Contouring Workshops - The Beneficial Impact on Radiation Oncology Specialist Training in Ireland

Background One of the key components of training in Radiation Oncology is gaining knowledge in contouring tumour volumes and organs at risk for radiotherapy planning. Trainees rotate through different tumour sites during their training and are expected to acquire competencies in contouring skills in tumour sites appropriate to their year of training. These skills are mostly acquired in an unstructured manner during supervised clinical work. We report on our institutional experience of introducing structured contouring workshops and on the feedback obtained from trainees. Methods Eight contouring workshops in different tumour sites - Head & Neck (n=3), Prostate (n=1), SABR Lung (n=2), Breast (n=1) and Oesophagus (n=1) were conducted between April 2019 and March 2022.Six were in-person workshops pre-COVID. Two were run virtually during the pandemic. The workshops were of 2-hour duration, limited to around 12 trainees each with varying degrees of experience in that particular tumour site. All workshops were similar in format with a tutorial on the tumour site followed by a contouring demonstration on an anonymised index case on the Eclipse planning platform referencing published contouring atlases. The trainees had access to a copy of the same case throughout the workshop. Their contours were reviewed individually and collectively. Feedback on the contouring experience was collected through a questionnaire after the workshop from each trainee. This feedback was incorporated into subsequent workshops where relevant. Results An average of 12 trainees (range 10 -14) attended the workshops. All trainees, irrespective of year of training, rated the content, format of the workshops highly and felt that they were relevant to their daily practice. Their reported subjective level of confidence in contouring improved significantly from an average score of 5.6 out of 10 (range 4-7) before the workshop to a score of 8.7 (range 8-9) after, over the 8 workshops. There was no cost associated with conducting these workshops as these were done on our existing planning software. Discussion Based on the feedback obtained from the trainees, the workshops were of definite educational benefit. They favoured the inclusion of this approach to the teaching of contouring skills in their curriculum. In keeping with this feedback and the recent implementation of the new radiation oncology training curriculum in Ireland efforts are currently underway in incorporating these contouring workshops into the training programme on a structured basis. This will ensure that trainees develop progressive expertise in contouring skills in keeping with highest international standards.

In-the-Moment Experiences of Rural School Principals in the COVID-19 Pandemic

According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), by the end of March 2020 more than 1.5 billion pupils or 87% of the worlds student population across 165 countries had been affected by school closures caused by COVID-19 (Sacks et al., 2021, as cited in UNESCO, 2020). Soon after the call for school closures, U.S. educational leaders faced numerous challenges, including parents with questions about remote and online learning opportunities;effects of school closures on student attendance requirements, assessment practices and student report cards;and graduation requirements for seniors in high school (Barrington, 2020). [...]COVID-19 resulted in a different form of school-led remote learning with challenges, such as reduced one-to-one engagement with teachers;difficulty in student engagement;less ability to monitor individual student progress;increased oversight required from parents and caregivers, particularly for younger children;increased social isolation and reduced ability to support student well-being;interruption to learning support for those children with additional needs;and different levels of access to technology, including internet and devices that support learning (Sahlberg, 2020). In the International Rural School Leadership Project, the authors of this paper collaborated to facilitate ZOOM forums for two panels of rural school principals to share early experiences in the pandemic with colleagues in each other's country.

Use of Adhesive Tape to Facilitate Optimal Mask Positioning and Use in the Emergency Department: A Randomized Controlled Trial.

STUDY HYPOTHESIS: We hypothesize that placing a piece of surgical tape at the bridge of the nose over the mask will improve proper mask use among emergency department patients by creating a physical deterrent to mask removal. METHODS: This study was an open-label single-center randomized controlled trial of a simple intervention to improve mask use performed at Eskenazi Hospital between April 2020 and October 2020. We permitted participants to either use their own mask or the surgical/cloth mask that we provided. We then randomized the participants to either the control group (no tape over the mask/nose) or to the intervention group (tape placed over the face mask at the bridge of the nose). The primary outcome of this study was the frequency at which participants correctly wore their masks upon reevaluation at 60 minutes. A subgroup analysis based on the mask type compared adherence in those with a hospital-provided mask versus in those with a patient-supplied mask. RESULTS: We enrolled 123 participants in this trial. At 60 minutes, 100% of the intervention group participants were correctly wearing their masks versus 69% of control participants (absolute risk reduction, 31%; 95% CI, 19% to 43%; number needed to treat=3.2 patients). Subjects who were observed wearing their masks incorrectly exhibited some combination of either their mask removed or their nose and/or mouth exposed. Hospital-provided masks were not more likely to be worn correctly (odds ratio, 3.4; 95% CI, 0.9 to 12.3). CONCLUSION: Applying a piece of tape to a mask on the bridge of the nose affords a simple, low-cost, and low-risk solution that resulted in 100% of patients wearing their masks correctly at a 60-minute reevaluation.