Defining an Undergraduate Radiation Oncology Microclerkship via the Delphi Method

Pract Radiat Oncol. 2024 Dec 27:S1879-8500(24)00354-0. doi: 10.1016/j.prro.2024.12.003. Online ahead of print.

Abstract

Purpose: Many medical students in the U.S. 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 a RO microclerkship. With these components, the microclerkship aims to provide medical students with necessary exposure to RO.

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

Results: Surveys demonstrated that third-year medical students and 3-5 days were the ideal target audience and duration for a RO microclerkship. Final goals emphasized the following: 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 pre-clinic/post-clinic quizzes, 1-hour introduction to RO lecture, and shadowing experience.

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