The Scholarly Impact of Student Participation in Radiation Oncology Research

Volume 99  Number 2S  Supplement 2017 2

Carolina Health Informatics Program, School of Information and Library Science, University of North Carolina, Chapel Hill, NC Purpose/Objective(s): To develop and assess the impact of simulationbased training intervention on radiation oncology providers’ workload and performance during treatment planning and quality assurance (QA) tasks. Materials/Methods: 18 radiation oncology professionals completed routine treatment planning and QA tasks on two clinical scenarios in a simulation laboratory, as part of a prospective IRB-approved study. Workload was measured at the end of each assessment using the NASA Task-Load Index (NASA-TLX). Performance was quantified based on procedural compliance (adherence to pre-set/standard QA tasks), time-to-scenario completion, and clinically relevant performance. Participants were then randomized to receive (vs. not receive) simulation-based training intervention (e.g., standardized feedback on workload and performance) and underwent repeat measurements of workload and performance. Pre- and post-intervention changes in workload and performance from participants who received (vs. did not receive) were compared using two-way analysis of variance (ANOVA). Results: Simulation-based training was associated with significant improvements in procedural compliance (pZ0.01) and increases in time-toscenario completion (pZ0.01), but had no significant impact on subjective workload or clinically relevant performance. Conclusion: Simulation-based training may be a tool to improve procedural compliance of RT professionals and to acquire new skills and knowledge to proactively maintain RT professionals’ preoccupation with patient safety. Author Disclosure: L. Mazur: None. B.S. Chera: None. L.B. Marks: None.

2305 Association of Preresidency Peer Reviewed Publications With Radiation Oncology Resident Choice of Academic Versus Private Practice Career S. McClelland III,1 C.R. Thomas Jr,2 L.D. Wilson,3 E. Holliday Jr,4 and J.J. Jaboin5; 1Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, 2Oregon Health & Science University, Knight Cancer Institute, Portland, OR, 3Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT, 4MD Anderson Cancer Center, Houston, TX, 5Oregon Health & Science University, Portland, OR Purpose/Objective(s): The decision of radiation oncology residents to pursue academic versus private practice careers plays a central role in shaping the present and future of the field, yet factors potentially predictive of this decision are lacking. This study was performed to examine the role of several factors publicly available prior to residency on post-residency career choice, including pre-residency peer-reviewed publications (PRP) which have been associated with resident career choice in comparably competitive subspecialties such as neurosurgery. Materials/Methods: Using a combination of internet searches, telephone interviews, and the 2015 Association of Residents in Radiation Oncology (ARRO) directory, a list of 2016 radiation oncology resident graduates was compiled along with their post-residency career choice of academic versus private practice. PRP was defined as the number of publications in PubMed encompassing the end of the calendar year in which residency applications were due (2010); this number was then correlated with the choice of an academic or private practice radiation oncology career. Additional factors examined were resident gender, MD/PhD status, and non-PhD dual degree holders. Results: A total of 163 residents from 76 programs certified by the Accreditation Council for Graduate Medical Education were examined. 127 (78%) were male, 36 (22%) were MD/PhD, and 79 graduates (48%) chose academic careers. 52% of graduates had at least one PRP at the time of application to radiation oncology residency, with 35% having more than one PRP. Regarding choice of academic career, the difference between no PRP and at least one PRP was statistically significant (pZ0.0002), but not between one PRP and more than one. Graduates with at least one PRP were 3.34 times more likely to choose an academic career than those with no PRP. Gender, PhD status, and non-PhD dual degree status were all not associated with academic versus private practice career choice.

Poster Viewing E127 Conclusion: Radiation oncology graduates with at least one PRP at the time of residency application were 234% more likely to choose an academic over private practice career compared with graduates with no PRP. Neither gender nor dual degree status were significant predictors of postresidency career choice. This information may prove useful to medical students, medical school advisors and residency program directors, and deserves further prospective investigation. Author Disclosure: S. McClelland III: None. C.R. Thomas: None. L.D. Wilson: Stock; Vertex, J and J, United Healthcare, UCAN, Pfizer. Board member; ABR, ASTRO. E. Holliday: None. J.J. Jaboin: None.

