ICEC 2018

Building Clinical Capacity through Education – Towards an unified approach for individualized solutions
 
Rebecca K.S. Wong
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
 
Radiation therapy (RT) is an essential modality in the treatment of cancer; yet globally, large segments of populations have suboptimal access. While the upfront investment in infrastructure and equipment is significant, the human life gains makes it mandatory. The practice of RT is critically dependent on first the availability of treatment and planning equipment to treat, followed closely by the availability of trained clinical teams to treat. As policy makers successfully mobilize resources for the infrastructure necessary to practice, professional training has become an urgent priority. While the need for learning is shared, the know how on creating effective learning solutions, and how to arrive at it is not. Multiple barriers including environment, human, motivation, communication, resources and systems, which when actively addressed and understood, become enablers. Our university of Department of Radiation Oncology is equipped with the expertise to deliver a full range of professional training in radiation medicine. Motivated by the obligation to contribute to improving global access to radiation therapy, we are fortunate to have the opportunity to work with multiple collaborating partners, from Ghana to Kenya, each with different educational needs and a health system that demands different solutions. With each of our partners, we first began by understanding the potential enablers and barriers, followed by a pilot design of the training solution. A six step program development approach was applied to each partnership from understanding the problem to reflection on the lessons learned. Two key knowledge areas including clinical research skills for radiation oncology trainees, and transition from 2D to 3D radiotherapy practice were the focus of training. A distant learning and longitudinal mentorship model was effective for the former, while an efficient way of providing experiential learning is required for the later, although much can be accomplished through distant training. Intermediate outcomes including feasibility, knowledge transfer and exploration of strengths and weaknesses of the programs were captured from both the learner and the teacher’s perspectives. Longer term outcomes including impact on practice and clinical care are planned for the future. We have successfully delivered three pilot training programs. Our iterative model towards developing professional training between resource rich and limited collaborating partners was effective for our program to transfer lessons learned from our partnership to another, with shortened timelines and the creation of transferrable resources. This approach is expected to be have a role to play in other health professional settings. Objectives: The participant shall be able to describe the six key enablers and barriers necessary to build an effective learning collaboration for resource limited countries. References: Atun R, Jaffray DA, Barton MB, et al: Expanding global access to radiotherapy. Lancet Oncol 16:1153-86, 2015 Yap ML, Hanna TP, Shafiq J, et al: The Benefits of Providing External Beam Radiotherapy in Low- and Middle-income Countries. Clinical Oncology 29:72-83, 2017