Professional Development

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Guerrero, Antonio C´esar Garza-Guerrero, Marco Vinicio G´omez-Meza, ´Angel .... Max S. Mano, Rafaela Gomes, Carlos H. Barrios, Gustavo Nader Marta, ...

PROFESSIONAL DEVELOPMENT

10500

Clinical Science Symposium, Mon, 1:15 PM-2:45 PM

Feasibility of implementing a resident oncology video curriculum. Sam Brondfield, Nicholas Iverson, Lakshmi Subbaraj, Jennifer Babik; University of California San Francisco, San Francisco, CA; University of California, San Francisco, San Francisco, CA Background: ACGME survey results consistently show that 40% of University of California, San Francisco (UCSF) internal medicine (IM) residents are dissatisfied with their oncology education— higher than the oncology national average and highest among UCSF IM subspecialties. A needs assessment revealed that UCSF residents desire online oncology resources for asynchronous learning. To address this need, we sought online oncology videos targeted to residents but found none. We thus used cognitive theory of multimedia learning principles to develop an oncology video curriculum and evaluated three feasibility components: demand (frequency of use), efficacy, and acceptability. Methods: We chose common cancers from the ABIM blueprint and filmed five 10-minute videos of UCSF oncologists discussing content they chose for residents. We created modules with pre/post tests derived from video content. After a pilot, we sent links to all IM residents on required oncology clinic rotations over four months (n = 25) and offered protected clinic time for optional completion. We compared pre/post test scores with a paired t test and surveyed residents. Results: Demand: 72% (18 of 25) completed $1 module; 32% completed all 5. Efficacy: The mean pre- vs. post-test score improved (50% vs. 87%, p = 0.002). Acceptability: 64% completed the survey. Of those who completed $1 module, 93% (13 of 14) felt strongly that the videos contributed to their knowledge. 93% recommended the videos to others. Residents praised the length, key points, and pre/post tests. Finding time for the modules was difficult; most did them at home. Suggestions included focusing on fundamentals and creating videos for all common cancers. Conclusions: We present demand, efficacy, and acceptability evidence supporting the feasibility of a resident oncology video curriculum. Formal protected time for module use is critical. We will focus on fundamentals for generalists as we make more videos. We will track ACGME survey results, examination scores, and clinical performance to study impact. We aim to publish the modules online for broader use and as a model solution to address similar needs across specialties and institutions, as complex resident schedules increasingly require asynchronous learning.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10501

Clinical Science Symposium, Mon, 1:15 PM-2:45 PM

Which factors are influencing good digital education? Analysis on ecancer programs from major international congresses. Danny Burke, Eva Thalmann, Gordon McVie; ECancer Global Foundation, Bristol, United Kingdom; Janssen, The Pharmaceutical Companies of J&J, Vienna, Austria Background: Factors limit the opportunities for healthcare professionals to attendinternational conferences including lack of financial support or time. Digital education from Independent Medical Education providers is therefore an important source of education for clinicians. One such provider is the ecancer Global Foundation (ecancer), an educational charity who publish ecancer.org. A landmark ecancer activity is sharing developments from conferences with video interviews of experts discussing the key data. Methods: We aim to get a deeper understanding of the factors that influence viewer satisfaction with these resources including whether industry support (through un-restricted educational grants) had a significant impact. Viewer satisfaction is measured using 3 metrics: 1. Viewer feedback; 2. Number of views; 3. Average viewing time. The analysis is based on programs from ASCO GU 2018, ASCO 2018 andESMO 2018 covering prostate and lung cancer education including unsupported as well as industry supported programs by Janssen, and two other pharma companies through unrestricted educational grants. Results: 68 videos were analysed with 95,249 views. This included 4 Expert to Expert Interviews, 4 Expert Panel Discussions and 60 To Camera Interviews. Of the 68 videos, 24 were supported by industry and all were peer-reviewed. Viewer feedback includes Net Promotor Score and a measure of likely impact on clinical practice as a result of watching the video. Conclusions: Expert to Expert and Expert Panel formats achieve higher viewer satisfaction than To Camera Interviews. Viewer satisfaction scores are very similar for industry supported vs non-industry supported content. These findings seem to suggest that the format of the educational video is a more important factor than whether it is supported by industry when impacting viewer satisfaction. Video format To camera (supported) To camera (nonsupported) Expert to Expert Expert Panel Discussion

