Harvard Medical School, Boston, MA.
Gatineau Cancer Centre, Gatineau, Quebec, Canada.
Brachytherapy. 2020 Nov-Dec;19(6):725-731. doi: 10.1016/j.brachy.2020.09.014. Epub 2020 Nov 9.
Brachytherapy is critical for the curative treatment of locally advanced cervical cancer. Although brachytherapy use is declining in the United States (U.S.), novel interstitial or intracavitary applicators and advances in image guidance for applicator placement and treatment planning have allowed for tumor dose escalation while reducing normal tissue toxicity. Recent survey data have suggested insufficient brachytherapy training for radiation oncology trainees in the United States. This study aimed to address these gaps by developing and piloting a simulation-based education (SBE) workshop for MR-guided cervical cancer brachytherapy.
An SBE workshop was developed for graduate medical education (GME) trainees focusing on MR-guided brachytherapy for cervical cancer. Four hands-on stations, simulating aspects of the procedure, were led by a team of gynecological brachytherapy experts. The learners were radiation oncology residents and fellows in a U.S. GME training program. The primary outcome was feasibility, assessed by completion of the workshop within the time constraints of the curriculum. Learners completed preworkshop and postworkshop surveys to provide information on efficacy.
The workshop was successfully completed in a 1-h block of GME didactic time. Ten trainees completed all four stations, and all completed preworkshop and postworkshop surveys, which showed improvements in knowledge and technical proficiency. Feedback was positive, and trainees requested additional learning opportunities.
This study showed that GME-focused SBE in MR-guided cervical cancer brachytherapy was feasible. SBE provided a nonclinical environment in which to practice aspects of MR-guided brachytherapy. Ongoing work includes collaboration with other U.S. institutions. Future studies should focus on international adaptation.
近距离放射治疗对于局部晚期宫颈癌的治疗至关重要。尽管在美国（美国）近距离放射治疗的应用正在减少，但新型的间质或腔内施源器以及用于施源器放置和治疗计划的图像引导技术的进步，使得在降低正常组织毒性的同时能够提高肿瘤剂量。最近的调查数据表明，美国的放射肿瘤学受训者近距离放射治疗培训不足。这项研究旨在通过开发和试行基于模拟的教育（SBE）来解决这些差距，用于 MR 引导的宫颈癌近距离放射治疗。
为研究生医学教育（GME）受训者开发了一个基于模拟的教育（SBE）研讨会，重点是 MR 引导的宫颈癌近距离放射治疗。四个实践站由一组妇科近距离放射治疗专家领导，模拟该过程的各个方面。学习者是美国 GME 培训计划中的放射肿瘤学住院医师和研究员。主要结果是可行性，通过在课程时间限制内完成研讨会来评估。学习者在课前和课后完成了调查，以提供关于疗效的信息。
在 GME 教学时间的 1 小时块内成功完成了研讨会。十名学员完成了所有四个站，并且都完成了课前和课后的调查，显示出知识和技术熟练程度的提高。反馈是积极的，学员要求提供更多的学习机会。
这项研究表明，针对 GME 的基于模拟的教育（SBE）在 MR 引导的宫颈癌近距离放射治疗中是可行的。SBE 在非临床环境中提供了实践 MR 引导的近距离放射治疗的机会。正在进行的工作包括与其他美国机构的合作。未来的研究应侧重于国际适应。
