Preferences Amongst Radiation Oncology Residents for Virtual and In-Person Radiation Treatment Planning Review

Background Broadly, medical education e-learning is equivalent to in-person in student satisfaction, knowledge, skills, and outcomes. However, when e-learning is best used, and in what form is still being determined. For instance, e-learning with greater interactivity, practice, and feedback is associated with improved learner satisfaction and outcomes. Considering the computer-basis of radiation treatment planning, radiation oncology residents plausibly may prefer virtual treatment planning and review formats. We aimed to assess resident use of Virtual, In-Person, or a combination of Both review formats, to elicit their format preferences, and reasons for their preferences. We theorized virtual-preferring residents would endorse areas previously associated with enhanced e-learning outcomes more than in-person peers. Methods Online questionnaires were emailed to current PGY1-PGY5 residents in Canadian radiation oncology programs. Questionnaires examined level of training, typical review format, preferred format, and reasons for format preference. Chi-square tests compared differences in format preference and reasons for preference. Results 52 respondents were included for analysis; PGY1s were excluded due to limited treatment planning exposure. 76.9% of residents typically review with Both virtual and in-person formats, significantly more than 17.3% who review In-Person (p<0.0001) or 5.8% who review Virtually (p<0.0001). When asked which format they preferred, 44.2% preferred Virtual, 36.5% In-Person, and 19.2% preferred a combination of Both. Preference was significantly greater for Virtual versus Both (p=0.006) and In-Person versus Both (p=0.049). Reasons for preference were thematically grouped, reflecting focus upon Interactivity, Practice, Feedback, Convenience, and Teaching Quality. Significant differences were not found between In-Person and Virtual-preferring respondents in terms of Feedback, Interactivity, or Practice. However, significant within-group differences existed between Convenience versus Teaching Quality (Virtual-preferring: 84.3%>61%, p=0.0198; Both-preferring: 76.7%>40%, p=0.0324; In-person-preferring: 25%<63%, p=0.00214), and between Feedback versus Interactivity (Virtual-preferring: 66.7%>45.4%, p=0.0048; In Person-preferring: 59.7%>37%, p=0.00634). Discussion Our results suggest residents review contours and treatment plans with a combination of virtual and in-person formats, more than either format alone, despite low resident preference for this approach. While use of either format appears acceptable to residents, differences in emphasis on convenience with virtual-preferring and teaching quality in residents preferring in-person review suggests that educational priorities may differ between residents. Feedback more than interactivity seems important for residents irrespective of preferred format. Thus, residents and attendings should identify a format that best meets resident's educational needs and priorities. Further research should explore attending preferences.