Radiation oncology teaching provision and practice prior to and during the first wave of the COVID-19 pandemic in medical schools in the United Kingdom and the Republic of Ireland: a cross-sectional survey.

OBJECTIVES: Radiotherapy is a key cancer treatment modality but is poorly understood by doctors. We sought to evaluate radiation oncology (RO) teaching in medical schools within the United Kingdom (UK) and Republic of Ireland (RoI), as well as any impacts on RO teaching delivery from the coronavirus disease 2019 (COVID-19) pandemic. METHODS: A bespoke online survey instrument was developed, piloted and distributed to oncology teaching leads at all UK and RoI medical schools. Questions were designed to capture information on the structure, format, content and faculty for RO teaching, as well as both the actual and the predicted short- and long-term impacts of COVID-19. RESULTS: Responses were received from 29/41 (71%) UK and 5/6 (83%) RoI medical schools. Pre-clinical and clinical oncology teaching was delivered over a median of 2 weeks (IQR 1-6), although only 9 (27%) of 34 responding medical schools had a standalone RO module. RO teaching was most commonly delivered in clinics or wards (n = 26 and 25 respectively). Few medical schools provided teaching on the biological basis for radiotherapy (n = 11) or the RO career pathway (n = 8), and few provide teaching delivered by non-medical RO multidisciplinary team members. There was evidence of short- and long-term disruption to RO teaching from COVID-19. CONCLUSIONS: RO teaching in the UK and RoI is limited with minimal coverage of relevant theoretical principles and little exposure to radiotherapy departments and their non-medical team members. The COVID-19 pandemic risks exacerbating trainee doctors' already constrained exposure to radiotherapy. ADVANCES IN KNOWLEDGE: This study provides the first analysis of radiotherapy-related teaching in the UK and RoI, and the first to explore the impact of the COVID-19 pandemic on radiationoncology teaching.

Observational study investigating Tolerance Of Anticancer Systemic Therapy In the Elderly (TOASTIE): a protocol.

INTRODUCTION: The number of older adults diagnosed with cancer is increasing. Older adults are more likely to have pre-existing frailty, which is associated with greater chemotherapy-related toxicity. Early identification of those at risk of toxicity is important to reduce patient morbidity and mortality. Current chemotherapy toxicity prediction tools including the Cancer and Ageing Research Group (CARG) tool exist but are not in routine clinical use and have not been prospectively validated in a UK population. This study is the first prospective study to investigate the CARG tool in a UK population with cancer. METHODS AND ANALYSIS: Tolerance Of Anticancer Systemic Therapy In the Elderly is a prospective observational study of patients, aged ≥65 years, commencing first-line (any indication) chemotherapy for a solid-organ malignancy. Patients receiving other systemic anticancer agents or radiotherapy will be excluded. The primary objective will be to validate the ability of the CARG score to predict grade 3+ toxicity in this population. Secondary objectives include describing the feasibility of screening for frailty, as well as the prevalance of frailty in this population and assessing patient and clinician perception of chemotherapy toxicity risk. 500 patients will be recruited over a two year period. Baseline assessments will be recorded. At the end of the 6-month follow-up period, toxicity data will be retrospectively collected. A descriptive analysis of the recruited population will be performed. The validity of the CARG model will be analysed using receiver-operating characteristic curves and calculation of the area under the curve (c-statistic). ETHICS AND DISSEMINATION: The study has received ethical approval from the East of Scotland Research Ethics Service 20/ES/0114. Results will be reported in peer-reviewed scientific journals and disseminated to patient organisations and media.

The effect of body size on countermovement jump kinetics in children aged 7-11 years.

The purpose this study was to examine the effect of body size on countermovement jump (CMJ) kinetics in children. Participants (n = 160) aged 7-11 years, divided equally by sex and into primary school year groups (years 3, 4, 5 and 6), each performed one CMJ on a force platform. The variables bodyweight (BW), peak force (Fmax), in-jump minimum force (IMF), in-jump vertical force range (IFR) and basic rate of force development (BRFD) were attained from the force-time history and then subsequently scaled to account for body size. A significant age, sex and interaction effect were found for the absolute variables BW, IMF, Fmax and IFR (P < 0.05) between school year groups 3 and 4 against year's 5 and 6. Simple main effects highlighted no significant sex differences between the boys and girls for all variables (P > 0.05). No significant age or sex differences were observed for normalised or allometrically scaled values (P > 0.05). The results indicate that girls and boys can be grouped together but that body size must be accounted for to enable accurate conclusions to be drawn independent of growth. Body size significantly effects the representation of CMJ kinetic results and therefore, future studies should report both absolute and scaled values. Future research should develop an age-appropriate criterion method for children in order to determine processed CMJ variables to further investigate the neuromuscular performance of children.

Motivators and barriers to engagement with evidence-based practice among medical and dental trainees from the UK and Republic of Ireland: a national survey.

OBJECTIVES: To explore the extent to which doctors and dentists in training within the UK and Republic of Ireland (RoI) engage in and with evidence-based practice (EBP), and to identify motivators and barriers to them doing so. DESIGN: An observational, prepiloted web-based survey developed by a trainee-led focus group. SETTING: The survey instrument was disseminated to doctors and dentists in training within the UK and RoI during June 2017 via social media and through deaneries, Royal Colleges and specialty-specific mailing lists. PARTICIPANTS: Data from 243 trainees were analysed; 188 doctors from 31 specialties and 55 dentists from 9 specialties. Responses were received from trainees at all stages of postgraduate training though the overall response rate was low. PRIMARY AND SECONDARY OUTCOME MEASURES: The motivators and barriers to, and the extent of, trainee engagement with EBP. RESULTS: Cronbach's α was 0.83. Most trainees (87.6% (n=148) of doctors and 75.1% (n=39) of dentists) consulted the evidence base at least monthly, while 23.1% [n=39 doctors, 12 dentists] of both specialties did so daily. The two most commonly cited barriers to engagement with EBP for both doctors and dentists, respectively, were insufficient time (57.6% (n=95) and 45.1% (n=23)) and a tendency to follow departmental practice (40.6% (n=67) and 45.1% (n=23)). Key motivators for EBP included curiosity, following the example set by senior colleagues and a desire to avoid harm. Most trainees reported high levels of confidence interpreting evidence yet for 26.8% (n=45) of doctors and 36.5% (n=19) of dentists, medical hierarchy would impede them querying a colleague's management plan based on their own reading of the evidence. CONCLUSIONS: Time, accepted departmental practice and the behaviour of senior clinicians all highly impact on trainee engagement with EBP. Given the low response rate, the extent to which these data represent the overall population is unclear.

Twelve Tips for Applicants from a Disadvantaged Background Considering a Career in Medicine.

This article was migrated. The article was marked as recommended. A minority of medical school entrants draw from disadvantaged backgrounds, which remain significantly under-represented within the medical workforce. Whilst multifactorial, this may in part relate to relative lack of information about the admissions process amongst these groups. In this article, Mohammed Abdul Waduud and colleagues offer their twelve essential tips to support students from disadvantaged backgrounds who are considering applying to medical school. The authors, all of whom are from disadvantaged backgrounds, have experience in applying to medical schools within the United Kingdom. The tips within this article should support students from disadvantaged backgrounds to decide whether a career in medicine is right for them and succeed in their applications to study medicine.