LAUSR

PURPOSE Despite the importance of brachytherapy in the curative treatment of locally advanced cervical cancer, reviews of practice patterns in the United States have identified a decline in brachytherapy use in clinically appropriate patient populations. A survey of radiation oncologists identified lack of time and lack of guidance as barriers. To address these barriers, the purpose of this study was to develop a simulation-based educational (SBE) gynecological brachytherapy workshop. METHODS The SBE gynecological brachytherapy workshop was developed with expertise from two institutions, combining procedural simulation with a practical discussion of brachytherapy applicator insertion techniques. The primary outcome was feasibility of workshop deployment, defined as completion of all workshop components in the time allotted. Pre- and post-workshop surveys were also administered to assess efficacy, a secondary outcome. RESULTS The workshop took place at a national radiation oncology meeting, with all workshop components completed in the two hours allotted. SBE stations focused on: 1) fiducial placement, 2-3) applicator selection, 4) suturing, and 5) pelvic exam and applicator placement. 14 participants completed surveys. Respondents included residents and attending physicians. Over 50% were from academic practices, practicing gynecological brachytherapy weekly or more. Curricular objectives for this workshop were for ≥20% trainees to report increased confidence in practice and ≥20% of trainees to report increased familiarity with applicators. After participation in the workshop, confidence in applicator choice improved in 69% (9/13), confidence in complication management in 62% (8/13), and familiarity with applicators improved in 54% (7/13). These differences were statistically significant at alpha=0.05. CONCLUSIONS This study demonstrated feasibility in utilizing simulation for gynecological brachytherapy education at a national meeting. While most respondents were experienced in brachytherapy, over half reported increased confidence and familiarity with aspects of the procedure following the workshop. Future work should address interstitial needle placement and improved time management of workshop stations.