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Mahoney MT, Linkowski LC, Wu TC, Chen JJ, Neilsen BK, Thompson PS, Mix MD, Sura KT, Mattes MD. Analysis of Oncology and Radiation Therapy Representation on the National Board of Medical Examiners Official Practice Material for the United States National Standardized Medical Board Examinations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024:10.1007/s13187-024-02475-0. [PMID: 38997529 DOI: 10.1007/s13187-024-02475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/25/2024] [Indexed: 07/14/2024]
Abstract
Radiation therapy (RT) is a critical component of multidisciplinary cancer care, but has inconsistent curricular exposure. We characterize the radiation oncology (RO) content on the standardized undergraduate medical examinations by comparing its context and prevalence with other domains in oncology. National Board of Medical Examiners (NBME) self-assessments and sample questions for the United States Medical Licensing Exam (USMLE) Steps 1-3 and NBME clinical science shelf examinations were accessed (n = 3878). Questions were inductively analyzed for content pertaining to oncology and treatment modalities of RT, systemic therapy (ST), and surgical intervention (SI). Questions were coded using USMLE Physician Tasks/Competencies and thematic analysis. Descriptive statistics and analyses using the Kruskal-Wallis test are reported. A total of 337 questions (8.6%) within the USMLE and shelf exams included oncology content, with 101 questions (2.6%) referencing at least one cancer treatment modality (n = 35 RT, 45 ST, 57 SI). Treatment questions were more common on USMLE Step 2 CK (n = 35/101, 32%) compared to Step 1 (n = 23/101, 23%) and Step 3 (n = 8/101, 8%) (p < 0.001). RT was significantly less likely to be the correct answer (2/35, 6%) compared to ST (4/45, 9%) and SI (18/57, 32%) (p = 0.003). Therapeutic oncology questions are uncommon on the examination material, with an under-representation of radiation-related content, and contextual bias favoring surgical approaches. We advocate for greater RO involvement in the content creation of such examinations to help trainees better understand multidisciplinary cancer care.
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Affiliation(s)
- Mary T Mahoney
- Transitional Year Residency Program, Garnet Health Medical Center, 707 East Main St, Middletown, NY, 10940, USA.
- Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, USA.
| | - Lauren C Linkowski
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Trudy C Wu
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Jie Jane Chen
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Beth K Neilsen
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USA
| | - Petria S Thompson
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Michael D Mix
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Karna T Sura
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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Mattes MD, Ye JC, Peters GW, Rizvi F, Thomas TO, Chandra RA, Weiss E, Gutiontov SI, Motwani SB. Pilot Study Demonstrating the Value of Interdisciplinary Education on the Integration of Radiation Therapy in Lung Cancer Management. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2023; 38:590-595. [PMID: 35357645 PMCID: PMC8967926 DOI: 10.1007/s13187-022-02158-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 05/20/2023]
Abstract
This study aimed to understand baseline knowledge of basic principles of radiation therapy for lung cancer among medical oncology, thoracic surgery, and pulmonology trainees and practicing physicians and also assess whether a didactic lecture will improve objective knowledge and perceived comfort level in making appropriate referrals to radiation oncology (RO). Radiation oncologists at 8 academic institutions offered a presentation covering indications, logistics, efficacy, and toxicity of thoracic radiation. Participants completed a survey to assess their prior exposures to RO and perceived value of the lecture, and objective knowledge gained based on pre/post-lecture questions. Among 121 attendees, 76 completed the pre-test, and 25 the post-test (response rates 62.8% and 20.7%, respectively). Fifty-seven (75.0%) had never previously experienced a RO didactic about lung cancer, 62 (81.6%) had never seen a linear accelerator, and 65 (85.5%) had never rotated in a RO department. The mean pre-test score was 53.5% (SD 17.6%), with a trend (p = 0.066) towards thoracic surgeons (61.5%) performing better than medical oncologists (55.5%) or pulmonologists (48.3%). Level of training (p = 0.130), and prior RO exposures (p = 0.240), did not significantly impact pre-test scores. The mean post-test score of 75.1% (SD 3.6%) was significantly higher than mean pre-test score (p < 0.001). After the lecture, 25 participants (100%) felt more knowledgeable about RO, and 24 (96%) felt more comfortable making appropriate referrals to RO. A didactic lecture about RO for trainees and physicians who treat lung cancer at 8 academic institutions was feasible, filled a gap in exposure, and improved knowledge.
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Affiliation(s)
- Malcolm D Mattes
- Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, 195 Little Albany Street, New Brunswick, NJ, 08901, USA.
| | - Jason C Ye
- Department of Radiation Oncology, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Gabrielle W Peters
- Department of Radiation Oncology, Yale School of Medicine, New Haven, CT, USA
| | - Faryal Rizvi
- Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Tarita O Thomas
- Department of Radiation Oncology, Northwestern Feinberg School of Medicine, Chicago, IL, USA
| | - Ravi A Chandra
- Department of Radiation Oncology, Oregon Health Sciences University, Portland, OR, USA
| | - Elisabeth Weiss
- Department of Radiation Oncology, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Stanley I Gutiontov
- Department of Radiation and Cellular Oncology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA
| | - Sabin B Motwani
- Department of Radiology, St. Joseph's University Medical Center, Paterson, NJ, USA
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