Assessing and teaching radiotherapy contouring

Advanced radiotherapy techniques such as image-guided adaptive brachytherapy for cervical cancer improve local tumour control and reduce treatment toxicity. This benefit is critically dependent on radiotherapy targeting or “contouring” by oncologists. Numerous studies have shown considerable inter-o...

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Main Author: Duke, Simon L.
Format: Thesis (University of Nottingham only)
Language:English
Published: 2021
Subjects:
Online Access:https://eprints.nottingham.ac.uk/66998/
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author Duke, Simon L.
author_facet Duke, Simon L.
author_sort Duke, Simon L.
building Nottingham Research Data Repository
collection Online Access
description Advanced radiotherapy techniques such as image-guided adaptive brachytherapy for cervical cancer improve local tumour control and reduce treatment toxicity. This benefit is critically dependent on radiotherapy targeting or “contouring” by oncologists. Numerous studies have shown considerable inter-observer contouring variation across all tumour sites, often measured in centimetres, suggesting that current methods of teaching contouring are ineffective. Moreover, assessing contouring competency is currently a subjective, time-consuming and onerous process. The aim of this programme of research is to investigate the assessment and teaching of radiotherapy contouring within an educational design research framework. The thesis reviews the limitations and challenges of current strategies to improve radiotherapy contouring and how insights from the educational literature such as cognitive load theory, deliberate practice theory, and best practices in assessment and feedback can inform and improve contouring assessment and teaching. Real-world data from two studies of online assessment and education for radiotherapy contouring, within an international clinical trial of advanced radiotherapy techniques for locally advanced cervical cancer, were analysed to substantiate the limitations of current approaches within a clinical trial setting. The thesis describes a novel low-fidelity radiotherapy contouring simulation tool developed to address some of the issues identified in the clinical studies. A detailed useability study was carried out in a small group of oncologists, which also yielded interesting insights into their clinical reasoning and self-regulation processes. The simulation was then used in three pilot studies of different types of learners (trainees and experts) and programmes (one-off workshops and longitudinal programmes) to explore its acceptability, useability and effectiveness. The thesis concludes by discussing possible approaches for the next iteration of software development and educational research, which could lead to meaningful change in the teaching and assessment of radiotherapy contouring.
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format Thesis (University of Nottingham only)
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language English
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publishDate 2021
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spelling nottingham-669982021-12-08T04:40:35Z https://eprints.nottingham.ac.uk/66998/ Assessing and teaching radiotherapy contouring Duke, Simon L. Advanced radiotherapy techniques such as image-guided adaptive brachytherapy for cervical cancer improve local tumour control and reduce treatment toxicity. This benefit is critically dependent on radiotherapy targeting or “contouring” by oncologists. Numerous studies have shown considerable inter-observer contouring variation across all tumour sites, often measured in centimetres, suggesting that current methods of teaching contouring are ineffective. Moreover, assessing contouring competency is currently a subjective, time-consuming and onerous process. The aim of this programme of research is to investigate the assessment and teaching of radiotherapy contouring within an educational design research framework. The thesis reviews the limitations and challenges of current strategies to improve radiotherapy contouring and how insights from the educational literature such as cognitive load theory, deliberate practice theory, and best practices in assessment and feedback can inform and improve contouring assessment and teaching. Real-world data from two studies of online assessment and education for radiotherapy contouring, within an international clinical trial of advanced radiotherapy techniques for locally advanced cervical cancer, were analysed to substantiate the limitations of current approaches within a clinical trial setting. The thesis describes a novel low-fidelity radiotherapy contouring simulation tool developed to address some of the issues identified in the clinical studies. A detailed useability study was carried out in a small group of oncologists, which also yielded interesting insights into their clinical reasoning and self-regulation processes. The simulation was then used in three pilot studies of different types of learners (trainees and experts) and programmes (one-off workshops and longitudinal programmes) to explore its acceptability, useability and effectiveness. The thesis concludes by discussing possible approaches for the next iteration of software development and educational research, which could lead to meaningful change in the teaching and assessment of radiotherapy contouring. 2021-12-08 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en cc_by https://eprints.nottingham.ac.uk/66998/1/Dr_Simon_Duke_PhD-Thesis_Teaching_and_Assessing_Radiotherapy_Contouring_REVISIONS_APPROVED-2021-10-22.pdf Duke, Simon L. (2021) Assessing and teaching radiotherapy contouring. PhD thesis, University of Nottingham. Radiotherapy education; assessment simulation; contouring quality assurance; design research; deliberate practice
spellingShingle Radiotherapy education; assessment simulation; contouring quality assurance; design research; deliberate practice
Duke, Simon L.
Assessing and teaching radiotherapy contouring
title Assessing and teaching radiotherapy contouring
title_full Assessing and teaching radiotherapy contouring
title_fullStr Assessing and teaching radiotherapy contouring
title_full_unstemmed Assessing and teaching radiotherapy contouring
title_short Assessing and teaching radiotherapy contouring
title_sort assessing and teaching radiotherapy contouring
topic Radiotherapy education; assessment simulation; contouring quality assurance; design research; deliberate practice
url https://eprints.nottingham.ac.uk/66998/