Department of Radiation Oncology, London Health Sciences Centre, London, Ontario, Canada.
Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Int J Radiat Oncol Biol Phys. 2015 Mar 15;91(4):701-7. doi: 10.1016/j.ijrobp.2014.11.009. Epub 2015 Jan 13.
Radiation therapy treatment planning has advanced over the past 2 decades, with increased emphasis on 3-dimensional imaging for target and organ-at-risk (OAR) delineation. Recent studies suggest a need for improved resident instruction in this area. We developed and evaluated an intensive national educational course ("boot camp") designed to provide dedicated instruction in site-specific anatomy, radiology, and contouring using a multidisciplinary (MDT) approach.
The anatomy and radiology contouring (ARC) boot camp was modeled after prior single-institution pilot studies and a needs-assessment survey. The boot camp incorporated joint lectures from radiation oncologists, anatomists, radiologists, and surgeons, with hands-on contouring instruction and small group interactive seminars using cadaveric prosections and correlative axial radiographs. Outcomes were evaluated using pretesting and posttesting, including anatomy/radiology multiple-choice questions (MCQ), timed contouring sessions (evaluated relative to a gold standard using Dice similarity metrics), and qualitative questions on satisfaction and perceived effectiveness. Analyses of pretest versus posttest scores were performed using nonparametric paired testing.
Twenty-nine radiation oncology residents from 10 Canadian universities participated. As part of their current training, 29%, 75%, and 21% receive anatomy, radiology, and contouring instruction, respectively. On posttest scores, the MCQ knowledge scores improved significantly (pretest mean 60% vs posttest mean 80%, P<.001). Across all contoured structures, there was a 0.20 median improvement in students' average Dice score (P<.001). For individual structures, significant Dice improvements occurred in 10 structures. Residents self-reported an improved ability to contour OARs and interpret radiographs in all anatomic sites, 92% of students found the MDT format effective for their learning, and 93% found the boot camp more effective than educational sessions at their own institutions. All of the residents (100%) would recommend this course to others.
The ARC boot camp is an effective intervention for improving radiation oncology residents' knowledge and understanding of anatomy and radiology in addition to enhancing their confidence and accuracy in contouring.
在过去的 20 年中，放射治疗计划已经取得了进展，越来越强调使用 3 维成像来描绘目标和器官风险（OAR）。最近的研究表明，有必要在这一领域为住院医师提供更好的指导。我们开发并评估了一项密集的全国性教育课程（“训练营”），旨在通过多学科（MDT）方法提供特定部位解剖学、放射学和轮廓绘制的专门指导。
解剖学和放射学轮廓（ARC）训练营是在之前的单机构试点研究和需求评估调查的基础上建立的。训练营结合了放射肿瘤学家、解剖学家、放射科医生和外科医生的联合讲座，进行了实际的轮廓绘制指导，并通过尸体切片和相关轴向射线照片使用小组互动研讨会进行了小型小组互动研讨会。使用预测试和后测试评估结果，包括解剖学/放射学多项选择题（MCQ）、定时轮廓绘制课程（相对于黄金标准使用骰子相似性度量进行评估）以及对满意度和有效性的定性问题。使用非参数配对测试对预测试与后测试得分进行分析。
来自 10 所加拿大大学的 29 名放射肿瘤学住院医师参加了培训。作为他们当前培训的一部分，分别有 29%、75%和 21%的人接受解剖学、放射学和轮廓绘制指导。在后测得分中，MCQ 知识得分显著提高（前测平均 60%，后测平均 80%，P<.001）。在所有被描绘的结构中，学生的平均骰子分数中位数提高了 0.20（P<.001）。对于单个结构，10 个结构的骰子得分均有显著提高。住院医师自我报告称，他们在所有解剖部位都能够更好地描绘 OAR 并解释射线照片，92%的学生认为 MDT 格式对他们的学习有效，93%的学生认为训练营比他们所在机构的教育课程更有效。所有住院医师（100%）都将向他人推荐该课程。
ARC 训练营是一种有效的干预措施，可提高放射肿瘤学住院医师对解剖学和放射学的知识和理解，同时增强他们在描绘轮廓方面的信心和准确性。
