Education: The Path to Better Care for Patients

Sep 10, 2018

By Carson Rolleri, ASCO Communications

Learning in the field of oncology is a career-long endeavor. Because of the rapid pace of advances made in the field, oncology professionals need to constantly stay abreast of the latest guidelines, therapies, and techniques (among many other topics) to provide the best care for their patients.

ASCO seeks to advance the education of all oncology professionals and ultimately facilitate and support enhanced patient care. Always at the forefront of the organization’s initiatives, ASCO was created with the mission to conquer cancer through research, education, and promotion of the highest quality patient care. Since the organization’s founding in 1964, ASCO’s educational portfolio continues to expand by incorporating the most relevant knowledge and advances made in the field. The educational portfolio has also grown with the latest breakthroughs in learning science to improve members’ learning experience.

But what is learning science exactly? At its most basic definition, it is the scientific understanding of how people learn. In recent years, there has been a significant increase of interest and investment in learning science research to better understand how people learn. Because learning is not a single process, learning science is complex; the brain has multiple learning systems, and discoveries in learning science are helping us better understand which teaching tools and methods are the most effective for different topics.

ASCO is staying abreast of the growing evidence and techniques found through learning science research, and applying them to its approach in education.

“ASCO is refreshing its approach to education,” said Jamie H. Von Roenn, MD, FASCO, ASCO vice president of Education, Science & Professional Development. “Based on advances in learning science and cognitive psychology, evidence-based learning techniques are being integrated into ASCO’s education programs. The result of these changes will be greater interactivity and enhanced participant engagement and learning.”

In this article, you’ll find an overview of how ASCO is applying learning science techniques to its educational offerings for members, as well as a sampling of specific programs that demonstrate the breadth of ASCO’s educational topics and formats.

Creating a Cohesive Educational Strategy

In November 2016, the ASCO Board of Directors came together to discuss how it could better support ASCO’s educational mission for its members. From that meeting, the Education Council was born. Created in 2017 and tasked with developing a streamlined educational strategy across all ASCO programs, the Educational Council’s purpose is to set the mission, vision, and strategic plan for ASCO’s education portfolio so that it is consistent with the goals of the ASCO Board of Directors. Specifically, the council oversees the integration of the newest and most relevant learning science theory into ASCO’s educational activities, establishes program success metrics, identifies gaps in ASCO’s educational programming, and advises on new educational technologies. The council’s wide sphere of program evaluation touches all of ASCO’s educational offerings, including meetings and symposia, digital education products, and trainings. 

“Too often, educational activities are considered a ‘given’, something everyone can do,” said inaugural Education Council chair James A. Stewart, MD, FACP, FASCO. “The advances in teaching science show that not to be true. Uninformed administrators may not appreciate the effort and time needed to accomplish good teaching. As Dr. Robert A. Wolff, current Education Council Chair, has reminded us: ‘Education is not a cost sink, but rather an investment with big pay-offs.’”

The Education Council works to develop a strategic plan to inform the ASCO Board of priority programs, content areas, and resources. The council is also responsible for collaborating on educational opportunities across ASCO’s many departments by working with the Education Council Staff Advisory Group (which includes members of ASCO’s Education, Clinical Affairs, Publishing, and Policy Departments). The council is composed of 12 ASCO members and oversees two groups: one focused on Continuing Education and one on Taxonomy.

“From a personal perspective, despite having been a fellowship director for over 20 years, I realized this past year how complex adult education theory and learning science is,” said Dr. Stewart. “As oncologists, we all think of ourselves as teachers: of patients, other doctors, and trainees. But most of us really haven’t studied contemporary educational literature. ASCO has a remarkable educational influence on the medical scene and is likely one of the leaders in this area. Yet we don’t really spend enough time on the skill sets needed for optimal teaching. Putting education skills, in the context of modern learning science, as a priority, is important.”

Learning Science Applied Online and In Person

To adapt to all the ways people learn, ASCO has a variety of both in-person and digital educational experiences, including the ASCO Annual Meeting, topic-specific symposia, and ASCO’s online learning platform, ASCO University®. Each avenue is incorporating learning science and more interactive teaching components to make the learning experience more effective. 

ASCO University eLearning

A central location for practical educational courses and materials on the full range of oncology topics, ASCO University’s mission is to support lifelong learning for oncology professionals. The platform is overseen by the ASCO University Editorial Board and includes numerous educational materials in different formats to support the learner. It is constantly integrating new learning science techniques, including contrasting and analogous cases, clinical decision branching, reflective pauses, question-and-answer bursts within courses, and use of social elements such as discussion forums.

A free program offered through ASCO University, the ASCO University Podcasts provide the latest updates for cancer treatment and care. These updates include recent ASCO guidelines, newly approved drugs in oncology, and self-evaluation questions sourced from various ASCO University materials. Cancer topics featured in the past have run the gamut, including immunotherapy, breast cancer, lung cancer, clinical trials, and fertility preservation. The podcasts also have special episodes that highlight medical errors and specific patient populations, among other topics. With new episodes released every Wednesday, interested listeners can check out the podcasts on university.asco.org/podcasts, in the Apple App store, or in the Google Play store.