Industry support

Views NPS

Impact on clinical practice rating

Viewing time

Viewing percentage

Yes No

1,251 23 1,256 24

4.2/5 4.0/5

03:54 03:33

44% 42%

Yes Yes

2,408 33 2,727 33

4.5/5 4.5/5

06:07 08:33

37% 46%

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

LBA10502

Clinical Science Symposium, Mon, 1:15 PM-2:45 PM

Survey of sexual harassment and gender disparities among gynecologic oncologists. Marina Stasenko, Christopher M. Tarney, Mitchell Veith, Kenneth Seier, Yovanni Casablanca, Carol L. Brown; Memorial Sloan Kettering Cancer Center, New York, NY; WRNMMC, Bathesda, MD; Wright Patterson Med Ctr, Beavercreek, OH The full, final text of this abstract will be available at abstracts.asco.org at 7:30 a.m. ET on Monday, June 3. Onsite at the Meeting, this abstract will be printed in the Monday edition of ASCO Daily News.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10503

Clinical Science Symposium, Mon, 1:15 PM-2:45 PM

Evaluating unconscious bias: Speaker introductions at an international oncology conference. Narjust Duma, Urshila Durani, Cynthia Brooke Woods, Lionel Aurelien Kankeu Fonkoua, Joselle Cook, Christopher Wee, Harry E Fuentes, Miguel Gonzalez-Velez, Martina Cathryn Murphy, Shikha Jain, Ariela Lucy Marshall, Stephanie L. Graff, Miriam Knoll; Mayo Clinic, Rochester, MN; Crescent Community Health Center, Dubuque, IA; Mayo Clinic, Phoenix, AZ; Shands/Univ of Florida, Gainsville, FL; Rush University Medical Center, Chicago, IL; Sarah Cannon Cancer Institutes HCA Midwest Health, Overland Park, KS; Mount Sinai Medical Center, Passaic, NY Background: Gender bias can be reinforced through the use of gender-subordinating language and differences in the forms of address. We examined how professional titles were used during speakers’ introductions at the American Society of Clinical Oncology (ASCO) Annual Meeting. Methods: A retrospective observational study of video-archived speaker introductions at the 2017 and 2018 ASCO annual meetings was conducted. Data were extracted by mixed-gender coders. Professional address was defined as professional title followed by full name or last name. Multivariable logistic regressions were used to identify factors associated with the form of address. Results: 2511 videos were reviewed and 812 met inclusion criteria. Regarding speakers’ characteristics, 530 (65%) were nonHispanic white (NHW), 743 (92%) held a MD or MD-PhD degree, and 484 (60%) were an associate or full professor. Female speakers were less likely to receive a professional address compared to male speakers (61% vs. 81%, p , 0.001). Female speakers were more likely to be introduced by first name only (17% vs. 3%, p , 0.001). Males were less likely to use a professional address when introducing female speakers compared to male speakers (53% vs. 80%, p , 0.01). No gender differences in professional address were observed for female introducers (p = 0.13). Male introducers were more likely to address female speakers by first name only compared to female introducers (24% vs. 7%, p , 0.01). In a multivariable regression including gender, race, degree, and academic rank, male speakers were more likely to receive a professional address compared to female speakers (OR: 2.67, 95%CI: 1.81-3.94, p , 0.01). Black speakers of both genders were less likely to receive a professional address compared to NHW (OR: 0.10, 95%CI: 0.01-0.53, p , 0.01). Female gender was a predictor for a non-professional form of address (first name only) (OR: 9.50, 95%CI: 4.38-20.62, p , 0.01). Conclusions: When introduced by men, female speakers were less likely to receive a professional address and more likely to be introduced by first name only compared to male speakers. Selective use of forms of address may strengthen gender bias; more research is needed to explore the causes of this disparity and its influence.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10504

