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Published in: Strahlentherapie und Onkologie 4/2023

Open Access 07-03-2023 | Brachytherapy | Original Article

Development, implementation, and results of a simulation-based hands-on brachytherapy workshop for medical students

Authors: Matthias A. Mäurer, Sonia Drozdz, Juliet Ehrenpfordt, Michael Schwedas, Melissa Friedlein, Nadine Hille, Cora Riede, Steffen Schrott, Maximilian Graf, Georg Wurschi, Marcel A. Kamp, Andrea Wittig, Stefan Knippen

Published in: Strahlentherapie und Onkologie | Issue 4/2023

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Abstract

Purpose

The new Medical Licensing Regulations 2025 (Ärztliche Approbationsordnung, ÄApprO) require the development of competence-oriented teaching formats. In addition, there is a great need for high-quality teaching in the field of radiation oncology, which manifests itself already during medical school. For this reason, we developed a simulation-based, hands-on medical education format to teach competency in performing accelerated partial breast irradiation (APBI) with interstitial multicatheter brachytherapy for early breast cancer. In addition, we designed realistic breast models suitable for teaching both palpation of the female breast and implantation of brachytherapy catheters.

Methods

From June 2021 to July 2022, 70 medical students took part in the hands-on brachytherapy workshop. After a propaedeutic introduction, the participants simulated the implantation of single-lead catheters under supervision using the silicone-based breast models. Correct catheter placement was subsequently assessed by CT scans. Participants rated their skills before and after the workshop on a six-point Likert scale in a standardized questionnaire.

Results

Participants significantly improved their knowledge-based and practical skills on APBI in all items as assessed by a standardized questionnaire (mean sum score 42.4 before and 16.0 after the course, p < 0.001). The majority of respondents fully agreed that the workshop increased their interest in brachytherapy (mean 1.15, standard deviation [SD] 0.40 on the six-point Likert scale). The silicone-based breast model was found to be suitable for achieving the previously defined learning objectives (1.19, SD 0.47). The learning atmosphere and didactic quality were rated particularly well (mean 1.07, SD 0.26 and 1.13, SD 0.3 on the six-point Likert scale).