Keeping in mind the busy schedule of an oncology professional and the new discoveries gleaned from advances in learning science, ASCO University is working to incorporate even more self-evaluation resources and personalization into its educational offerings. This includes the Personalized Learning Dashboard, where learners create a personal profile that identifies media preferences such as videos, articles, audio podcasts, or eLearning courses. Participants then take a 60-question self-assessment where they select a single best answer and rate their confidence in the chosen answer. The learner receives two scores: an actual score based on right and wrong answers and an adjusted score that accounts for their level of confidence in their correct answer responses. The adjusted score provides insight as to whether a learner is confident and correct (informed), confident and incorrect (misinformed), not confident and correct (guessing), or not confident and incorrect (uninformed).  Based on the adjusted score, content recommendations are offered through the personalized dashboard. Recommendations target the knowledge gaps identified by the performance on the assessment. The overall goal of this dashboard, and other self-evaluation programs that ASCO University offers (including ASCO-SEP, the MOC App, and more), is to make learning more interactive and the learner more aware of their strengths and weaknesses.

“Without the incorporation of interactive techniques, the educational experience is greatly diminished and participants are less likely to learn anything,” said ASCO University editor in chief Daniel G. Haller, MD, FASCO. “A multimodal approach to learning, combined with interactive and thought-provoking presentation techniques and social aspects, is better. Putting all of this together to maintain a dynamic eLearning center such as ASCO University is a complex process! But, it’s really rewarding when we see participants becoming involved with the activities and sharing that they learned something new or now think about something in a different way.”

For more information on the positive effects of self-evaluation and a sneak peek of how ASCO University is integrating more personalized learning techniques into its website, check out this article

ASCO University also offers resources for medical educators. For oncology professionals writing exams and assessment materials, ASCO University’s “Writing Effective Test Questions” course helps participants review the basic components and development process of creating effective multiple-choice questions. Participants then use what they’ve learned to critique several sample questions. After the course is over, learners can take a brief assessment to gauge how well they understood the course content and apply principles that they learned. Medical educators are also invited to attend the Item Writing Workshop, a 1-day workshop held at ASCO headquarters that offers training on how to formulate good questions. Always looking for skilled question writers and reviewers, ASCO covers the expense for workshop participants who are ASCO volunteers. For more information on this workshop or to volunteer, email ascou@asco.org.

Learning Science at ASCO’s Meetings

The ASCO Annual Meeting attracts the brightest minds in oncology from around the world and brings them to McCormick Place Convention Center in Chicago, IL, where more than 40,000 total attendees gather to network and hear the latest innovations in cancer care. There is no better forum to learn about and discuss the important issues in cancer care across a variety of disease sites, treatment approaches, and disciplines.

As education is an integral part of the ASCO Annual Meeting, the advances made in learning science are essential to the meeting’s educational programming. To help presenters better prepare for the meeting and reach their audience more effectively, ASCO supplies speakers at educational sessions with a presentation toolkit. This toolkit lays out best practices for slides and explains how to enhance engagement and interactivity during their presentation, develop effective patient case examples using contrasting cases, and incorporate visual components (such as video) into these presentations. By following this toolkit, educational presenters are more equipped to make a lasting impact on their audiences with the information they present.

In addition to preparing educational speakers with helpful teaching techniques, the ASCO Annual Meeting has built interactive technologic components into sessions. The ticketed Clinical Problems in Oncology Sessions combine the use of case-based panel discussion with interactive technology for audience participation. Recent Clinical Problems in Oncology topics included stem cell transplants, precision medicine, and melanoma. Because of the success of the interactive technology in these sessions, 2019 ASCO Annual Meeting attendees can expect to see similar interactive learning elements in sessions in every track at the meeting.

Piloted at 2018 symposia and rolled out at the most recent ASCO Annual Meeting, attendees are now able to use a new learning platform in all sessions: Interact, powered by Sync. With an emphasis on personalized learning, this platform allows attendees to view speaker slides on their personal devices in real time, take notes on slides during sessions, and pose questions to session faculty. After a session, Interact users receive an email with a link to all the slides and their notes. Attendees can access Interact using their mobile device or laptop. The platform proved to be wildly successful at the 2018 ASCO Annual Meeting: usage peaked at over 20,000 devices on Monday, June 4.

In a decidedly low-tech set of talks, the 2018 ASCO Annual Meeting also explored storytelling as a powerful teaching technique, creating a space for personal narrative and emotional connection that centered around patients with cancer and our own humanity. This new session, ASCO Voices, spotlighted the personal and emotional impact of cancer care. Unlike most presentations at the Annual Meeting, ASCO Voices talks had no slides or data; instead, presenters shared their perspectives on oncology and how their experiences have shaped their worldview. These short presentations (each no more than 7 minutes) were chosen from 60 video submissions, and the effect of the session was emotionally profound. For example, Trevor John Bayliss, MD, reflected on his own leukemia diagnosis as a young adult, and Patrick J. Loehrer Sr., MD, FASCO, recalled his colleague’s ultimately fatal experience with cancer. ASCO Voices presentations can be found ASCO’s Facebook page.