Poster Session (Board #83), Sat, 1:15 PM-4:15 PM

Gender-based analysis of pre-residency research productivity among a current United States radiation oncology resident class. Shearwood McClelland, Blair Murphy, Jerry Jeff Jaboin, Richard C. Zellars; Indiana University School of Medicine, Indianapolis, IN; Oregon Health and Science University, Portland, OR; Washington University Medical Center, Springfield, MO; Indiana University Dept of Radiation Oncology, Indianapolis, IN Background: The increasing proportion of women in medicine has not been adequately reflected in the gender distribution of residents, particularly in highly competitive subspecialties such as neurosurgery and radiation oncology. The presence of at least one pre-residency peer-reviewed publication (PRP) was found to be associated with future resident choice of academic over private practice career in a recent radiation oncology resident graduating class, with no significant gender difference in the likelihood of having a PRP (McClelland et al., Practical Radiation Oncology 2017). We sought to pursue a genderbased analysis of PRP productivity in a current junior resident class. Methods: A list of radiation oncology residents from the graduating class of 2022 (PGY-2 academic year of 2018-2019) was obtained through internet investigation. In addition to gender, demographics included dual degree status and presence/absence of a PhD. Research productivity was calculated using PRP number, defined as the number of a resident’s publications listed in PubMed (pubmed.gov) through the calendar year of residency application (2016 for the class of 2022), as previously described. Fisher’s exact test was used for statistical analysis. Results: Of 179 residents examined from the 2022 class, 55 (31%) were women, representing a nine percent increase from the resident class of 2016. Four-fifths had at least one PRP, 33% had dual degrees, and 18% had a PhD. These percentages were comparable to their male counterparts, 73% of whom had at least one PRP, 28% who had dual degrees, and 15% who had a PhD. Specific analyses revealed no statistically significant differences by gender in any of these benchmarks (p.0.05). Conclusions: While slower than the overall trend of increased female representation in medicine, the proportion of women in radiation oncology residency has increased by approximately 1.4% per year over a recent six year span. There remain no significant differences in PRP productivity between male and female residents, and there are no significant gender differences in the likelihood of dual degree status or PhD status. Further study will be needed to determine how these findings manifest in career choice following graduation.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10505

Poster Session (Board #84), Sat, 1:15 PM-4:15 PM

Humanism in global oncology curricula: An emerging priority. Meredith Elana Giuliani, Maria Athina (Tina) Martimianakis, Janet Papadakos, Michaela Broadhurst, Erik Driessen, Janneke Frambach; Princess Margaret Cancer Centre, Toronto, ON, Canada; Hospital For Sick Children, Toronto, ON, Canada; Maastricht University, Maastricht, Netherlands Background: Training in humanism provides the skills to achieve shared decision making with patients and their families, to navigate systems level challenges and to function positively within the healthcare team. However, there is potentially a lack of attention to humanistic competencies in global oncology curricula due to the dominance of the biomedical model in curriculum design, the challenge of assessing humanistic competencies and global cultural considerations. The aims of this study were to explore to what extent humanistic competencies are included in global oncology curricula and the nature of the humanistic competencies included. Methods: Sixteen global oncology curricula identified in a prior systematic review were analysed. The curricula were coded using the Gold Foundation’s I.E.C.A.R.E.S (Integrity, Excellence, Collaboration & compassion, Altruism, Respect & Resilience, Empathy and Service) humanistic competency framework and the CanMEDS framework. Descriptive statistics were used to describe the proportion of items attributed to each aspect of the framework. Results: 7733 curricular items were identified in the 16 curricula and 729 (9%) aligned with the I.E.C.A.R.E.S framework. The proportion of humanistic items in individual curricula ranged from 2% to 26%. The proportion of humanistic items has been increasing from the curricula published in 19801989 (3%) to the curricula published in 2010-2017 with a mean of 11% (4 to 25%). There was a higher proportion of humanistic competencies in curricula from the European region (9%) than in other regions. Of the humanistic items 35% were under respect, 31% under compassion, 24% under empathy, 5% were under integrity, 2% under excellence, 1% under altruism, and 1% under service. The majority of the humanistic items also aligned with the professional (35%), medical expert (31%) or communicator (26%) CanMEDS domains. Conclusions: The proportion of humanistic competencies has been increasing in global oncology curricula over time however the overall proportion remains low. Humanism is largely represented by competencies of respect, compassion and empathy and there exists a conflation between humanism and professionalism. Future global curricular efforts may benefit from attention to incorporating all aspects of humanistic competencies.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10506