Conclusion

The simulation-based medical education course for multicatheter brachytherapy can improve self-assessed technical competence. Residency programs should provide resources for this essential component of radiation oncology. This course is exemplary for the development of innovative practical and competence-based teaching formats to meet the current reforms in medical education.
Literature
1.
go back to reference Dapper H et al (2022) Integration of radiation oncology teaching in medical studies by German medical faculties due to the new licensing regulations : an overview and recommendations of the consortium academic radiation oncology of the German society for radiation oncology (DEGRO). Strahlenther Onkol 198(1):1–11CrossRefPubMed Dapper H et al (2022) Integration of radiation oncology teaching in medical studies by German medical faculties due to the new licensing regulations : an overview and recommendations of the consortium academic radiation oncology of the German society for radiation oncology (DEGRO). Strahlenther Onkol 198(1):1–11CrossRefPubMed
2.
go back to reference Vorwerk H, Engenhart-Cabillic R (2022) Students’ learning behavior in digital education for radiation oncology. Strahlenther Onkol 198(1):12–24CrossRefPubMed Vorwerk H, Engenhart-Cabillic R (2022) Students’ learning behavior in digital education for radiation oncology. Strahlenther Onkol 198(1):12–24CrossRefPubMed
3.
go back to reference Mäurer MA, Mäurer I, Kamp MA (2022) Can neuro-oncology teaching contribute to educate medical doctors better? A reflection on the value of neuro-oncology for student teaching. Chin Neurosurg J 8(1):23CrossRefPubMedPubMedCentral Mäurer MA, Mäurer I, Kamp MA (2022) Can neuro-oncology teaching contribute to educate medical doctors better? A reflection on the value of neuro-oncology for student teaching. Chin Neurosurg J 8(1):23CrossRefPubMedPubMedCentral
5.
go back to reference Mäurer MA et al (2022) Erstmalige interdisziplinäre DKK-Programmplanung durch Zusammenschluss onkologischer Nachwuchsgruppen. Forum 37(1):19–23CrossRef Mäurer MA et al (2022) Erstmalige interdisziplinäre DKK-Programmplanung durch Zusammenschluss onkologischer Nachwuchsgruppen. Forum 37(1):19–23CrossRef
6.
8.
go back to reference Oertel M et al (2020) Quality of teaching radiation oncology in Germany-where do we stand? : results from a 2019 survey performed by the working group “young DEGRO” of the German society of radiation oncology. Strahlenther Onkol 196(8):699–704CrossRefPubMedPubMedCentral Oertel M et al (2020) Quality of teaching radiation oncology in Germany-where do we stand? : results from a 2019 survey performed by the working group “young DEGRO” of the German society of radiation oncology. Strahlenther Onkol 196(8):699–704CrossRefPubMedPubMedCentral
9.
go back to reference Singer L et al (2019) Development and implementation of a simulation-based educational workshop on gynecological brachytherapy: pilot study at a national meeting. Pract Radiat Oncol 9(5):E465–E472CrossRefPubMed Singer L et al (2019) Development and implementation of a simulation-based educational workshop on gynecological brachytherapy: pilot study at a national meeting. Pract Radiat Oncol 9(5):E465–E472CrossRefPubMed
10.
go back to reference Mesko S et al (2020) Development, implementation, and outcomes of a simulation-based medical education (SBME) prostate brachytherapy workshop for radiation oncology residents. Brachytherapy 19(6):738–745CrossRefPubMed Mesko S et al (2020) Development, implementation, and outcomes of a simulation-based medical education (SBME) prostate brachytherapy workshop for radiation oncology residents. Brachytherapy 19(6):738–745CrossRefPubMed
11.
go back to reference Thaker NG et al (2014) Establishing high-quality prostate brachytherapy using a phantom simulator training program. Int J Radiat Oncol Biol Phys 90(3):579–586CrossRefPubMed Thaker NG et al (2014) Establishing high-quality prostate brachytherapy using a phantom simulator training program. Int J Radiat Oncol Biol Phys 90(3):579–586CrossRefPubMed
12.
go back to reference Frank SJ et al (2020) The American brachytherapy society prostate brachytherapy LDR/HDR simulation workshops: hands-on, step-by-step training in the process of quality assurance. Brachytherapy 19(6):787–793CrossRefPubMed Frank SJ et al (2020) The American brachytherapy society prostate brachytherapy LDR/HDR simulation workshops: hands-on, step-by-step training in the process of quality assurance. Brachytherapy 19(6):787–793CrossRefPubMed
13.
go back to reference Correa C et al (2017) Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol 7(2):73–79CrossRefPubMed Correa C et al (2017) Accelerated partial breast irradiation: executive summary for the update of an ASTRO evidence-based consensus statement. Pract Radiat Oncol 7(2):73–79CrossRefPubMed
14.
go back to reference Polgár C et al (2013) Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial. Radiother Oncol 108(2):197–202CrossRefPubMed Polgár C et al (2013) Breast-conserving therapy with partial or whole breast irradiation: ten-year results of the Budapest randomized trial. Radiother Oncol 108(2):197–202CrossRefPubMed
15.
go back to reference Strnad V et al (2016) 5‑year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet 387(10015):229–238CrossRefPubMed Strnad V et al (2016) 5‑year results of accelerated partial breast irradiation using sole interstitial multicatheter brachytherapy versus whole-breast irradiation with boost after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: a randomised, phase 3, non-inferiority trial. Lancet 387(10015):229–238CrossRefPubMed
16.
go back to reference Polgár C et al (2017) Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5‑year results of a randomised, controlled, phase 3 trial. Lancet Oncol 18(2):259–268CrossRefPubMed Polgár C et al (2017) Late side-effects and cosmetic results of accelerated partial breast irradiation with interstitial brachytherapy versus whole-breast irradiation after breast-conserving surgery for low-risk invasive and in-situ carcinoma of the female breast: 5‑year results of a randomised, controlled, phase 3 trial. Lancet Oncol 18(2):259–268CrossRefPubMed
18.
go back to reference Frobenius W (2021) Nationaler Kompetenzbasierter Lernzielkatalog Medizin (NKLM) Version 2.0 Frobenius W (2021) Nationaler Kompetenzbasierter Lernzielkatalog Medizin (NKLM) Version 2.0