2306 Trends in Radiation Oncology Fellowship Training in the United States O. Mohamad1 and J.J. Meyer2; 1UT Southwestern Dallas, TX, 2University of Texas Southwestern Medical Center, Dallas, TX Purpose/Objective(s): The number of radiation oncology fellowship programs and the number of fellows completing these programs have reportedly increased in the past decade. The purpose of this study was to identify trends in fellowship training in radiation oncology in the United States from 2003 until now. Materials/Methods: An excel sheet questionnaire was distributed by e-mail to ninety-six radiation oncology residency programs or practices identified using the ARRO, ASTRO, ABS and AAMC directories. Follow-up contact by email or phone was made to maximize response rate. For the purposes of this study, a fellowship is defined as “paid” post-residency clinical training in radiation oncology. Pure research or informatics fellowships, as well nonclinic fellowships for international physicians, are reported separately. Results: Eighty programs (83%) responded to our survey. Of the programs that did not respond, seven programs have or have had fellowship training as listed on their website or on other directories. Fourteen of the responding programs (18%) currently have active fellowships, and two programs will start offering fellowship training in July, 2017. Seven programs had fellowship training that did not fit our definition and included pure research, clinical informatics, and research training for international fellows. The number of programs and fellows was relatively stable between 2003 (3 programs and 5 fellows) and 2009 (5 programs and 7 fellows). Since 2009, there has been a steady increase in the number of fellowship programs associated with even a sharper increase in the number of fellows. In 2016, there were fourteen programs offering fellowships and nineteen fellows. By adding the new positions from the programs planning to expand and from the new programs, we anticipate twenty-seven fellows in 2017, assuming that all positions are filled but not considering the programs which did not respond. SBRT/SRS fellowships increased at the fastest rate followed by brachytherapy and proton fellowships. Other available subspecialties include, but not limited to, general radiation oncology, genitourinary, pediatrics, CNS and palliative care. Conclusion: The number of radiation oncology fellowship programs and the number of fellows have significantly increased since 2009. The complexity of radiation therapy techniques may be driving this trend as residents seek further training in specific sub-specialties (proton, SBRT/ SRS, brachytherapy, etc). However, concerns about the increasing supply of radiation oncologists in a tight job market may also push some graduates to pursue further training to better market their skills. Author Disclosure: O. Mohamad: None. J.J. Meyer: Research Grant; Peregrine Pharmaceuticals, Inc.. clinical trials support; D-fine Inc.. Honoraria; Osler Institute, Texas Radiological Society, UpToDate, Inc.. Travel Expenses; Osler Institute.

2307 The Scholarly Impact of Student Participation in Radiation Oncology Research M. Paracha,1 M.M. Qureshi,1 A. Shah,1 T. Sachs,2 S. Sarfaty,1 and A.E. Hirsch3; 1Boston University School of Medicine, Boston, MA, 2 Boston University School of Medicine and Boston Medical Center, Boston, MA, 3Department of Radiation Oncology, Boston University School of Medicine and Boston Medical Center, Boston, MA

E128

International Journal of Radiation Oncology  Biology  Physics

Purpose/Objective(s): Literature evaluating student authorship has used the H-index (Hi), a measure of scholarly impact. However, student authorship over time is less well defined. In this study, we evaluated the rate of nondoctoral student authors publishing in an academic journal over time. Additionally, we examined the effects student authors have on the scholarly impact of corresponding authors (CA) by comparing their respective Hi. Materials/Methods: We created a database of authors that published articles in the International Journal of Radiation Oncology Biology Physics (IJROBP) in 2006, 2010, and 2014. This database included CA, degree and student author designations. CAs’ Hi were obtained from Scopus (scopus.com). Student authorship rates were compared between the sampled years. The data was divided into two groups, CA publishing with student authors (SA) and those without (nSA). CAs’ median and mean Hi with standard deviation (sd) and a 95% confidence interval (CI) were compared between SA and nSA. Results: A total of 1,728 published articles were identified with 1,477 unique CA. Percentage of published articles with student authors increased from 44.4% in 2006, 52.9% in 2010 to 55.9% in 2014, pZ00003. In overall analysis, mean Hi was noted to be higher for SA as compared to nSA (24.3 vs. 22.9), although this did not achieve statistical significance (pZ0.094). Mean Hi (sd) in 2006, 2010 and 2014 were 27.9 (16.6), 23.6 (16.7) and 18.5 (14.6), respectively. Mean Hi was significantly higher for SA compared to nSA in years 2006 (29.5 vs. 26.6, pZ0.048) and 2010 (24.9 vs. 21.9, pZ0.038), but not in 2014 (18.5 vs. 18.4, pZ0.963). Conclusion: Student authorship rates in IJROBP are increasing. The data suggest that student participation in research may benefit both corresponding and student authors. Creating and expanding research programs to integrate research into medical education may enhance students’ experience and encourage interest in radiation oncology. Author Disclosure: M. Paracha: None. M.M. Qureshi: None. A. Shah: None. T. Sachs: None. S. Sarfaty: None. A.E. Hirsch: None.

(64%) felt that the focus on institution-specific dosimetric planning software was well balanced with general principles. Residents were most satisfied with learning the techniques of forward-planning and inverseplanning. Several residents requested a more formal structure to the rotation with specific didactic lectures and goals to be achieved. Conclusion: We demonstrated the feasibility of utilizing current and former resident feedback to inform the development and improvement of the resident dosimetry curriculum, highlighting its strengths and weaknesses. Our survey results serve as the foundation for curriculum restructuring for future trainees, and may serve as a springboard for nationwide curriculum improvement initiatives. Author Disclosure: G. Shukla: Employee; Holy Redeemer Hospital. G. Alexander: None. V. Nettleton: None. N.L. Williams: None. V. Bar Ad: None.