Poster Session (Board #85), Sat, 1:15 PM-4:15 PM

Integrating concept maps into a medical student oncology curriculum. Sam Brondfield, Allen Seol, Katherine Hyland, Arianne Teherani, Gerald Hsu; University of California San Francisco, San Francisco, CA; University of California, Irvine, Irvine, CA; San Francisco VA Medical Center, San Francisco, CA Background: Proliferating knowledge domains have prompted medical schools to reconsider how best to facilitate multidisciplinary learning. Concept maps promote knowledge retention and integration; however, the feasibility and utility of integrating concept maps into a medical student oncology curriculum as a learning and assessment tool have not previously been described. Methods: In 20152016, all 152 second-year University of California, San Francisco (UCSF) medical students in a hematology/oncology course produced a concept map about a single cancer type over four weeks. Two of three graders independently scored each map using a standard rubric. We used linear regression to calculate the Pearson correlation coefficient between graders and between concept map scores and preclinical examination scores, USMLE Step 1 scores, and clerkship grades. We sent course evaluations to 50 randomly selected students (as is typical in the UCSF curriculum) and performed an inductive content analysis of open-ended comments about concept mapping. Results: We graded all 152 concept maps. Inter-rater reliability was excellent (r = 0.95 or greater between the graders). Concept map scores did not correlate with preclinical or clinical performance. 43 of 50 students (86%) rated the helpfulness of concept mapping on a 5-point agreement scale (1=strongly disagree; 5=strongly agree). The median rating was 3, and the mean (SD) rating was 2.81 (1.44). 22 of 50 (44%) students submitted comments about concept mapping. Some (9 of 22) found concept mapping useful, expressing themes such as “learning the material better” and delving into the “details.” Others (7 of 22) did not, expressing themes such as preferring “other study methods” and feeling that concept mapping was “busy work” or “stressful.” Conclusions: Integrating concept maps into a medical student oncology curriculum was feasible, and we demonstrated reliability evidence as an assessment tool. Future studies should explore whether integrating concept maps earlier in medical school, producing multiple concept maps over time with training and feedback, or developing concept maps collaboratively may increase utility as a learning and assessment tool.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10507

Poster Session (Board #86), Sat, 1:15 PM-4:15 PM

Development of an “Art of Oncology” curriculum to mitigate burnout and foster solidarity among hematology/oncology fellows. Daniel R. Richardson, Gary Winzelberg, Donald Lee Rosenstein, Frances A. Collichio; The Cecil G. Sheps Center for Health Services Research, Chapel Hill, NC; University of North Carolina at Chapel Hill, Chapel Hill, NC; University of North Carolina School of Medicine, Chapel Hill, NC Background: Oncologists and fellows in Hematology/Oncology (HO) training programs report high levels of burnout. The ACGME requires accredited programs to have a mechanism to foster “well-being” and “ethical behavior” among fellows. A loss of solidarity among oncology professionals may contribute to known causes of burnout, such as heavy workload and severity of patient illness, that may in turn negatively impact patient outcomes. Methods: Through a multidisciplinary process involving fellows and faculty from psychiatry, palliative care, and hematology/oncology, a 3-year longitudinal “Art of Oncology” (AOO) curriculum was created for HO fellows at our institution to foster solidarity and mitigate burnout. The curriculum principally involved monthly hour-long sessions intended to promote reflection on oncologists’ shared experiences and the humanistic aspects of caring for patients with cancer. Facilitated by topic experts utilizing personal and published narratives, sessions foster group discussion. Fellows are also invited to write a personal narrative reflecting on their role as an oncologist. Topics include death and dying, caring for patients after treatment failure, cultivating resilience, religion/spirituality, the moral responsibility of oncologists, and oncology as a calling. Cancer patients and spouses were invited to facilitate a session to emphasize the patient experience. Burnout and preparedness for covered topic areas were measured prior to curriculum initiation and will be re-assessed annually. Results: The curriculum began in 2018. Of current fellows, 94.7% (18/19) completed the initial survey. A greater proportion of HO fellows participated in the AOO sessions than non-AOO didactic lectures (mean attendance, 59.2% v. 42.7%, p = 0.037). At curriculum initiation, most fellows reported burnout a few times or more a month (all fellows = 75%, 1st year = 85.7%, 2nd year = 80%, and higher = 62.5%). Conclusions: The implementation of a dedicated curriculum to foster solidarity among HO fellows through narrative medicine and group discussion of the humanistic aspects of oncology is feasible. A substantial degree of burnout exists among HO fellows, even incoming fellows. Further research to assess whether this curriculum mitigates burnout is needed. Because burnout is already a problem for incoming fellows, further work should investigate interventions aimed at ameliorating burnout among both residents and fellows.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10508

