ABSTRACT
In recent years, medical student (MS) applications to U.S. and Canadian radiation oncology (RO) residency programs have declined. The Radiation Oncology Education Collaborative Study Group (ROECSG) recently formed an Undergraduate Medical Education (UGME) committee consisting of attending physicians, residents, and MSs across the globe to further UGME educational efforts. This group identified a need for outreach activities to increase exposure to and interest in RO. In collaboration with LearnOncology, an online, interactive tool to teach oncology skills to learners at all levels, the UGME subcommittee created a structure for a podcast series to highlight oncology careers. This podcast series will be hosted on LearnOncology. Together, these groups identified key topics, informally surveyed MSs, wrote a standardized script, trained interviewers on recording and editing audio content, and set goals for the future scope of the podcast. MS and resident interviewers recently completed training and have scheduled initial faculty interviews. Edited podcast episodes will be ≤20 minutes, conducted informally to spotlight both the career and personality of the interviewee. Prominent oncology specialists (e.g. radiation, surgery, medicine, interventional radiology, and physics) will be featured. Listeners will be prompted to complete a brief survey. Interviewers and interviewees will partake in a separate survey to examine the impact of project participation. Podcast analytics and survey data will guide subsequent iterations of podcast episodes. Podcasts for UGME are a cost-effective teaching method, which gained popularity during the COVID-19 pandemic. We hypothesize that this podcast will be a unique way to positively impact undecided MSs facing the challenge of choosing a career path and increase awareness about oncology specialties. Additionally, this may positively impact mentorship through linking MS and resident interviewers to specialist interviewees. The LearnOncologyXROECSG podcast platform, Cancer Careers, was created to address student questions, anxieties, and excitement related to choosing an oncology career. We expect that this project will increase exposure to oncology and MS interest in oncology careers, including RO. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Purpose: In 2018, the Canadian Medical Association acknowledged that physician health remains a significant threat to the viability of Canada's health care system. The prevalence of burnout among American oncologists was 44% in a 2014 survey. The purpose of this survey was to determine the national prevalence of burnout indicators and report work engagement among Canadian radiation oncologists. Materials and Methods: Between November 2019 and March 2020 (pre-COVID-19 pandemic), an online questionnaire was distributed electronically to 333 Canadian radiation oncologists, across 49 centres, through the National Canadian Association of Radiation Oncology mailing list. The survey included 62 questions determining job engagement, and validated burnout scale The Maslach Burnout Inventory (MBI) (22 questions). Results: Two-hundred forty-one of the 333 surveyed Canadian radiation oncologists (72%) completed the questionnaire and were included in this analysis. Responses to the MBI showed that 15% of radiation oncologists met the strict criteria for burnout (i.e. negative scores in all three domains: exhaustion, depersonalization, and low accomplishment). Another 60% scored negative in at least one of the three burnout domains. Using the more commonly reported definition of burnout (negative scores in either exhaustion and/or depersonalization), 44% of Canadian radiation oncologists reported burnout. Only 25% had positive scores in all three domains, and were fully engaged in their work. Three-domain burnout varied among jurisdictions with highest prevalence in British Columbia (22%) and lowest in Quebec (3%). The responses to work engagement questions revealed significant concerns regarding inefficiency in workflow (50%), heavy workloads (>50%), poor work-life balance (68%), lack of control over the work environment (47%) and lack of recognition from administrators (45%). Forty-eight percent perceive the atmosphere at their primary work area as “chaotic and hectic”. Within the last three years, 41% had considered leaving their institution to work elsewhere and 51% were considering reducing their full-time equivalent (FTE). Reassuringly, 80% reported a sense of overall ability to provide high quality care and a 59% feel they have a supportive network of colleagues and 80% are willing to try something new. The top four strategies identified by respondents aimed to improve work-life quality were: (1) more support staff at work;(2) more efficient care models;(3) more resources for patients;and (4) lighter workloads for physicians. Conclusions: Our survey showed that only 25% of Canadian radiation oncologists are fully engaged in their work, whereas 15% met the strict criteria for burnout and 44% met the commonly used burnout criteria. With the rising incidence of cancer and complexity of care, there is an urgent need for system change, leverage enthusiasm to “try something new”, and develop appropriate strategies to improve the well-being of the Canadian radiation oncologist workforce.
