Implementation of a fellow-led tumor board to enhance learning and support in fellow continuity clinic.

Abstract

9000 Background: Hematology/oncology fellows in our program manage diverse and complex cases in continuity clinic (CC), including uncommon malignancies and challenging clinical scenarios, providing a rich educational opportunity. To further enhance case-based learning and in response to fellows’ feedback from an internal program survey, we implemented a Fellow Tumor Board (FTB) to provide clinic-specific additional guidance and structured learning. Methods: The FTB was integrated into an existing biweekly didactic virtual didactic to minimize added burden and encourage participation. Investment in learning was fostered by focusing on fellows’ own cases. Chief fellows reviewed recent CC consults, selecting cases involving new malignancies, rare conditions, or complex management scenarios, and invited guest faculty experts for targeted feedback. Each 30-minute FTB, moderated by chief fellows, included multiple 5-minute case discussions: fellows presented cases, posed clinical questions, and received expert and peer input. Chief fellows summarized key recommendations and clinical pearls while senior fellows provided insights and mentorship. This collaborative format enabled fellows to learn from their own and peers’ cases. An anonymous electronic survey was distributed six months after FTB implementation to assess its impact. Fellows rated their experiences on a Likert scale (1 = strongly disagree to 4 = strongly agree). Results: Survey responses (12) showed positive reception. Fellows reported feeling more supported in managing CC patients (3.6 ± 0.4), empowered to seek guidance (3.6 ± 0.4), found expert input valuable (3.7 ± 0.4), that FTB fostered a collaborative environment (3.5 ± 0.5) and that case-based learning was effective (3.4 ± 0.4). However, 4/12 fellows disagreed that they learned from their co-fellows’ cases. All respondents agreed that the FTB should continue as part of the didactic curriculum. Additional informal feedback highlighted improved confidence, ability to present cases in tumor boards, and mentorship while faculty praised the active learning environment. In-training exam scores to assess knowledge retention and program survey responses to evaluate supervision quality at year-end will be tracked to further evaluate FTB’s impact and will be available at time of presentation. Conclusions: FTB is a feasible and adaptable innovation that addresses gaps in CC education. By promoting case-based learning, collaboration, and mentorship, it enhances fellows’ support, knowledge, confidence and preparedness for oncology practice. To optimize its effectiveness, strategies to encourage fellows to engage and learn from their peers’ cases – not just their own – should be explored.