Poster Session (Board #87), Sat, 1:15 PM-4:15 PM

Mindful fellows: Study results from a pilot wellness curriculum in hematology oncology. Monica Sheila Chatwal, Christine Vinci, Richard R. Reich, Marc McDowell, Angela Reagan, Jhanelle Elaine Gray; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL Background: Rates of physician burnout, depression, and career dissatisfaction are rising. It is imperative to develop solutions. Studies find mindfulness is an effective therapeutic means for physician burnout, but few programs address this in clinical trainees, specifically hematology oncology fellows. The aims of this pilot study were to determine the feasibility and acceptability of a mindfulnessbased wellness curriculum. To our knowledge, this is the first study assessing this type of intervention in this population. Methods: In this single center, nonrandomized study, six monthly 30-45 minute sessions were integrated within the framework of existing didactic conferences. Each session had two parts – didactics on mindfulness and guided meditation exercises. Sessions were led by a social worker trained in mindfulness techniques. Participants completed pre and post intervention questionnaires, including Mindfulness Attention Awareness Scale (MAAS) (Carlson, 2005), Perceived Stress Scale (PSS) (Cohen, 1983), and reflection questions, with an opportunity for free responses. The primary endpoint was feasibility as determined through recruitment (target 70%) and treatment adherence defined as participation and questionnaire completion (target 80%). A secondary aim was acceptability determined through self-reflection questions (target 80%). Results: A total of 27 participants (59% female) enrolled with 37% in post-graduate year 6 (PGY-6). Of the eligible fellows, 96% enrolled and 96% of participants completed questionnaires. On self-reflection questions, 65% reported that the program was useful and 81% reported they would participate again in the future. Participants suggested modifications including location, timing, and a broader scope to include skills in addition to mindfulness (e.g. resiliency-focused). Data on self-reported levels of stress and self-awareness, an exploratory aim, will be presented at the meeting. Conclusions: Findings indicate that a mindfulnessbased wellness curriculum was both feasible and acceptable for hematology oncology fellows. Modifications are being made to expand on this program, and incorporate it as a recurring component of the existing curriculum.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10509