ABSTRACT
Purpose: To report the degree to which post-graduate trainees in radiation oncology perceive their education has been impacted by COVID-19. Materials and Methods: A cross-sectional online survey was administered in June 2020 to trainee members of Canadian Association of Radiation Oncology (CARO). The 82-item survey was adapted from a similar survey administered during SARS and included the Stanford Acute Stress Reaction and Ways of Coping Questionnaires. The survey was developed using best practices including expert review and cognitive pre-testing. Frequency statistics are reported. Results: Thirty-four trainees (10 fellows, 24 residents) responded. Nearly half of participants indicated that the overall impact of COVID-19 on training was negative/very negative (n=15;46%) or neutral (n=15;46%) with a small number indicating a positive/very positive (n=3;9%). Majority of trainees agreed/ strongly agreed with the following statements: “I had difficulty concentrating on tasks because of concerns about COVID-19” (n=17;52%), “I had fears about contracting COVID-19” (n=17;52%), “I had fears of family/loved ones contracting COVID-19” (n= 29;88%), “I felt socially isolated from friends and family because of COVID-19” (n=23;70%), “I felt safe from COVID-19 in the hospital during my clinical duties“ (n=15;46%), and “I was concerned that my personal safety was at risk if/when I was redeployed from my planned clinical duties” (n=20;61%). The changes that had a negative/very negative impact on learning included “the impact of limited patient contact” (n=19;58%), “the impact of virtual patient contact” (n=11;33%), and “limitations to travel and networking” (n=31;91%). Most reported reduced teaching from staff (n=22;66%). Two-thirds of trainees (n=22, 67%) reported severe (>50%) reduction in ambulatory clinical activities, 16 (49%) reported a moderate (<50%) reduction in new patient consultations, while virtual follow-ups (n=25: 76%) and in-patient clinical care activities (n=12;36%) increased. Nearly half of respondents reported no impact on contouring (n=16;49%), on-treatment management (n=17;52%) and tumour boards (n=14;42%) with the majority of other respondents reporting a decrease in these activities. Electives were cancelled in province (n=10/20;50%), out-of-province (n=16/20;80%) and internationally (n=15/18;83%). Conclusions: Significant changes to radiation oncology training were wrought by the COVID-19 pandemic and roughly half of trainees perceive that these changes had a negative impact on their training. Safety concerns for self and family were significant and strategies to mitigate these concerns should be a priority.
ABSTRACT
Purpose: Cancer is the leading cause of morbidity and mortality in the developed world, yet gaps are identified in all levels of medical education. Learnoncology is an online resource originally developed to function as a standardized resource for medical students based on the Canadian oncology objectives. It has since expanded to reach 169 countries and multiple health professional programs. Learnoncology was created using Kern's framework for curriculum development. It features multiple instructional modalities including modules, YouTube videos, podcasts, and virtual patients. COVID-19 has presented an opportunity to seek novel avenues which further expand our impact. To date, evaluation of the website has focused on Kirkpatrick's Evaluation hierarchy: user satisfaction. Recently, self-assessment in the form of a quiz bank was added to evaluate knowledge acquisition. A description of assessment method use was undertaken to evaluate the website and inform future development. Materials and Methods: Between March 15, 2020 to June 30, 2020, 31 multiple choice assessments, consisting of over 300 questions were written to complement national oncology objectives and content on Learnoncology. Quizzes were developed by medical students, reviewed by practicing oncologists and hosted on Learnoncology. Users are provided with formative feedback in the form of written explanations and asked to complete a brief evaluation. The assessment module was added to the website in July 2020. Results: Between July 2020 and February 2021 the quizzes were attempted 2143 times. Most commonly accessed topics included common cancers such as breast and prostate, as well as fundamental principles of oncology. User feedback indicates that quizzes are overall appropriate, with some users requesting more high level content and incorporation of pictures. The most common user type is medical students at 47.7%, but there has been an increasing number of other healthcare professionals including nurses and resident physicians. The average score across the most heavily utilized quizzes is 71.5%, indicating good knowledge acquisition of fundamental and common oncology topics. Conclusions: As with most educational projects, Learnoncology initially focused on the development of education content with only preliminary evaluation metrics. With increasing online teaching in medical schools due to COVID-19 there is a need to continually improve online resources. The development of an assessment module will allow for enhanced evaluation of this learning tool and may inform similar projects. Further, while Learnoncology was initially created to target medical school goals and objectives, our quiz data shows that a much broader audience is utilizing the website to learn oncology principles.
