Proficiency-Based Cervical Cancer Brachytherapy Training: An Effort to Combat Recent Trends in Radiation Oncology That Result in Worse Outcomes for an Underserved Population through Resident Education

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Fields, Emma
Cervical Cancer; Brachytherapy; Radiation Oncology; Simulation; Proficiency-Based; Pelvic Model; Resident Curriculum; Procedure Training; Medicine and Health Sciences
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Radiation therapy is the mainstay of treatment for women with cervical cancer with disease outside of the uterine cervix. To deliver the high doses needed for cure, brachytherapy (BT) is necessary to avoid toxicity to normal tissues (1). Technique is of utmost importance for outcomes of BT, but due to a lack of training during residency, the use of BT is declining nationwide (2, 3). The effectiveness of procedural simulation training, especially proficiency-based training, has been well established in other medical specialties, but there is no simulation training for cervical cancer brachytherapy used anywhere else in the country at this time (4-8). To combat this problem, we developed and implemented a structured proficiency-based BT simulation curriculum that will be able to be modified and replicated at training programs across the country and will be particularly practical for programs with less exposure to gynecologic brachytherapy. Residents who participated in the simulation training had measurable improvements in the time to perform the procedure, applicator placement quality and confidence, which translate to fewer complications and better tumor control for patients.