Poster Session (Board #88), Sat, 1:15 PM-4:15 PM

Management of muscle-invasive bladder cancer with bladder preservation in Russia: A survey-based analysis of current practice and the impact of an educational workshop on clinical expertise. Natalia Dengina, Marina Chernich, Sergey Usychkin, Catherine Degnin, Yiyi Chen, Oleg Gladkov, Dmitry Nosov, Ilya Tsimafeyeu, Charles R. Thomas, Sergei Tjulandin, Timur Mitin; Ulyanovsk Regional Cancer Center, Ulyanovsk, Russian Federation; PET-Technology Podolsk, Podolsk, Russian Federation; Medscan Clinic, Moscow, Russian Federation; Oregon Health and Science University, Portland, OR; Evimed Medical Center, Chelyabinsk, Russian Federation; The Central Clinical Hospital of the Presidential Administration of the Russian Federation, Moscow, Russian Federation; Russian Society of Clinical Oncology, Moscow, Russian Federation; Oregon Health & Science University, Portland, OR; Russian Cancer Research Centre, Moscow, Russian Federation Background: Trimodality bladder preservation (BP) is an accepted alternative to radical cystectomy for patients with muscle-invasive bladder cancer (MIBC). The global utilization of BP is variable, and practice patterns have not been previously studied in Russia. During the Russian Annual Oncology Congress, organized by the Russian Society of Clinical Oncology in November 2018, our group has conducted a contouring workshop for Russian radiation oncologists (ROs). We sought to elucidate the contemporary practice patterns in Russia and determine the impact of this workshop on attitudes of Russian ROs towards BP. Methods: Pre- and post-workshop IRB-approved surveys were analyzed to determine baseline clinical experience and patterns of care among Russian ROs. The effect of the contouring workshop on participants’ knowledge and attitudes was performed using tests for paired nominal data. Results: We analyzed 77 pre-workshop and 32 matched post-workshop questionnaires. 56% (43 out of 77) of respondents treated MIBC patients with bladder-directed radiation therapy (RT). Of these, 40% (17 out of 43) treated only inoperable patients, and 60% treated both operable and inoperable MIBC patients. 14% offered RT alone to their patients, while the rest offered concurrent chemoRT. 63% (26 out of 41) offered suboptimal concurrent systemic agents, such as single agents carboplatin or paclitaxel. 63% of respondents felt that BP can only be done in specialized centers with established expertise, but only 10% felt uncomfortable offering an MIBC patient a BP option in their clinic. Prior to workshop, 40% of respondents estimated universal poor bladder and erectile functions after BP. The workshop resulted in dramatic change in participants’ attitudes towards BP long-term urinary (Stuart-Maxwell-test, p , 0.01), and sexual (exact McNemar test, p , 0.01) side-effects. Prior to workshop, only 52% of respondents routinely discussed smoking cessation (SC) with their patients, whereas after workshop almost 90% agreed that SC discussion is mandatory (exact McNemar test, p = 0.04). Conclusions: Bladder preservation is commonly used in Russia in the management of MIBC patients. Our contouring workshop resulted in dramatically improved understanding of long-term BP toxicities and inspired Russian ROs to incorporate smoking cessation counseling into routine clinical practice. International educational efforts are critical to improve multi-disciplinary management of MIBC patients.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10510

Poster Session (Board #89), Sat, 1:15 PM-4:15 PM

Molecular profiling (MP) for malignancies: Knowledge gaps and variable practice patterns among United States oncologists (Onc). Bhavana Pendurthi Singh, Susan Lynne Britton, Petra Prins, Chao Yin, Maria L. Lankford, Joanne P. Willey, Arden Buettner, Brynn Tiscione, Mitchell Scharf, Jan Blancato, John Marshall; Medstar Georgetown University Hospital, Washington, DC; Xcenda, Palm Harbor, FL; Xcenda, Tampa, FL; Lombardi Comprehensive Cancer Center, Washington, DC; Georgetown University, Washington, DC Background: Clinically impactful therapies for malignancies require the identification of specific molecular alterations. Onc must be aware of these targets and how to interpret them to provide optimum care. The use of MP has become the standard of care for many cancers, and is recently FDA approved. Using 2 data sets, we assessed the current awareness and incorporation of MP in the treatment of cancer; comparing data from community based Onc (C) to academic Onc (A). Methods: C consisted of 292 physicians polled using an audience response system during 6 case-based research events across the US. Questions focused on various aspects of molecular testing. Data for A was obtained from a chart review focused on timing and extent of MP in disease specific academic practices (lung, breast, GI) (N = 59). Results: Within C, 257 (88%) were Onc from community-based practices. The frequency at which Onc ordered MP significantly varied depending on tumor type; 33% in lung cancer (LC), 18% in colorectal cancer (CRC) and less commonly in breast cancer (BC) (8%). In A, MP was ordered more frequently; 74% in LC, 27% in CRC and 0% in BC. These results reflect a gap in practice among community versus academic Onc, as C had lower utilization of MP for both LC and CRC. In C, Onc were also asked to match the molecular alteration with the appropriate targeted therapy. Onc incorrectly matched the molecular alteration to the targeted therapy or marked unknown in up to 69%. This reflects a large knowledge gap among community Onc with regards to the correct application of MP to currently FDA approved targeted therapies. Conclusions: Given the significant knowledge and practice gap, we conclude there is an urgent need for focused educational activities that facilitate improved knowledge of MP and corresponding personalized therapeutic strategies for Onc in the US.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10511