The 2018 ASCO Annual Meeting also saw the first presentation of education research abstracts, including Clinical Science Symposia dedicated to the topic. These abstracts were solicited and presented to underscore the importance of education research and scholarship to the field of oncology, as well as to increase the visibility and recognition for the important but often underappreciated role of physician educators.

According to Dr. Stewart, “The poster session of education research abstracts included over a dozen projects focusing on a wide range of educational science, including trainee assessment, gender differences in faculty rank, use of social media, and delivery of bad news”—crucial topics that now have a true home in the Annual Meeting program.

The ASCO Annual Meeting also has four workshops where attendees can learn from interactive, didactic teaching coupled with hands-on experiences. Workshop participants operate in small groups to learn practical take-home skills and tools to implement in their practices. At the 2018 ASCO Annual Meeting, the following workshops were offered: “Talking With Patients About Risk and Uncertainty,” “Genomics for Oncologists 101,” “Developing a Survivorship Clinic,” and “Grant Writing for Young Researchers.”

How You Can Get Involved

With its increasing number of programs and rapid advances in oncology and learning science, ASCO is always looking for volunteers to help shape and support its educational initiatives. Consider joining ASCO’s Volunteer Corps, a diverse group of ASCO members with varied interests that has a flexible time commitment for volunteering.

Learning Programs Tailored to Professional Groups

ASCO offers many educational programs specific to a professional’s career stage, specialty, and designation, such as:

Education Essentials for Oncology Fellows: Developed specifically for fellows as they pursue training in the field of oncology, Education Essentials for Oncology Fellows (EEOF) offers access to educational content from ASCO University at a significantly reduced price. Fellows receive unlimited access to over 100 ASCO University eLearning courses and materials, including Tumor Boards, Cancer Genetics, Tumor Genomics, Immuno-oncology, Anti-cancer Treatment Toxicities, Meeting Videos and Slides, the Personalized Learning Dashboard, and the new ASCO-SEP 6th Edition eBook and Mock Exam. For more information, visit university.asco.org/eeof.

Medical Oncology In-Training Examination: A 6-hour, 200-question, case-based multiple-choice exam, the Medical Oncology In-Training Examination is a teaching tool that provides a snapshot of trainees’ knowledge and identifies potential program gaps. The online exam is administered over 2 days so that fellows in the same program can alternate, ensuring coverage of clinical responsibilities. This highly valuable but “low-stakes” exam is intended for self-evaluation and program improvement. Click here for more information. 

Oncology Training Program Directors’ Retreat: The retreat was developed to expand the knowledge of program directors by exposing them to best practices and enabling them to share information with other program directors and medical education professionals. This year’s retreat will take place on Thursday, October 18, and Friday, October 19, at ASCO headquarters in the DC metro area. Click here for more information.

Advanced Practitioner Certificate Programs: Available to physician assistants, nurse practitioners, pharmacists, and nurses, these courses are designed to train all practice staff in providing 360-degree oncology care. The three certificate programs cover general and disease-specific content at both basic and advanced levels. For more information, see this article

ASCO Advantage: Designed for industry professionals, ASCO Advantage is a disease-state content immersion program to help learners evolve their knowledge into true understanding and build confidence when engaging in clinical conversations with oncology treatment teams. 

ASCO and the ABIM: Changes to Maintenance of Certification

ASCO has continued to work closely with the American Board of Internal Medicine (ABIM) to further shape the maintenance of certification (MOC) program for oncology, with the goal of making the process less burdensome and more meaningful. Beginning in 2020, oncologists will be able to choose from two different assessment pathways: completing the traditional, high-stakes ABIM exam every 10 years, or a shorter, targeted (topic-based) assessment every 2 years, thus providing more flexibility and a way to personalize the process so that it aligns with your practice profile. Of note:

  • The shorter, 2-year assessments are not high stakes in that everyone has two attempts to pass. 
  • Assessments will be developed jointly by ASCO and ABIM, resulting in a test that keeps pace with rapidly evolving cancer science, research, and oncology practice. 
  • The shorter assessment pathway will replace ABIM’s 2-year Knowledge Check-In for Medical Oncology that had been planned for 2020.
  • The alternate MOC pathway will include periodic summative assessments and a continuous learning component that includes content recommendations based on identified knowledge gaps.
  • ABIM will continue to set performance standards, issue certifications, and administer the assessment process. 

If you have questions about MOC, please contact ascou@asco.org.

ASCO’s educational programs are supported in part by ASCO’s Conquer Cancer Foundation.

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