McGee, Lisa A

Healthcare Systems Science (HSS) is an important part of medical education because it helps physicians understand how healthcare systems work and how to improve them. However, it is not commonly included in graduate medical training. This manuscript describes the creation and use of a radiation oncology (RO) HSS curriculum that was built with medical school faculty and adapted to the needs of residents in our residency program. The curriculum included sixteen sessions over ten months and covered six domains: person centered care, population centered care, team-based care, high value care, leadership, and health policy economics and technology. Each session included a short lecture and a case discussion on topics such as financial toxicity, telemedicine, workflow improvement, burnout, health equity, and billing. The curriculum was used successfully with regular participation from residents and faculty, showing that it can fit into an existing residency schedule. Residents completed pre- and post-intervention surveys assessing understanding, consideration, confidence, and satisfaction related to HSS domains using 5-point Likert-scale items. Among residents with paired survey data, scores for understanding of HSS, incorporation of HSS into care planning, confidence applying HSS principles, and satisfaction with HSS integration all improved following curriculum completion. This experience shows that adding HSS to RO residency training is practical and useful, and it may also be a helpful model for other residency programs.

Purpose To implement and evaluate a faculty mentorship skill development curriculum within a radiation oncology department at a single academic medical center. Methods A three-part faculty development curriculum consisting of three 45-minute facilitated workshops was implemented for physician faculty mentors. The curriculum was designed to support mentors in navigating mentoring relationships, aligning expectations, and fostering mentee independence. Content was informed by evidence-based mentorship frameworks and adult learning principles, including models developed by the Center for the Improvement of Mentored Experiences in Research, social cognitive theory, and principles of psychological safety and self-efficacy. Faculty participants representing a range of academic ranks and mentoring experience levels participated voluntarily. Pre- and post-curriculum self-assessment surveys evaluated participant understanding and implementation of mentorship skills, as well as perceptions of common mentorship challenges, using a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Descriptive statistics were used to analyze responses. Results Curriculum content progressed from foundational mentorship concepts, including mentor roles, mentoring networks, and stages of mentoring relationships, to communication strategies, expectation alignment, and promotion of mentee independence. Educational methods included brief didactic instruction, case-based discussion, guided reflection, and peer-to-peer learning. Survey data demonstrated improvement in participant self-assessment scores across all evaluated mentorship domains, including mentoring across differences, supporting mentee goal achievement, confidence as a mentor, providing constructive feedback, awareness of mentorship challenges, setting clear expectations, and understanding core mentorship competencies. Participants also reported reduced perceived challenges related to mentorship, with the largest improvements observed in setting boundaries, mentoring across differences, and addressing sensitive topics. Conclusions This faculty mentorship development curriculum was feasible to implement and demonstrated favorable early improvements in self-reported mentorship knowledge, confidence, and perceived ability to navigate common mentorship challenges. Further longitudinal evaluation is needed to assess sustained implementation of mentorship skills and longer-term impact on mentoring relationships.

Abstract Purpose: Head and neck (HN) radiotherapy contour quality directly impacts local control (LC) and survival; however, few departments peer review (PR) contours prior to radiotherapy planning (RTP). This study reports outcomes of a single institution’s formal HN contour PR process. Methods: A formal HN contour PR process was implemented. Prior to RTP, HN radiation oncologists reviewed contours, provided feedback and assigned contour grades as follows: R0 (no change), R1 (minor revision, not high risk) or R2 (major revision; high risk). The PR task was completed and the contour grade was recorded. Cochran-Armitage trend test was performed. Results: Pilot PR process was performed over a 7-month period for 88 patients, followed by a maintenance phase. Contours were graded as follows: R0 ( N = 51), R1 ( N = 20) and R2 ( N = 17). Over time, the number of R2 revisions decreased ( p = 0.0001); month 1 ( N = 7), month 2 ( N = 3), month 3 ( N = 5), month 4 ( N = 2) and months 5–7 ( N = 0). Conversely, the number of R0 revisions improved over time ( p = 0.0203); month 1 ( N = 5), months 2–3 ( N = 9), month 4 ( N = 5), month 5 ( N = 8), month 6 ( N = 12) and month 7 ( N = 3). Each radiation oncologist demonstrated reduction in R2 revisions during the pilot. During maintenance, all 3 radiation oncologists demonstrated low rates of R2 revisions of less than 3 cases per year. Conclusion: Incorporation of HN contour PR into routine clinical workflow is feasible. The collective experience of multiple high-volume HN radiation oncologists led to improved contour quality in the pilot for each radiation oncologist and continued to ensure high quality in the maintenance phase.

ABSTRACT Background As head and neck cancer survival rates improve, there is growing demand for quality survivorship care and tools to predict patient adherence; this study aims to evaluate an advanced practice provider ( APP )‐led survivorship clinic and assess these key metrics. Methods We performed a retrospective review of 213 head and neck cancer patients treated with curative radiation therapy between 2016 and 2023, to assess follow‐up adherence in an advanced practice provider–led survivorship clinic. Results With a median follow‐up of 2.4 years, follow‐up care metrics identified high completion percentages (> 90%) for lung cancer screening, smoking cessation, thyroid screening, dental evaluation, xerostomia, dysphagia, and dysgeusia. The HOUsing ‐based SocioEconomic Status ( HOUSES ) index at diagnosis showed a significant adherence difference (median percentile, 78% vs. 55%, adherent vs. nonadherent; p = 0.03). Conclusions High adherence rates with guideline‐defined care metrics are achievable in an advanced practice provider‐led head and neck cancer survivorship clinic. The HOUSES index may assist in predicting nonadherence; however, further studies are needed.