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运用德尔菲法定义本科放射肿瘤学微见习课程

Defining an Undergraduate Radiation Oncology Microclerkship Using the Delphi Method.

作者信息

Willcox Julia, Gregg Austin T, Braunstein Steve, Mattes Malcolm D, Gunther Jillian, Abrams Matthew

机构信息

Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Harvard Medical School, Boston, Massachusetts.

出版信息

Pract Radiat Oncol. 2025 Jul-Aug;15(4):320-325. doi: 10.1016/j.prro.2024.12.003. Epub 2024 Dec 27.

Abstract

PURPOSE

Many medical students in the US lack formal exposure to radiation oncology (RO). In contrast to multi-week electives, microclerkships, defined here as brief (<1 week) observerships, could provide exposure to RO. The primary objective of this study was to establish expert consensus for the duration, curriculum, target audience, and goals/objectives of an RO microclerkship. With these components, the microclerkship aims to provide medical students with the necessary exposure to RO.

METHODS AND MATERIALS

A needs assessment evaluating the demand for, and essential elements of, an RO microclerkship was distributed to medical student clerkship directors. Based on responses, the authors developed a preliminary set of 7 goals, 5 objectives, and 4 curricular items. These were refined through an iterative Delphi process. Three surveys were sent to 7 medical education experts across several institutions and medical specialties. Surveys asked experts to rank elements for inclusion, comment on clarity, and suggest new ones. The consensus threshold was defined as 83% of respondents selecting "Definitely Include" or "Maybe Include." The final survey asked experts to explain the selection of exclusionary options.

RESULTS

Surveys demonstrated that third-year medical students and 3 to 5 days were the ideal target audience and duration for an RO microclerkship. The final goals emphasized the following: the role/value of RO, understanding of RO mechanisms, RO integration in care, interdisciplinary management, longitudinal care, and workflow. Final objectives included seeing a consult, follow-up, and on-treatment visit; participating in a simulation; and observing contouring, treatment planning, and radiation plan review. Curricular items were preclinic/postclinic quizzes, a 1-hour introduction to RO lecture, and a shadowing experience.

CONCLUSIONS

Through the Delphi process, we have established a framework for an RO microclerkship with a consensus duration, curriculum, target audience, and goals/objectives. Integration of this 3- to 5-day microclerkship into third-year medical school curricula would provide an avenue for increased exposure to RO during undergraduate medical education.

摘要

目的

美国许多医学生缺乏接受放射肿瘤学(RO)正规培训的机会。与为期数周的选修课不同,在此定义为短期(<1周)见习的微实习,可为学生提供接触RO的机会。本研究的主要目的是就RO微实习的时长、课程设置、目标受众以及目标/目的达成专家共识。通过这些要素,微实习旨在为医学生提供接触RO所需的机会。

方法与材料

向医学生临床实习主任发放了一份需求评估问卷,以评估对RO微实习的需求及其基本要素。根据反馈,作者制定了一套初步的7项目标、5项目的和4项课程内容。通过反复的德尔菲法对这些内容进行了完善。向来自多个机构和医学专业的7位医学教育专家发送了三轮调查问卷。调查要求专家对纳入的要素进行排序、对清晰度发表评论并提出新的要素。共识阈值定义为83%的受访者选择“肯定纳入”或“可能纳入”。最后一轮调查要求专家解释选择排除选项的原因。

结果

调查表明,三年级医学生以及3至5天是RO微实习的理想目标受众和时长。最终目标强调了以下几点:RO的作用/价值、对RO机制的理解、RO在医疗中的整合、跨学科管理、长期护理以及工作流程。最终目的包括参与会诊、随访和治疗中访视;参与模拟;观察轮廓勾画、治疗计划制定以及放疗计划审查。课程内容包括临床前/临床后测验、1小时的RO讲座介绍以及跟班见习经历。

结论

通过德尔菲法,我们建立了一个RO微实习的框架,在时长、课程设置、目标受众以及目标/目的方面达成了共识。将这个为期3至5天的微实习纳入医学院三年级课程,将为本科医学教育期间增加接触RO的机会提供一条途径。

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