ABSTRACT
Purpose: One in two Canadians will be diagnosed with cancer in their lifetime. With a growing proportion of patients under the age of 60, it is estimated that upwards of 25% of cancer patients are managing the demands of childbearing and parenting alongside their diagnosis. There is a paucity of research detailing how parents with cancer balance their needs with the needs of their children. This study aims to more completely define the childcare needs and perspectives of cancer patients with dependent children. Materials and Methods: Between December 2020 and February 2021, cancer patients at one major Canadian Cancer Centre, who identified as primary caregiver to at least 1 dependent (<18 years of age) were invited to partake in a survey study. The survey was developed through consultation with a multidisciplinary team and best survey practices, and consisted of 34 closed and open-ended questions designed to assess childcare needs and the experiences of cancer patients with dependent children. Specific questions were also designed to assess the impact of COVID-19 on childcare needs. Eligible participants were identified by a research assistant and presented the opportunity to complete an electronic or paper-based survey. This study was approved by the local Research Ethics Board. Results: As of February 2021, 42 patients had been contacted and 29 had completed the survey in full (69%) Participants were an average age of 44.7 years ± 4.8 years and 97% female (28/29). Twenty-two participants (76%) reported diagnoses of breast cancer. Participants reported caring for two (18/29), one (10/29), or three (1/29) children. The average age of participants' children was 8.4 years, and ranged from 8 months to 18 years. Fourteen participants (48%) indicated having to reschedule appointments due to issues with childcare (nine of 14 rescheduling 1-3 appt.;4/14, 4-6 appt.;one of 14, 10+ appt.). Additionally, 11 participants (38%) reported bringing their child or children to their appointments as a solution for issues with childcare (seven of 11 for 1-3 appt.;three of 11, 4-6 appt.;one of 11, 10+ appt.). Fourteen of 26 respondents (54%) indicated that balancing childcare throughout their cancer journey has had a moderate (eight of 26) or extreme (six of 26) impact on their stress levels. Sixty-one percent (17/28) reported that the COVID-19 Pandemic has impacted their childcare needs and impacted their stress levels moderately (10/17) or extremely (three of 17). Seventy-eight percent (21/27) reported that a flexible childcare service would allow them to more regularly attend their appointments. The preferred delivery of such a program was onsite (hospital or cancer centre) (13/20, 65%), followed by in-home (seven of 20, 35%). Narrative analysis noted themes of increased stress and childcare responsibilities associated with the COVID-19 Pandemic and reduction of childcare resources and support. Conclusions: These preliminary results indicate that childcare issues are broadly impactful for parents battling cancer. The lack of supportive childcare negatively impacts the emotional psychological well-being of patients and their children, as well as impacts system efficiency and treatment compliance. Survey accrual is continuing and complete findings will aid in defining the childcare needs and perspectives of parents with cancer, as well as highlight potential solutions to support these individuals.
ABSTRACT
Purpose: The COVID-19 pandemic has compelled an increased use of virtual care delivery models in oncology. This study sought to examine the views of oncology health care providers (HCP) on the value and impact of virtual care models in clinical practice. Materials and Methods: A semi-structured interview-survey was developed to compare provider practice patterns between May 2019 and May 2020. Questions were designed to determine provider-perceived value and impact of virtual visits on clinical interactions with patients. HCP (including physicians, dentists, and nurse practitioners) at a provincial oncology institution were invited to participate. Responses to the interview questions were de-identified and HCP names were replaced with a study code. Quantitative questions were interpreted with descriptive statistics. Qualitative results were analyzed and iteratively coded by multiple reviewers for emerging themes. Results: Among 531 invited participants, 61 completed the interview-survey and 60 were included in the final analysis. Of those interviewed, 47% were radiation oncologists and 33% were medical oncologists. The remainder of HCP interviewed (n=12) included functional imaging physicians, general practitioners in oncology, hereditary cancer physicians, nurse practitioners, palliative care physicians, psychiatrists, and surgical oncologists. Most oncology providers (87%) desired the continuation of virtual visits as part of their clinical practice so long as barriers to integration were addressed. Barriers identified included limited access to physical resources, such as hardware (70% responses) and quiet spaces (54% responses), insufficient logistic support such as information technology services (84% responses) and operational workflows (46% responses), the absence of guidelines to select patients for this delivery model (38% responses), and concerns regarding HCP liability, security and privacy (30% responses). Conclusions: Oncology HCP value delivering patient care through virtual means, however, barriers to implementation must be better understood. These data may inform continued use and implementation of virtual care at other Canadian oncology centres.
