Remote Contouring Education in Latin America: Longitudinal Effects of Asynchronous Resources with or without Synchronous Virtual Lectures

Background

Contouring is required for conformal radiotherapy planning. To facilitate increased adoption and quality of advanced radiation techniques in Latin America, additional provider education is needed. It is unclear if asynchronous learning materials versus the combination of asynchronous and synchronous education is more effective. We evaluated the efficacy of a remote, resident-led contouring curriculum.

Methods

Residents and radiation oncologists from 2 public centers in Nicaragua and Paraguay were invited to enroll. Syllabus, lecture materials, quiz questions, and a folder of published contouring guidelines were created based on contemporary standards for prostate, breast, gastrointestinal, gynecologic, and head and neck malignancies. Content was reviewed by expert US-based radiation oncologists. Both centers completed a pre-test before gaining access to Spanish-translated lecture materials and English guidelines. Then, only Center 1 received 15 one-hour live remote lectures over 4 months delivered by a U.S. senior radiation oncology resident in Spanish using the same materials and with access to the recordings. Finally, both centers completed post-tests. Paired t-test analysis was used to compare pre- vs. post-test scores.

Results

Twenty-one participants enrolled from Center 1 (n = 11, 100% staff participation) and Center 2 (n = 10, 71% staff participation), including 10 residents and 11 attending physicians. Pre-test mean score was 57.0% (59.3% Center 1 and 54.4% Center 2), including 56% for residents and 58% for attending physicians. 11 participants completed both pre- and post-tests, including 6 residents and 5 attending physicians. Providers from Center 1 (n = 6) improved significantly (64.4% vs 83.3%, p = 0.003), while providers from Center 2 did not (55.1% vs 62.0%, p = 0.24).

Conclusions

The addition of a longitudinal remote, resident-led contouring curriculum resulted in greater improvements in contouring knowledge than written resources alone. This program has the potential to be repeated and scaled globally for one-to-one center support.