Linking comfort levels and knowledge gaps in hematology/oncology (HO) fellowship education: Insights from a multicenter survey.

Abstract

9030 Background: HO fellowship programs lack standardized educational approaches. This can impact learning & self-assessment of learning gaps. This study investigates the relationship between HO fellows’ (HOF) comfort levels & objective knowledge assessments across diverse HO topics, addressing a critical need for data in this area. Methods: HOF from 27 U.S. programs were invited to complete an anonymous survey (Sept-Oct 2023) in which they rated their comfort managing representative HO diseases, namely breast cancer (BC), plasma cell dyscrasias (PCD), hemophilia, von Willebrand disease (vWD), & heparin-induced thrombocytopenia (HIT), on a 7-point Likert scale (1 = extremely uncomfortable, 7 = extremely comfortable). An optional multiple choice knowledge quiz on these topics followed, including an option for “not sure & need to look it up.” Fellows were categorized into low (1–3), moderate (4–5), & high (6–7) comfort groups. One-way ANOVA assessed differences in knowledge scores by comfort levels. Results: In total,222 HOF completed the comfort survey (53% response rate): 82 PGY4 (37%), 72 PGY5 (32%), & 69 PGY6+ (31%). Also, 189 HOF completed the knowledge quiz (46% response rate): 71 PGY4 (38%), 57 PGY5 (30%), & 60 PGY6+ (31%). Mean comfort levels (±SD) were: BC diagnosis 4.8±1.4, localized BC management (mgmt.) 4.2±1.5, metastatic BC mgmt. 4.2±1.5, PCD diagnosis 4.8±1.4, MGUS/smoldering myeloma mgmt. 4.7±1.4, front-line myeloma treatment 4.5±1.6, maintenance myeloma treatment 4.1±1.5, inherited/acquired hemophilia mgmt. 3.7±1.5, vWD diagnosis 4±1.4, vWD mgmt. 3.8±1.4, HIT diagnosis 5.4±1.1, & HIT mgmt. 5.4±1.1. Mean knowledge scores were 41% for BC, 39% for PCD, 47% for hemophilia, 33% for vWD, & 51% for HIT. When evaluated by comfort level groups (low, medium, & high), knowledge scores increased significantly with higher comfort levels for BC (25%, 43%, 55%; p<0.01), PCD (25%, 38%, 51%; p<0.01), hemophilia (29%, 55%, 77%; p<0.01), & vWD (13%, 39%, 62%; p<0.01). HIT scores showed no significant difference by comfort levels (p=0.89). The number of “not sure” responses (%) significantly decreased (p<0.01) with greater comfort across topics: BC (53%, 20%, 10%), PCD (39%, 23%, 7%), hemophilia (52%, 28%, 2%), vWD (69%, 40%, 12%). HIT “not sure” responses showed no significant difference by comfort levels. Conclusions: This multicenter analysis demonstrates a correlation between HOF comfort levels & knowledge assessments. Despite overall low performance on knowledge tests, comfort levels effectively discriminated between knowledge groups, underscoring their potential utility as a surrogate for educational progress. These data highlight the need for interventions to bridge gaps between perceived & actual knowledge. Future studies to validate these results across broader topics & institutions to inform optimal education strategies in HO training programs are needed.