ABSTRACT
Purpose: Cancer patients are increasingly using the Internet to educate themselves about COVID-19. Recent studies have shown that cancer patients are at risk of more serious outcomes of COVID-19 compared to the general population. Some cancer treatments such as chemotherapy can impact the immune system, which may make COVID-19 infection more dangerous. This study looks to systematically examine the quality of web resources available for cancer patients about COVID-19. Materials and Methods: The term “COVID-19 Risk and Cancer” was searched in Google and metasearch engines Yippy and Dogpile. URLs were recorded from each search and inclusion and exclusion criteria were applied. The results from the three lists were combined to come up with a final list based on overall average rank order. This list was analyzed using a previously validated structured rating tool with respect to accountability, currency, interactivity, readability, and content coverage and accuracy. Results: Three hundred ninety-eight websites were identified prior (this includes overlap between the three search sites used), 37 websites were included for analysis. Out of 37 websites, only 43% disclosed authorship and 24% cited sources. Most websites (76%) revealed date of creation, and 32% were updated less than three months before the date of search. Sixty-eight percent of websites enabled questions to be sent to the author or webmaster regarding COVID-19 risk queries. Fifty-four percent of websites had high school readability (8.0-12.0), 43% were at university level or above, and only one website demonstrated the recommended reading level for general public (below 8.0). Topics most commonly discussed were special consideration for cancer patients in COVID-19 (84%), COVID-19 risk factors (73%), and infection prevention (62%), while topics least covered were COVID-19 incidence/prevalence (5%), prognosis (8%), and treatment (16%). Conclusions: There is some COVID-19 in cancer risk information available online, but quality is variable. The total number of sites with relevant information related to COVID-19 and cancer was relatively low and many sites lacked markers for accountability. Some information may not be up to date and content may be difficult to comprehend. Healthcare professionals may direct cancer patients to the most reliable online resources about COVID-19 and cancer shown in this study. In addition, this may be helpful to consider when designing comprehensive web resources regarding COVID-19.
ABSTRACT
Purpose/Objective(s): Cancer patients are increasingly using the Internet to educate themselves about COVID-19. Recent studies have shown that cancer patients are at risk of more serious outcomes of COVID-19 compared to the general population. Some cancer treatments such as chemotherapy can impact the immune system, which may make COVID-19 infection more dangerous. This study looks to systematically examine the quality of web resources available for cancer patients about COVID-19. Materials/Methods: The term “COVID-19 Risk and Cancer” was searched in Google and metasearch engines Yippy and Dogpile. URLs were recorded from each search and inclusion and exclusion criteria were applied. The results from the 3 lists were combined to come up with a final list based on overall average rank order. This list was analyzed using a previously validated structured rating tool with respect to accountability, currency, interactivity, readability, and content coverage and accuracy. Results: 398 websites were identified prior (this includes overlap between the three search sites used), 37 websites were included for analysis. Out of 37 websites, only 43% disclosed authorship and 24% cited sources. Most websites (76%) revealed date of creation, and 32% were updated less than 3 months before the date of search. 68% of websites enabled questions to be sent to the author or webmaster regarding COVID-19 risk queries. 54% of websites had high school readability (8.0-12.0), 43% were at university level or above, and only one website demonstrated the recommended reading level for general public (below 8.0). Topics most commonly discussed were special consideration for cancer patients in COVID-19 (84%), COVID-19 risk factors (73%), and infection prevention (62%), while topics least covered were COVID-19 incidence/prevalence (5%), prognosis (8%), and treatment (16%). Conclusion: There is some COVID-19 in cancer risk information available online, but quality is variable. The total number of sites with relevant information related to COVID-19 and cancer was relatively low and many sites lacked markers for accountability. Some information may not be up to date and content may be difficult to comprehend. Healthcare professionals may direct cancer patients to the most reliable online resources about COVID-19 and cancer shown in this study. In addition, this may be helpful to consider when designing comprehensive web resources regarding COVID-19.