2308 The Dosimetry Curriculum in Radiation Oncology Residency: A Single Institution Quality Improvement Project G. Shukla, G. Alexander, V. Nettleton, N.L. Williams, and V. Bar Ad; Sidney Kimmel Medical College at Thomas Jefferson University, Sidney Kimmel Cancer Center, Philadelphia, PA Purpose/Objective(s): Radiation oncology residents receive training in several domains, including practice in critiquing radiation plans. As part of comprehensive training, residents at many institutions have a rotation in clinical dosimetry, for which there is no standardized curriculum. The purpose of the present project was to assess the quality of the resident dosimetry curriculum at our institution, to identify concrete routes of improvement, and to determine the feasibility of surveying current and former residents toward optimization of this rotation. Materials/Methods: An anonymous survey was developed and approved by faculty and dosimetry supervisors and was distributed to current and former trainees of our institution’s residency program. The survey included questions on expectations for the course goals, timing of the dosimetry rotation relative to other rotations in the department, allocation of time on the rotation, satisfaction with the course format, and confidence in skills acquired during the rotation. Results: Eleven former and current residents (92% of those polled) responded to the anonymous survey. Seven (64%) reported low understanding of the goals of the rotation prior to starting the rotation. The timing of the rotation was distributed throughout the first three years of training: 18% in the first twelve months, 27% in the first half of the second year, 36% in the second half of second year, and 18% in the third or fourth year. The large majority of residents (91%) spent more than 20 hours per week with physicists and dosimetrists working on plan development, evaluation, and quality assurance. All residents spent less than ten hours with radiation therapists at the treatment machines or simulator. Most residents (82%) spent at least ten hours per week pursuing self-directed goals, including research. Nearly all residents (91%) felt that clinical training during other rotations was more important than the dosimetry curriculum in preparing them for critiquing radiation plans. Most residents

2309 Smoke Out: Educating Oncology Providers to Improve Tobacco Cessation Among Cancer Patients B. Silver,1 J. Kodiyan,1 R. Yechieli,2 and S.J. Ramey3; 1University of Miami, Miami, FL, 2Department of Radiation Oncology, University of Miami / Sylvester Comprehensive Cancer Center, Miami, FL, 3University of Miami; Jackson Health System, Miami, FL Purpose/Objective(s): Cancer patients who smoke have an increased risk of all-cause mortality, cancer specific mortality, cancer recurrence, and treatment toxicities when compared to those who do not smoke. National guidelines are explicit in their recommendations that all cancer patients who are using tobacco should receive cessation counseling and assistance with quitting. Unfortunately, some cancer patients are not even advised to quit and many are offered no assistance with quitting. This study evaluated whether educating radiation oncology providers on smoking cessation benefits and treatment guidelines for cancer patients will result in improved provider knowledge and likelihood to assist patients with tobacco cessation. Materials/Methods: This prospective analysis consisted of a radiation oncology department “Grand Rounds” lecture on tobacco cessation for the oncology provider with pre- and post-lecture surveys conducted to evaluate provider knowledge, perceptions, previous training, and self-reported behaviors related to tobacco cessation. Surveys were sent through REDCap to all attending physicians, nurses, PA’s, and resident physicians working in the academic radiation oncology center. Post-lecture surveys were sent only to providers who responded to the pre-lecture survey. Comparison of repeated pre- and post- lecture questions was done using an “N-1” Chi-Squared test. Results: Thirty-six eligible participants received the pre-lecture survey, 34 responded, and 19 attended the lecture. Of the respondents, 35.3% were residents or physician assistants, 35.3% were attending physicians, and 29.4% were nurses. After the lecture, 100% of participants either agreed or strongly agreed that they feel more comfortable discussing smoking cessation, 73.7% were more likely to prescribe medications, 84.2% were more likely to refer patients, and 89.5% felt more knowledgeable about potential harmful effects. When comparing pre- and post-lecture surveys, there was a 36.8% (pZ0.0039) increase in respondents saying, “I feel confident I know how to refer patients to smoking cessation services,” and a 26.3% (pZ0.0392) increase in respondents correctly identifying the likelihood of quitting with first line therapies. There was an increase in all confidence and knowledge questions after the lecture when compared to before. However, none of the other prompts were statistically significant, most likely due to the small sample size. Conclusion: Attending a short lecture increased both oncology providers’ knowledge and confidence related to assisting patients with tobacco cessation. A similar lecture may be worthwhile for oncology trainees and staff members nationwide to improve tobacco cessation. This study also plans to assess clinical efficacy by retrospectively comparing tobacco cessation counseling and referral in the radiation oncology clinic before and after the lecture. Author Disclosure: B. Silver: None. J. Kodiyan: None. R. Yechieli: None. S.J. Ramey: None.