19.
go back to reference Bundesministerium für Bildung und Forschung (2017) Masterplan Medizinstudium 2020 Bundesministerium für Bildung und Forschung (2017) Masterplan Medizinstudium 2020
20.
go back to reference Ärzteblatt (2019) Medizinische Fakultäten wollen sich bei Neustrukturierung des Medizinstudiums engagieren. Deutscher Ärzteverlag GmbH Ärzteblatt (2019) Medizinische Fakultäten wollen sich bei Neustrukturierung des Medizinstudiums engagieren. Deutscher Ärzteverlag GmbH
21.
go back to reference Oertel M et al (2019) Successful integration of radiation oncology in preclinical medical education : experiences with an interdisciplinary training project. Strahlenther Onkol 195(12):1104–1109CrossRefPubMed Oertel M et al (2019) Successful integration of radiation oncology in preclinical medical education : experiences with an interdisciplinary training project. Strahlenther Onkol 195(12):1104–1109CrossRefPubMed
22.
go back to reference Winter IP, Ingledew PA, Golden DW (2019) Interprofessional education in radiation oncology. J Am Coll Radiol 16(7):964–971CrossRefPubMed Winter IP, Ingledew PA, Golden DW (2019) Interprofessional education in radiation oncology. J Am Coll Radiol 16(7):964–971CrossRefPubMed
23.
go back to reference Patel VL, Yoskowitz NA, Arocha JF (2009) Towards effective evaluation and reform in medical education: a cognitive and learning sciences perspective. Adv Health Sci Educ Theory Pract 14(5):791–812CrossRefPubMed Patel VL, Yoskowitz NA, Arocha JF (2009) Towards effective evaluation and reform in medical education: a cognitive and learning sciences perspective. Adv Health Sci Educ Theory Pract 14(5):791–812CrossRefPubMed
24.
26.
go back to reference Bi M et al (2019) Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology. Med Teach 41(10):1124–1128CrossRefPubMed Bi M et al (2019) Comparison of case-based learning and traditional method in teaching postgraduate students of medical oncology. Med Teach 41(10):1124–1128CrossRefPubMed
27.
go back to reference McGaghie WC et al (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86(6):706–711CrossRefPubMedPubMedCentral McGaghie WC et al (2011) Does simulation-based medical education with deliberate practice yield better results than traditional clinical education? A meta-analytic comparative review of the evidence. Acad Med 86(6):706–711CrossRefPubMedPubMedCentral
28.
go back to reference Akaike M et al (2012) Simulation-based medical education in clinical skills laboratory. J Med Invest 59(1):28–35CrossRefPubMed Akaike M et al (2012) Simulation-based medical education in clinical skills laboratory. J Med Invest 59(1):28–35CrossRefPubMed
29.
go back to reference Cook DA et al (2011) Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 306(9):978–988CrossRefPubMed Cook DA et al (2011) Technology-enhanced simulation for health professions education: a systematic review and meta-analysis. JAMA 306(9):978–988CrossRefPubMed
30.
go back to reference Griswold-Theodorson S et al (2015) Beyond the simulation laboratory: a realist synthesis review of clinical outcomes of simulation-based mastery learning. Acad Med 90(11):1553–1560CrossRefPubMed Griswold-Theodorson S et al (2015) Beyond the simulation laboratory: a realist synthesis review of clinical outcomes of simulation-based mastery learning. Acad Med 90(11):1553–1560CrossRefPubMed
31.
go back to reference Cook DA et al (2013) Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach 35(1):e867–98CrossRefPubMed Cook DA et al (2013) Comparative effectiveness of instructional design features in simulation-based education: systematic review and meta-analysis. Med Teach 35(1):e867–98CrossRefPubMed
32.
33.
go back to reference Dubois N et al (2022) Training of radiotherapy professionals: status, content, satisfaction and improvement suggestions in the greater region. BMC Med Educ 22(1):485CrossRefPubMedPubMedCentral Dubois N et al (2022) Training of radiotherapy professionals: status, content, satisfaction and improvement suggestions in the greater region. BMC Med Educ 22(1):485CrossRefPubMedPubMedCentral
34.
go back to reference Rooney MK et al (2018) Simulation as more than a treatment-planning tool: a systematic review of the literature on radiation oncology simulation-based medical education. Int J Radiat Oncol Biol Phys 102(2):257–283CrossRefPubMedPubMedCentral Rooney MK et al (2018) Simulation as more than a treatment-planning tool: a systematic review of the literature on radiation oncology simulation-based medical education. Int J Radiat Oncol Biol Phys 102(2):257–283CrossRefPubMedPubMedCentral
35.
go back to reference Merriam SB (2010) Adult learning. International encyclopedia of education. Elsevier Merriam SB (2010) Adult learning. International encyclopedia of education. Elsevier
36.
go back to reference Stein D (1998) Situated learning in adult education. ERIC Digest 195:1–7 Stein D (1998) Situated learning in adult education. ERIC Digest 195:1–7
37.
go back to reference Dapper H et al (2021) Radiation oncology as part of medical education—current status and possible digital future prospects. Strahlenther Onkol 197(6):528–536CrossRefPubMed Dapper H et al (2021) Radiation oncology as part of medical education—current status and possible digital future prospects. Strahlenther Onkol 197(6):528–536CrossRefPubMed
38.
go back to reference Oertel M et al (2022) Digital transfer in radiation oncology education for medical students—single-center data and systemic review of the literature. Strahlenther Onkol 198(9):765–772CrossRefPubMedPubMedCentral Oertel M et al (2022) Digital transfer in radiation oncology education for medical students—single-center data and systemic review of the literature. Strahlenther Onkol 198(9):765–772CrossRefPubMedPubMedCentral
Metadata
Title
Development, implementation, and results of a simulation-based hands-on brachytherapy workshop for medical students
Authors
Matthias A. Mäurer
Sonia Drozdz
Juliet Ehrenpfordt
Michael Schwedas
Melissa Friedlein
Nadine Hille
Cora Riede
Steffen Schrott
Maximilian Graf
Georg Wurschi
Marcel A. Kamp
Andrea Wittig
Stefan Knippen
Publication date
07-03-2023
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 4/2023
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-023-02058-w

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