Enhancing competence and confidence in thoracic oncology: A pilot study on the impact of self-assessment and reflection tools for hematology-oncology fellows.

Abstract

e21019 Background: The knowledge base in oncology is continuously evolving; this poses challenges in evaluating competency of medical trainees.To help advance trainee education, self-assessments can invite self-involved reflection of previously identified standards, which may further identify strengths and weaknesses. Testing as an element of learning has also been efficacious in knowledge retention. Methods: This single-center pilot study evaluated eight heme/onc fellows rotating through the thoracic oncology department. Fellows were administered a pre-rotation survey and knowledge assessment to determine baseline understanding and comfort with treating thoracic tumors. Following a 6-week rotation in thoracic and head/neck oncology, fellows were provided with the same survey and test. Scores between the two surveys and assessments were used to determine comfort and competency. Fellows were assessed on questions from ASCO-SEP related to small-cell lung cancer (SCLC) (5 questions), non-small cell lung cancer (NSCLC) (17 questions), and other thoracic tumors (OTT) (6 questions). Fellows were also provided with survey regarding comfort of various thoracic oncology concepts graded on a richter scale (1-5). A paired t-test was used to analyze differences in these administered surveys and assessments. Results: The analysis revealed significant improvement in fellows’ knowledge and comfort following the rotation.The pre-rotation and post-rotation assessments showed a significant increase in overall scores, from 53.6% to 79.9% (P< 0.0043). There was no significant difference in scores for SCLC questions, (pre-rotation: 65%, post-rotation: 70%, P<0.6986), however, post-rotation scores were slightly higher. A statistically significant improvement was found in the NSCLC questions, with scores increasing from 59.56% to 84.56% (P < 0.0057). A statistically significant improvement was also seen in OTT questions, with scores rising from 33.33% to 74.99% (P< 0.0065). There was a statistically significant increase in fellows’ self-reported comfort in treating thoracic tumors, with scores improving from 29.43% to 61.14% (P< 0.0001). Conclusions: This study highlight demonstrates a positive impact of a dedicated thoracic oncology rotation on fellows’ competence and confidence in managing thoracic tumors. Improvements in assessment scores across various lung cancer categories—including non-small cell lung cancer and miscellaneous thoracic tumors—demonstrate a clear enhancement in fellows’ knowledge. Additionally, the notable increase in fellows’ comfort levels with treating thoracic tumors, as reflected in the post-rotation self -reflection, underscores value of this training. Incorporating structured self-assessment and reflection tools into clinical medical education may also further enhance clinical training.