Systematic review of educational interventions to improve contouring in radiotherapy.

Blended learning Educational Radiotherapy contouring

Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
03 2020
Historique:
received: 18 07 2019
revised: 31 10 2019
accepted: 04 11 2019
pubmed: 2 12 2019
medline: 15 4 2021
entrez: 2 12 2019
Statut: ppublish

Résumé

Contouring is a critical step in the radiotherapy process, but there is limited research on how to teach it and no consensus about the best method. We summarize the current evidence regarding improvement of contouring skills. Comprehensive literature search of the Pubmed-MEDLINE database, EMBASE database and Cochrane Library to identify relevant studies (independently examined by two investigators) that included baseline contouring followed by a re-contouring assessment after an educational intervention. 598 papers were identified. 16 studies met the inclusion criteria representing 370 participants (average number of participants per study of 23; range (4-141). Regarding the teaching methodology, 5/16 used onsite courses, 8/16 online courses, and 2/16 used blended learning. Study quality was heterogenous. There were only 3 randomized studies and only 3 analyzed the dosimetric impact of improving contouring homogeneity. Dice similarity coefficient was the most common evaluation metric (7/16), and in all these studies at least some contours improved significantly post-intervention. The time frame for evaluating the learning effect of the teaching intervention was almost exclusively short-time, with only one study evaluating the long-term utility of the educational program beyond 6 months. The literature on educational interventions designed to improve contouring performance is limited and heterogenous. Onsite, online and blended learning courses have all been shown to be helpful, however, sample sizes are small and impact assessment is almost exclusively short-term and typically does not take into account the effect on treatment planning. The most effective teaching methodology/format is unknown and impact on daily clinical practice is uncertain.

Sections du résumé

BACKGROUND AND PURPOSE
Contouring is a critical step in the radiotherapy process, but there is limited research on how to teach it and no consensus about the best method. We summarize the current evidence regarding improvement of contouring skills.
METHODS AND MATERIALS
Comprehensive literature search of the Pubmed-MEDLINE database, EMBASE database and Cochrane Library to identify relevant studies (independently examined by two investigators) that included baseline contouring followed by a re-contouring assessment after an educational intervention.
RESULTS
598 papers were identified. 16 studies met the inclusion criteria representing 370 participants (average number of participants per study of 23; range (4-141). Regarding the teaching methodology, 5/16 used onsite courses, 8/16 online courses, and 2/16 used blended learning. Study quality was heterogenous. There were only 3 randomized studies and only 3 analyzed the dosimetric impact of improving contouring homogeneity. Dice similarity coefficient was the most common evaluation metric (7/16), and in all these studies at least some contours improved significantly post-intervention. The time frame for evaluating the learning effect of the teaching intervention was almost exclusively short-time, with only one study evaluating the long-term utility of the educational program beyond 6 months.
CONCLUSION
The literature on educational interventions designed to improve contouring performance is limited and heterogenous. Onsite, online and blended learning courses have all been shown to be helpful, however, sample sizes are small and impact assessment is almost exclusively short-term and typically does not take into account the effect on treatment planning. The most effective teaching methodology/format is unknown and impact on daily clinical practice is uncertain.

Identifiants

pubmed: 31786422
pii: S0167-8140(19)33470-X
doi: 10.1016/j.radonc.2019.11.004
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

86-92

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Jon Cacicedo (J)

Radiation Oncology Department, Cruces University Hospital, Osakidetza/Biocruces Health Research Institute/Department of Surgery, Radiology and Physical Medicine of the University of the Basque Country (UPV/EHU), Barakaldo, Spain. Electronic address: jon.cacicedofernandezbobadilla@osakidetza.eus.

Arturo Navarro-Martin (A)

Radiation Oncology Department, Hospital Duran i Reynals (ICO) Avda, Gran VIa de ĹHospitalet, Barcelona, Spain. Electronic address: anavarro@iconcologia.net.

Susana Gonzalez-Larragan (S)

Department of Health Science Library, Cruces University Hospital, Osakidetza, Barakaldo, Spain. Electronic address: susana.gonzalezlarragan@osakidetza.eus.

Berardino De Bari (B)

Radiation Oncology Department, Centre Hospitalier Régional Universitaire Jean Minjoz, INSERM U1098 EFS/BFC, Besançon, France. Electronic address: bdebari@chu-besancon.fr.

Ahmed Salem (A)

Division of Cancer Sciences, University of Manchester, United Kingdom; Department of Clinical Oncology, The Christie Hospital NHS Trust, Manchester, United Kingdom. Electronic address: ahmed.salem@manchester.ac.uk.

Max Dahele (M)

Department of Radiation Oncology, Cancer Center Amsterdam, Amsterdam UMC (VUmc location), the Netherlands. Electronic address: m.dahele@vumc.nl.

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Classifications MeSH