Development of a gynecologic brachytherapy curriculum and simulation modules to improve radiation oncology trainees' skills and confidence
Development of a gynecologic brachytherapy curriculum and simulation modules to improve radiation oncology trainees' skills and confidence
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DOI：
10.1016/j.brachy.2020.09.016
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发表时间：
2020-11-01
期刊：
影响因子：
1.9
通讯作者：
Strauss, Jonathan B.
中科院分区：
文献类型：
--
作者：
Donnelly, Eric D.;Sachdev, Sean;Strauss, Jonathan B.
目的：近距离放疗治疗宫颈癌与提高生存率直接相关。不幸的是，我们继续看到其利用率的下降。最近对美国居民的一项调查表明，有限的病例量是近距离治疗实践中实现独立性的最大障碍。为了提高住院医师的近距离治疗技能和独立进行近距离治疗的信心，我们开发并测试了妇科近距离治疗模拟课程。方法和材料：采用说教式教育、自学、实习和以患者为中心的案例相结合的方法开发妇科近距离治疗课程和模拟模块。模拟模块由2小时的会话组成。第一个小时是在模拟的手术室环境中进行的，住院医生在尸体模型中独立完成了涂抹器插入的所有方面。第二个小时包括轮廓、剂量计计划和治疗评估。放射肿瘤学住院医师协会在课程前后进行了近距离治疗培训调查。结果：对特定疾病部位独立进行近距离放射治疗的感知能力与所进行病例的数量直接相关。大多数住院医师认为，在完成5例后，他们将能够独立执行其他病例（18例中的10例）。在15个案例后，所有人都强烈同意（18人中有8人）或同意（18人中有10人）这是正确的。与近距离治疗模拟课程前的调查数据相比，学员感觉自己独立进行近距离治疗的能力有所提高（p < 0.001）。结论：近距离放射治疗模拟课程可用于在受控环境中获得进一步的经验。我们的研究结果表明，妇科近距离治疗模拟增加了学员独立执行程序的信心。(C) 2020美国近距离放射治疗学会。Elsevier Inc.出版。版权所有。
PURPOSE: Brachytherapy in the management of cervical cancer is directly linked to improved survival. Unfortunately, we continue to see a decline in its utilization. A recent survey of U.S. residents demonstrated limited caseload as the greatest barrier to achieving independence in brachytherapy practice. To improve residents' brachytherapy skills and confidence in performing brachytherapy independently, a gynecologic brachytherapy simulation course was developed and tested.METHODS AND MATERIALS: The gynecologic brachytherapy curriculum and simulation modules were developed using a combination of didactic education, self-study, practicums, and patient-centered cases. The simulation modules consisted of 2-h sessions. The first hour occurred within a simulated OR environment, where residents independently performed all aspects of applicator insertion in a cadaver model. The second hour consisted of contouring, dosimetric planning, and treatment evaluation. A brachytherapy training survey developed by the Association of Residents in Radiation Oncology was given before and after the course.RESULTS: The perceived ability to perform brachytherapy independently for a given disease site correlated directly with number of cases performed. Most residents believed that after performing five cases they would be capable of performing additional cases independently (10 of 18). All strongly agreed (8 of 18) or agreed (10 of 18) this to be true after 15 cases. Compared with survey data before the brachytherapy simulation course, trainees felt that their ability to independently perform brachytherapy (p < 0.001) improved.CONCLUSIONS: A brachytherapy simulation course can be used to gain further experience in a controlled environment. Our results demonstrate that gynecologic brachytherapy simulation increased trainees' confidence in performing the procedures independently. (C) 2020 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.