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The Continuum of Learning: Putting the Latest Oncology Information Into Practice, Effectively

Mar 09, 2022

By Katherine H. Crawford, MA, PMP, ASCO Communications
 
When we think of education, what often comes to mind is our experience as students—those on the receiving end of the learning. If you’re not an educator, you may not think about education as an academic discipline with attendant research, evidence, studies, and debates of all academic subjects.
 
Learning is a science, and the leadership and staff in ASCO’s Education, Science, and Professional Development (ESPD) Department have been evaluating the Society’s educational offerings and updating them in accordance with the latest evidence about how people process, retain, and apply it. This supports the needs of the members, who are busy professionals with limited time.
 
What they’ve developed is a series of educational products and experiences—“a continuum of learning,” as ESPD vice president Jamie H. Von Roenn, MD, FASCO, calls it—that takes learners on a journey from hearing the latest studies and evidence presented at an ASCO meeting to putting findings into practice with their patients.

Listen

One of the most significant updates to education at ASCO meetings was debuted in June 2021 following the 2021 ASCO Annual Meeting: a series of post-plenary sessions designed to go in-depth on some of the most-discussed abstracts from the meeting. The format is virtual, which allows for more interaction between the experts and audience, with each session hosted by a discussant and featuring the abstract lead author or a co-author explaining the research. There is a live question-and-answer session, and the session is available on demand for later viewing. The goal is to help disseminate the latest science and findings presented at the meeting to a wider audience and delve into the impact on physicians and patients.
 
“With the fast pace of innovation and ASCO’s commitment to provide up-to-date information and education to providers and patients worldwide, regularly scheduled opportunities to disseminate important new data have become a necessity,” said 2021-2022 ASCO president Everett E. Vokes, MD, FASCO.
 
The virtual ASCO Plenary Series, designed to rapidly share practice-changing science with the global oncology community, is overseen by a multidisciplinary Scientific Review Committee whose members have diverse expertise spanning many disease sites. Members of the cancer community from all oncology disciplines are encouraged to submit abstracts. The first session took place in November 2021, and sessions are being held monthly through April 2022 and then will resume after the 2022 ASCO Annual Meeting in June. One or two abstracts are presented at each session, followed by a live discussion with the audience. The series is now open to everyone, supporting the Society’s goal to make new science available to every practitioner, everywhere, as quickly as possible to improve patient care.
 
A select number of new courses in the Expert Answers series focus on how the data from a particular abstract might be applied to clinical practice. Most notably, the courses address how experts evaluate the data, in addition to patient and disease factors to make treatment decisions.

Learn

ASCO has recently overhauled the style in which it delivers its courses by limiting cognitive overload and focusing on application. The changes reflect the Society’s continuous enhancement of its educational offerings to make sure members are getting the right information, in the right format, presented in the most effective way possible, as well as keeping members up to date on the latest science and best practices.
 
“A modern oncology workforce is really overworked and sometimes wants information that is less a comprehensive covering of a subject and more a clinical query,” said ASCO Education Editorial Board editor-in-chief Marie Wood, MD. “To better meet the needs of ASCO members, we’ve designed point-of-care learning that is concise, multidisciplinary, and really digestible so professionals can find something that helps them with a specific patient and a specific clinical question.”
 
To avoid cognitive overload—too much information presented at one time—ASCO courses are now shorter and more streamlined, focusing on fewer teaching points, whether those are foundational knowledge or clinical questions. Additionally, to prioritize application—putting what you’ve learned into practice—ASCO’s courses focus on what practitioners should do with the new information learned.

Expert Answers

Expert Answers, ASCO’s newest course series, launched in August 2021, features bite-sized education presented by experts through video and audio narration, with plenty of interactive activities for the learners.
 
The 15- to 20-minute courses are designed for practicing medical oncologists, who can earn continuing medical education (CME) credits for completing them. Each course is focused on a particular topic within a disease area. An expert discusses the patient case, explaining their thought process on why a particular treatment was selected over another, the research evidence, and patient and disease factors that influenced their decision.
 
“For each course, we’re taking a smaller concept, bringing the expert opinion to the patient case, focusing on a specific issue—one that may be controversial—and trying to help people figure out how to incorporate some of the newest information, data, and clinical trials into their practice,” explained Dr. Wood.
 
In 2021, five of the eight Expert Answers courses published were tied to research presented at the 2021 ASCO Annual Meeting to connect the latest science that practitioners were learning at the meeting to patient care and real cases they would see in their clinics, helping them to apply best practices and evidence-based research.

Oncology Topics

The 20- to 30-minute foundational courses, Oncology Topics, provide up-to-date training that’s beneficial for the entire oncology care team. The interactive courses in this series feature patient cases, patient-care resources, and interactive activities for learners to practice applying knowledge presented in the course. Topics span from fundamentals of chemotherapy, biologic therapy, and immunotherapy to supportive care, oncologic emergencies, genomics, biostatistics, cultural literacy, and team-based care.

Tumor Boards

Multidisciplinary discussions of patient cases led by recognized experts in the topic area, the ASCO Education Tumor Boards have been updated to more closely resemble an in-person tumor board in a virtual, on-demand format. These discussions feature medical oncologists, surgical oncologists, radiation oncologists, gynecologic oncologists, pathologists, and others from relevant specialty areas. Several recent tumor boards included global perspectives. Each tumor board features one or two patient cases and several discussion questions around key clinical decision points for that case. Members of the tumor board explain the factors they consider when making their treatment recommendations, including how they weigh pertinent research evidence and clinical guidelines alongside clinical factors and patients’ goals and preferences. Controversial areas and scenarios where evidence is lacking are often discussed as well.
 
