ABSTRACT
Purpose/Objective(s): Medical student education in radiation oncology traditionally takes place in-person during 3rd or 4th year of medical school. Due to the COVID-19 pandemic, onsite clerkships were placed on hold, leading to virtual medical student clerkships in radiation oncology which incorporated didactics and hands-on learning. We sought to implement this virtual medical student clerkship in radiation oncology at multiple institutions and analyze the impact and utility of this platform. Materials/Methods: An IRB-approved virtual clerkship was created and implemented at 7 institutions. Students enrolled in home or away rotations. Clerkships offered general and disease subsite-specific oncology topics through recorded didactics geared towards medical students on www.radoncvirtual.com, as well as clinical vignettes, telehealth visits, chart rounds, contouring, and capstone presentations. Surveys were given pre- and post-clerkship to assess baseline comfort and knowledge. At the end of each clerkship, a course exam was given consisting of 48 questions. Clerkship directors were given a survey to assess comfort and ease of implementing the virtual clerkship. Surveys and course exams were analyzed using Wilcoxon Signed rank test and t-test, 2-sided. Results: Seventy-two (72) students enrolled at 7 institutions between 4/2020 and 2/2021. Survey response rates were 100% pre- and post-clerkship as well as from course directors. The majority of students were MS4 (57%) and MS3 (33%) with equal distribution in gender. Each institution's median number of total medical students doing an away rotation was 4 (range 3-9) and home rotation number of students 2 (range 0-36). The median length of each virtual rotation was 2.5 weeks (range: 1-4 week). 71% (n = 51) of medical students had never previously enrolled in a radiation oncology elective. Improvements in the overall knowledge of radiation oncology, as well as specific knowledge in the scope of radiation oncology, roles of radiation physicist, dosimetrist and therapist, contouring, treatment planning, and training path to the field (all P < 0.001). There was no significant difference in course final exam scores between students who had attended a radiation oncology elective before enrollment and those who had not (P = 0.27). Course directors reported spending an additional 5-10 hours per week with students. The survey revealed 100% were satisfied with content and delivery of this virtual elective, and 83% (n = 6) indicated they would utilize the material for future rotations. Conclusion: Implementation of a multi-institutional virtual radiation oncology elective was successful at improving knowledge for medical students at all levels, even those that had exposure previously. This virtual elective platform can be utilized to improve access to multiple institutions, resources, mentors, and networking opportunities. Resources in the virtual rotation platform can also be integrated into traditional educational paradigms to increase exposure in the field.
ABSTRACT
Introduction: The SARS-COVID-19 pandemic restricted in-lab research activities especially in older individuals who are considered at-risk for severe disease. To continue longitudinal sleep research in this population we sought to test the feasibility of remotely conducting at-home sleep and memory research and to compare two ambulatory polysomnography (PSG) devices for ongoing home sleep testing. Methods: 20 older (age=65.6±5.5 years) cognitively normal adults (65% female) who had previously undergone 2 nights in-lab sleep, memory and vigilance testing were delivered equipment for 2 nights at-home, technician-guided remote PSG set-up (1 night each for Somté [EEG: Fp1-M2, Cz-M1] and Sleep Profiler (SP) [EEG: Fp1-Fp2] devices- randomized presentation), and 6 timed trials on a 3D spatial maze navigation memory plus morning psychomotor vigilance testing (PVT). The night-to-night differences for devices and in-lab versus at-home testing environments were compared for sleep macro and EEG microarchitecture using paired Wilcoxon rank sum and t-tests where appropriate. First-night maze completion time (CT) and PVT reaction time and lapses were also compared. Results: 19 people completed 2 nights at-home PSG, 18 completed PVT and 9 completed all 6 maze trials. Quality frontal EEG signals were obtained for 16 SP and 11 Somté recordings. There was no significant night to night differences (night 1-night 2) between in-lab and at-home environments for total sleep time (mean difference: in-lab= -0.27 vs at-home = 0.35 hours), wake after sleep onset (WASO) (median difference: in-lab= 3.0 vs at-home = 0.7 %WASO), or slow wave sleep (SWS) (mean difference: in-lab= -0.70 vs at-home = 2.3 %SWS). Relative frontal slow wave activity and spindle density were not significantly different between devices or environments. K-complex density (SP= 1.0 vs Somté =2.7/minNREM2, p=0.004) was significantly reduced with the SP device compared to Somté devices. There were no significant differences for maze CT and PVT measures between in-lab and at-home environments. Conclusion: The night-to-night differences in sleep macroarchitecture do not appear to be influenced by environment or device however measures of EEG microstructure such as K-complexes, which are amplitude-dependent, may be underestimated with the Sleep Profiler device due to smaller EEG amplitude from a derivation with short inter-electrode distances.