Radiation Oncology Providers' Practices and Preferences for Delivering Patient Education on Radiation Therapy: A Mixed Methods Study

Background Patient understanding of the radiation treatment process, including anticipated logistics, side effects, and outcomes of treatment, is often limited. We lack data on optimal radiation oncology provider approaches to patient education. Our objective was to assess patient education practices and preferences of interdisciplinary radiation oncology providers to inform recommendations for providers and institutions. Methods An anonymous, web-based survey was developed in collaboration with the Radiation Oncology Education Collaborative Study Group (ROECSG) Patient Education Working Group and distributed to all members of the ROECSG listserv via Qualtrics in October 2022. The survey contained 17 items: 13 multiple choice and 4 open-ended. Descriptive statistics summarized survey responses. Thematic analysis was used to analyze qualitative responses. Results 123 ROECSG members completed the survey (31% response rate). Most respondents were radiation oncology attendings (64%), worked in an academic/university affiliated setting (86%), and were in North America (82%). Aside from verbal communication, the most common educational approaches used were institution-specific materials (61%) and electronic health system-generated materials (38%). 41% of respondents highlighted that their patient education practices differed according to whether assessments were in-person or virtual; printed handouts versus Internet images/videos were used most often for in-person versus virtual visits, respectively. A majority (86%) stated that their institution utilized disease site-specific patient education materials. Over half (58%) reported that their institution had non-English materials available. Review of patient education materials by staff (53%) was the most common assessment method, though 19% reported no assessment of materials at their institution. Among institutions with an assessment process, respondents were largely "unsure" (56%) of the assessment frequency. On qualitative analysis, a central theme surrounding challenges for providing patient education was lack of time for providers to deliver and patients to review materials provided. Respondents also identified administrative roadblocks such as inadequate leadership support, training, and funding for developing education materials. Key strategies for successful patient education included using visual/multimedia materials, personalizing content for patients/caregivers (e.g., based on their learning styles, preferences, and language), reiterating information at multiple timepoints by multiple team members, and utilizing active education (e.g., teach-back method, encouraging notetaking, involving caregivers). Discussion Many radiation oncology providers use institution-specific and disease site-specific materials to provide patient education, with personalization of content for patients differing for in-person versus virtual environments. Increased adoption of visual/multimedia materials and partnerships with organizational leadership may facilitate access to and contribute towards the development of high-quality, tailored patient education resources. Patient understanding of the radiation treatment process, including anticipated logistics, side effects, and outcomes of treatment, is often limited. We lack data on optimal radiation oncology provider approaches to patient education. Our objective was to assess patient education practices and preferences of interdisciplinary radiation oncology providers to inform recommendations for providers and institutions. An anonymous, web-based survey was developed in collaboration with the Radiation Oncology Education Collaborative Study Group (ROECSG) Patient Education Working Group and distributed to all members of the ROECSG listserv via Qualtrics in October 2022. The survey contained 17 items: 13 multiple choice and 4 open-ended. Descriptive statistics summarized survey responses. Thematic analysis was used to analyze qualitative responses. 123 ROECSG members completed the survey (31% response rate). Most respondents were radiation oncology attendings (64%), worked in an academic/university affiliated setting (86%), and were in North America (82%). Aside from verbal communication, the most common educational approaches used were institution-specific materials (61%) and electronic health system-generated materials (38%). 41% of respondents highlighted that their patient education practices differed according to whether assessments were in-person or virtual; printed handouts versus Internet images/videos were used most often for in-person versus virtual visits, respectively. A majority (86%) stated that their institution utilized disease site-specific patient education materials. Over half (58%) reported that their institution had non-English materials available. Review of patient education materials by staff (53%) was the most common assessment method, though 19% reported no assessment of materials at their institution. Among institutions with an assessment process, respondents were largely "unsure" (56%) of the assessment frequency. On qualitative analysis, a central theme surrounding challenges for providing patient education was lack of time for providers to deliver and patients to review materials provided. Respondents also identified administrative roadblocks such as inadequate leadership support, training, and funding for developing education materials. Key strategies for successful patient education included using visual/multimedia materials, personalizing content for patients/caregivers (e.g., based on their learning styles, preferences, and language), reiterating information at multiple timepoints by multiple team members, and utilizing active education (e.g., teach-back method, encouraging notetaking, involving caregivers). Many radiation oncology providers use institution-specific and disease site-specific materials to provide patient education, with personalization of content for patients differing for in-person versus virtual environments. Increased adoption of visual/multimedia materials and partnerships with organizational leadership may facilitate access to and contribute towards the development of high-quality, tailored patient education resources.