, followed by contouring, treatment planning and plan evaluation 27.…”

Section: Simulation-based Medical Education For Gynecological Brachyt...mentioning

confidence: 99%

“…The trainees at Northwestern had a curriculum that included didactics and self-study, hands-on applicator insertions on cadaveric pelvic models, followed by contouring, treatment planning and plan evaluation 27. Similarly, the experience in India included the entire brachytherapy workflow, from applicator selection and insertion to treatment planning and optimization 28. These workshops show how SBME can be used for end-to-end testing for workflow, team building and safety evaluations, in addition to trainee education.…”

Section: Simulation-based Medical Education For Gynecological Brachyt...mentioning

confidence: 99%

“…In clinical practice, careful tandem placement relies on ultrasound guidance and contouring and treatment planning requires volumetric imaging with CT or MRI, none of which are available with the gynecological skills model due to the material used and the air cavities. Creative solutions have been arrived at, including the development of imaging-compatible mannequins as well as using cadavers as models [26][27][28] (Figure 1).…”

Section: Pelvic Models For Intracavitary Brachytherapy Trainingmentioning

confidence: 99%

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Education in gynecological brachytherapy

Fields

Kahn

Singer

2022

Int J Gynecol Cancer

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Brachytherapy is an essential component in the curative treatment of many gynecological malignancies. In the past decade, advances in magnetic resonance imaging and the ability to adapt and customize treatment with hybrid interstitial applicators have led to improved clinical outcomes with decreased toxicity. Unfortunately, there has been a shift in clinical practice away from the use of brachytherapy in the United States. The decline in brachytherapy is multifactorial, but includes both a lack of exposure to clinical cases and an absence of standardized brachytherapy training for residents. In other medical specialties, a clear relationship has been established between clinical case volumes and patient outcomes, especially for procedural-based medicine. In surgical residencies, simulation-based medical education (SBME) is a required component of the program to allow for some autonomy before operating on a patient. Within radiation oncology, there is limited but growing experience with SBME for training residents and faculty in gynecological brachytherapy. This review includes single institutional, multi-institutional and national initiatives using creative strategies to teach the components of gynecological brachytherapy. These efforts have measured success in various forms; the majority serve to improve the confidence of the learners, and many have also demonstrated improved competence from the training as well. The American Brachytherapy Society launched the 300 in 10 initiative in 2020 with a plan of training 30 competent brachytherapists per year over a 10 year period and has made great strides with a formal mentorship program as well as externships available to senior residents interested in starting brachytherapy programs. Moving forward, these curricula could be expanded to provide standardized brachytherapy training for all residents. SBME could also play a role in initial certification and maintenance of certification. Given the burden of disease, it would be valuable to develop similar training for providers in low and middle income countries.

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Section: Simulation-based Medical Education For Gynecological Brachyt...mentioning

confidence: 99%

Section: Simulation-based Medical Education For Gynecological Brachyt...mentioning

confidence: 99%

Section: Pelvic Models For Intracavitary Brachytherapy Trainingmentioning

confidence: 99%

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Education in gynecological brachytherapy

Fields

Kahn

Singer

2022

Int J Gynecol Cancer

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“…In-country training programmes or elective postings within high incidence regions may be developed to train residents in low incidence regions. Innovative training solutions, like cadaveric brachytherapy programmes, may help to close the skills gap [72].…”

Section: Access To Brachytherapy For Cervical Cancermentioning

confidence: 99%

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

et al. 2019

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Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and lowemiddle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and lowemiddle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.

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“…There are a few questionnaire-based surveys on the topic of brachytherapy in general like that published in 2015 by Gandhi and his colleagues [5] on Attitude and Practice of Brachytherapy in India and Nuances of Brachytherapy published by Ram Alva and colleagues [6] .The present survey is a bit different in terms of being a web-based survey and only addressing head and neck brachytherapy in particular. As with any survey, there are a few drawbacks in the present one too like:…”

mentioning

confidence: 99%

Brachytherapy in Head and Neck Cancers: “Are We Doing It or Are We Done with It”

Koushik

Alva

2018

Indian J Surg Oncol

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We performed an e-Survey and reviewed the literature on the prevalence of use of brachytherapy in head and neck cancers in order to understand the patterns of care and probable application of this modality. A five-point questionnaire was prepared and sent to 300 oncologists through a web-based survey engine. This was done in preparation for my lecture on "Ongoing Research and Potential Research Avenues" in IBSCON held in Chennai in August 2016. SPSS software was used for the statistical analysis. Of a total of 300 emails that were sent out for the survey, 120 replies were received, which is 40%. Among the results of various questions, (i) 65% of the oncologists felt that there were > 300 ongoing studies in brachytherapy and out of them only 10-20 were on head and neck brachytherapy; (ii) 58% of the responders felt that external beam radiotherapy (EBRT) advances followed by lack of training and experience are the reasons for declining role of brachytherapy; (iii) among the responders, numbers of head and neck brachytherapy performed stand third after gynecological and breast brachytherapy. This survey shows that brachytherapy in head and neck cancers is an essential tool, but seldom practiced. If no path-breaking event happens, we may be dealing with it as a dying art.

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The nuances of brachytherapy taught by teachers from beyond: Questionnaire-based assessment of the first cadaveric hands-on brachytherapy workshop in India

Cited by 15 publications

References 7 publications

Education in gynecological brachytherapy

Education in gynecological brachytherapy

Global Collaborations for Cervical Cancer: Can the East–West Alliance Facilitate Treatment for all?

Brachytherapy in Head and Neck Cancers: “Are We Doing It or Are We Done with It”

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