ABSTRACT
Purpose/Objective(s): In 2018, the Canadian Medical Association acknowledged that physician health remains a significant threat to the viability of Canada's health care system. The prevalence of burnout among American oncologists was 44% in a 2014 survey. The purpose of this survey was to determine the national prevalence of burnout indicators and report work engagement among Canadian radiation oncologists. Materials/Methods: Between November 2019 and March 2020 (pre-COVID pandemic), an online questionnaire was distributed electronically to 333 Canadian radiation oncologists across 49 centers through the Stadt lander Canadian Association of Radiation Oncology mailing list. The survey included 62 questions assessing work engagement, and the validated Maslach Burnout Inventory (MBI) burnout scale (22 questions). Results: 241 of the 333 surveyed Canadian radiation oncologists (72%) completed the questionnaire and were included in this analysis. Responses to the MBI showed that 15% of radiation oncologists met the strict criteria for burnout (i.e., negative scores in all 3 domains: exhaustion, depersonalization, and low accomplishment). Another 60% scored negative in at least one of the three burnout domains. Using the more commonly reported definition of burnout (negative scores in either exhaustion and/or depersonalization), 44% of Canadian radiation oncologists were burnt out. Only 25% had positive scores in all 3 domains and were fully engaged in their work. The full burnout syndrome varied between provinces and was the highest in British Columbia (22%) and lowest in Quebec (3%). The responses to work engagement questions revealed significant concerns regarding inefficiency in workflow (50%), heavy workloads (> 50%), poor work life balance (68%), lack of control over the work environment (47%) and lack of recognition from administrators (45%). 48% perceive the atmosphere at their primary work area as “chaotic and hectic”. Within the last 3 years, 41% had considered leaving their institution to work elsewhere and 51% were considering reducing their full-time equivalent (FTE). Reassuringly, 80% reported a sense of overall ability to provide high quality care and a 59% feel they have a supportive network of colleagues and 80% are willing to try something new. The top 4 strategies identified by respondents aimed to improve work-life quality were (1) more support staff at work, (2) more efficient care models, (3) more resources for patients, and (4) lighter workloads for physicians. Conclusion: Our survey showed that only 25% of Canadian radiation oncologists are fully engaged in their work, whereas 15% met the strict criteria for burnout and 44% met the commonly used burnout criteria. With the rising incidence of cancer and complexity of care, there is an urgent need for system change, leverage enthusiasm to “try something new”, and develop appropriate strategies to improve the well-being of the Canadian radiation oncologist workforce
ABSTRACT
Background: The Canadian Medical Association recently acknowledged that physician health remains a significant threat to the viability of Canada's health care system. A 2014 survey reported a 44% prevalence of burnout among American oncologists. The purpose of this survey was to determine the national prevalence of burnout and document work engagement among Canadian radiation oncologists. Methods: Between November 2019 and March 2020 (pre COVID pandemic), an online questionnaire was distributed electronically to 333 Canadian radiation oncologists, across 49 centers, through the National Canadian Association of Radiation Oncology membership list. The survey included 62 questions determining job engagement, and validated burnout scale The Maslach Burnout Inventory (MBI) (22 questions). Results: 241 of the 333 surveyed Canadian radiation oncologists (72%) completed the questionnaire and were included in this analysis. Responses to the MBI showed that 15% of radiation oncologists met the strict criteria for burnout (i.e. negative scores in all 3 domains: exhaustion, depersonalization, and low accomplishment). Another 60% scored negative in at least one of the three burnout domains. Using the more commonly reported definition of burnout (negative scores in either exhaustion and/or depersonalization), 44% of Canadian radiation oncologists were burnt out. Only 25% had positive scores in all 3 domains and were fully engaged in their work. The full burnout syndrome varied between provinces and was the highest in British Columbia (22%) and lowest in Quebec (3%). The responses to work engagement questions revealed significant concerns regarding inefficiency in work flow (50%), heavy workloads (>50%), poor work life balance (68%), lack of control over the work environment (47%) and lack of recognition from administrators (45%). 48% perceive the atmosphere at their primary work area as “chaotic and hectic”. Within the last 3 years, 41% had considered leaving their institution to work elsewhere and 51% were considering reducing their full-time equivalent (FTE). Reassuringly, 80% reported a sense of overall ability to provide high quality care and a 59% feel they have a supportive network of colleagues and 80% are willing to try something new. The top 4 strategies identified by respondents aimed to improve work-life quality were (1) more support staff at work, (2) more efficient care models, (3) more resources for patients, and (4) lighter workloads for physicians. Conclusion: The survey shows that only 25% of the Canadian radiation oncologists are fully engaged in their work, 15 % meet the strict criteria for burnout and 44% meet the more commonly used burnout criteria. With the rising incidence of cancer and complexity of care, there is an urgent need for change, leverage the enthusiasm to “try something new”, and develop appropriate strategies to improve the well-being of the oncology work force.