Educational characteristics of tumor conferences in teaching and non-teaching hospitals.

Hospital tumor conferences (tumor boards) were observed and evaluated over an 18-month period to determine their organizational and educational characteristics as well as their impact on conference participants. In conjunction with a previous nationwide survey of tumor conferences, this study was designed to identify features that would facilitate the learning that occurs in conference sessions. Study investigators observed a regional sample of 43 tumor boards in 37 participating hospitals, which included 513 sessions at general (hospital-wide) conferences and 198 sessions at specialty conferences. A total of 1,866 tumor cases were presented during these 711 conferences. Participants completed questionnaires to supplement the investigators' evaluations. Session observations revealed several ways in which tumor boards could increase their educational impact on participants, including combining case presentations with presentations of related didactic material and using the method of progressive disclosure to promote increased participation in discussions related to retrospective case presentations. Improvements can be made in session organization and case presentation with the potential for increasing participant learning with little increase in the effort or expense associated with tumor conferences.

An educational intervention to improve hospital tumor conferences.

Hospital tumor conferences exist to improve patient care through the application of a multidisciplinary approach to cancer management decisions and to provide continuing medical education for physicians and other health professionals who participate in cancer care. Based on educational needs identified by means of direct observation of conference sessions, this study implemented an experimental intervention designed to increase the educational benefits associated with participation in these conferences. Participating hospitals were randomly assigned either to a study group that received an "educational case" intervention (emphasizing progressive disclosure of cases, an active leadership style, and use of educational principles such as stating objectives at the beginning of sessions) or to a control group receiving no intervention. Each of the nine experimental and nine control group hospitals had multiple tumor sessions and case presentations with sessions observed and coded before and after intervention. Results showed significant differences in the specific educational procedures emphasized in the educational case intervention, such as use of the progressive disclosure method of presentation, and quality of session leadership. No difference, however, was found in other factors such as participation rates by major categories of specialists. The study has thus shown that educational interventions of this type can have a significant impact on the clinical and educational effectiveness of ongoing hospital conferences.