As of January 2022, all Expert Answers, Oncology Topics, and Tumor Boards are available at no cost to Full and Allied members. The courses are available for purchase by non-members and other member types that do not include access.

Podcasts

Another format ASCO is using to disseminate critical scientific and clinical information is podcasts.  ASCO’s ESPD Department produces three podcast series, all of which are free to everyone: Cancer Topics, Social Determinants of Health, and Oncology, Etc.
 
Cancer Topics explores a variety of timely topics pertinent not only to patient care, such as case-based discussions of new cancer treatments and telemedicine, but also topics on clinician wellbeing, such as burnout and COVID. The series features a variety of guest speakers, including oncologists, researchers, oncology fellows, and patient advocates.
 
Social Determinants of Health features engaging conversations on health disparities, cultural literacy, modifiable risk factors, and much more.
 
Oncology, Etc. is a series of conversations in which the hosts, Patrick J. Loehrer, MD, FACP, FASCO, and David H. Johnson, MD, MACP, FASCO, explore various topics through casual interviews with thought leaders, humanitarians, and innovators in medicine and beyond. The podcast “started out with a discussion of friendship, and the importance and value of friendship comes through in every episode,” Dr. Von Roenn explained. 
 
The ASCO Education podcasts are part of ASCO’s family of podcasts, with six others that are currently active. View the full list of ASCO podcasts

Evaluate

After participating in educational activities offered at a meeting, via an online course, or a podcast, individuals can assess their learning through ASCO’s Self-Evaluation Program (SEP). ASCO-SEP is a comprehensive resource designed to help providers assess their levels of knowledge in the full range of cancer disease areas, treatment, and supportive care. Content is updated annually, and the resource includes links to other ASCO digital content, including podcasts, courses, and Virtual Meeting presentations. Learners can obtain CME and MOC credit by taking chapter assessments for up to 70 credits. For extra question practice, the ASCO Question Bank, a self-assessment generator, helps learners assess their medical oncology knowledge and address identified gaps. Questions include patient case information, educational links, and rationales for each answer.
 
As of January 2022, ASCO-SEP is available at a lower price, and the Question Bank is included with purchase.

Apply

To bridge the gap between scientific research and clinical practice and help get practice-changing information to decision-making oncology care team members, ASCO has sped up its process for updating its guidelines and last year began issuing Rapid Recommendation Updates. These special articles highlight updates to select ASCO guideline recommendations, and they are developed as a response to what experts have identified as high-quality, practice-changing data.
 
The criteria for a rapid recommendation update are:
  1. The identified evidence is of high methodological quality.
  2. There is high certainty among experts that results are clinically meaningful to practice.
  3. The identified evidence represents a significant shift in clinical practice from a recommendation in an existing ASCO guideline (e.g., change from recommending against the use of a particular therapy to recommending the use of that therapy or vice versa) such that it should not wait for a scheduled guideline update.
An example of evidence meeting these criteria would be a large phase III trial, conducted and powered appropriately, that detected important differences between patient groups in primary outcomes, such as disease-free or overall survival, that are both clinically and statistically significant.
 
The goal is to disseminate the identified evidence and updated recommendations in a timely manner to better inform health practitioners and the public on the best available cancer care options.
 
By offering a variety of formats for learning, ASCO is ensuring that busy oncology professionals have a choice in how they access the latest knowledge.

Putting It All Together: A Real-World Example of Educational Products Working Cohesively

Last year, an abstract was presented at the 2021 ASCO Annual Meeting on a study that showed disease-free survival benefit with adjuvant atezolizumab versus best supportive care after adjuvant chemotherapy in patients with resected stage II-IIIA non-small cell lung cancer (NSCLC). The abstract, “IMpower010: Primary results of a phase III global study of atezolizumab versus best supportive care after adjuvant chemotherapy in resected stage IB-IIIA non-small cell lung cancer (NSCLC),” was featured in an Oral Abstract Session at the meeting and published in the Journal of Clinical Oncology to highlight the practice-changing science contained therein to a larger audience.
 
The data presented in this abstract were of such clinical importance that further dissemination to practitioners seemed crucial. ASCO staff worked with volunteers to develop an Expert Answers case-based course on this topic, “Adjuvant Immunotherapy for Early-Stage Non-Small-Cell Lung Cancer,” which discusses the current treatment approaches, the potential impact of findings from the IMpower010 on patient care, and key patient and disease factors that affect shared decision-making.
 
The significance of this research was such that in October 2021, the U.S. Food and Drug Administration (FDA) approved atezolizumab for adjuvant treatment following resection and platinum-based chemotherapy in patients with stage II to IIIA NSCLC whose tumors have PD-L1 expression on 1% or more of tumor cells, as determined by an FDA-approved test. The major efficacy outcome measure was, as the ASCO Annual Meeting abstract showed, disease-free survival in this population.
 
Following FDA approval, ASCO recorded a podcast, “Cancer Topics—Beyond Adjuvant Chemotherapy: Precision Oncology in Early-Stage NSCLC,” featuring a deep-dive, case-based discussion on shared decision-making and personalizing therapy for early-stage lung cancer.
 

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