Objective Evaluation of a Didactic Curriculum for the Radiation Oncology Medical Student Clerkship

Purpose: A structured didactic radiation oncology clerkship curriculum for medical students is in use at multiple academic medical centers (AMCs). Objective evidence supporting this educational approach over the traditional clerkship model is lacking. This study evaluates the curriculum efficacy using an objective knowledge assessment. Materials/Methods: Medical students received the Radiation Oncology Education Collaborative Study Group (ROECSG) curriculum consisting of three lectures (Overview of Radiation Oncology, Radiation Biology/Physics, and Practical Aspects of Simulation/Radiation Emergencies) and an interactive hands-on radiation oncology treatment-planning workshop. A standardized 20 item multiple choice question (MCQ) knowledge assessment was completed pre- and post-curriculum and approximately six months after receiving the curriculum. Paired and unpaired t tests and Pearson's correlation coefficient were used to analyze the data. Results: 146 students at 22 AMCs completed the ROECSG curriculum from 7-11/2016. 109 students completed pre- and post-clerkship MCQ knowledge assessments (response rate 74.7%). 24 students reported a prior rotation at a ROECSG institution. Data are reported for the 85 students receiving the curriculum de novo. Mean assessment scores increased from pre- to post-curriculum (63.9% vs. 80.2%, p<0.01). Subset analysis did not show a correlation between pre-test score and USMLE step 1 score or time since first rotation. Mean MCQ knowledge subdomain assessment scores all improved post-curriculum (t test, p values <0.01). Post-scores for students rotating de novo at ROECSG institutions (n=30) were higher compared with pre-scores for students with ≥1 prior rotations at non-ROECSG institutions (n=55) (77.3% vs. 68.8%, p=0.01) with an effect size of 0.8. Students who completed rotations at ROECSG institutions continued to demonstrate a trend towards improved performance on the objective knowledge assessment at approximately 6 months after curriculum exposure (70.5% vs. 65.6%, p=0.11). Conclusion: Objective evaluation of a structured didactic curriculum for the radiation oncology clerkship at early and late time points demonstrates significant improvement in general radiation oncology knowledge and all knowledge subdomains. On exploratory analysis, students completing a clerkship at ROECSG institutions perform objectively better when compared with students who completed clerkships at non-ROECSG institutions. These results support including a structured didactic curriculum as a standard component of the radiation oncology clerkship.