Poster Session (Board #90), Sat, 1:15 PM-4:15 PM

Evaluation of Colorado oncology providers on the use of medical marijuana. Ashley Elizabeth Glode, Garth C. Wright, Stephen Leong; Univsersity of Colorado, Aurora, CO; University of Colorado, Aurora, CO; University of Colorado Comprehensive Cancer Center, Aurora, CO Background: There is a lack of knowledge regarding medical marijuana use in cancer patients. More information is needed due to increase in both state approvals and access to medical marijuana. We hypothesized that variation in provider knowledge, attitudes, and behaviors exists across all professions in oncology, which contributes to a lack of both provider awareness of patient use and patient education on marijuana use. Methods: A survey was distributed to oncology providers in the state of Colorado. The primary objective was to describe provider knowledge, attitudes, and behaviors regarding medical marijuana use in cancer patients. Other objectives were identifying educational needs for oncology providers to feel comfortable recommending medical marijuana and reporting provider interest in future marijuana studies. Results: We received responses from 172 oncology providers; 48 advanced practice providers, 47 physicians, 53 registered nurses, 17 pharmacists, and 7 other. Most providers (73.3%) believe marijuana provides a medical benefit to cancer patients, and 81.5% believe it should be available as a prescription drug. Yet, 60.1% had not recommend its use to any cancer patient in the past 6 months, and 54.3% are not comfortable recommending or suggesting it to a patient to manage cancer related symptoms. Major concerns included uncertain dosing (83%), limited knowledge of available products and where to get them (73.1%), and interactions with other medications (64.9%). Providers reported that educational programs for healthcare providers (79.3%), more clinical data (74%), and endorsed clinical guidelines (67.5%) would increase their comfort level in recommending medical marijuana. The areas of research most interesting or important were specific product information and doses (77.6%), efficacy for specific side effects (77.6%), and drug-drug interactions (74.7%). Conclusions: Regardless of profession, the majority of oncology providers in Colorado do not recommend and do not feel comfortable recommending or suggesting medical marijuana to a cancer patient, yet most believe it provides medical benefit. Providers believe there is a need for education and research on the use of medical marijuana in oncology patients.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10512

Poster Session (Board #91), Sat, 1:15 PM-4:15 PM

The higher school of oncology: An educational program adopting the western oncology experience in Russia. Ekaterina Baron, Michelle Sittig, Vadim Gushchin; Mercy Medical Center, Baltimore, MD Background: Disparities in current global oncology care are a major concern for many societies. Two-year oncological training in Russia is deficient in evidence-based medicine (EBM) and effective patient communication skills, despite the fact that these dictate the ability to provide optimal cancer care. We report a 3.5-year sustained program aimed at implementing Western-oriented education among young Russian oncologists to combat these educational deficiencies. Methods: The Higher School of Oncology (HSO) is a 5-year national competitive program established to supplement the traditional 2-year Russian oncology curriculum with an emphasis on patient communication, critical appraisal of oncologic articles, multidisciplinary cancer care, and program development. A total of 35 PGY1-4 residents (8-9 residents annually) have enrolled in the program. Expatriate Russian physicians practicing in the US led 140 online educational seminars with journal clubs and clinical case presentations. Communication skills were evaluated by an independent private educational group. Results: Significant improvement of EBM knowledge was marked among HSO residents, from inability to explain basic concepts to practicing and teaching EBM. Beginning in the 3rd year of the program, residents organized educational courses and conducted journal clubs for HSO and non-HSO colleagues. Residents of the program had higher patient communication scores compared to that of residents of standard Russian programs. HSO residents promoted the spread and popularization of EBM and a patient-centered approach among attending physicians, improving the quality of cancer care. The HSO also triggered imitation of similar projects in other residency programs. Conclusions: The HSO project has pioneered EBM training and led to systemic changes in cancer patient care for Russian oncologists. This model has shown success and may be useful in overcoming global medical educational disparities in other specialties and in other countries facing similar challenges.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10513

Poster Session (Board #92), Sat, 1:15 PM-4:15 PM

Burnout and level of mental functioning in oncology staff. Adelina Alcorta-Garza, Fernando Alcorta-Nu~ nez, Oscar Vidal-Gutierrez, ´ Juan Francisco Gonzalez´ Guerrero, Antonio Cesar ´ Garza-Guerrero, Marco Vinicio Gomez-Meza, ´ Angel Enrique Alcorta-Garza; University Hospital, Monterrey, Mexico; UANL, San Pedro Garza Garcia, Mexico; UANL, Monterrey, NL, Mexico; UANL, Monterrey NL, Mexico Background: The Burnout Syndrome takes relevance for its investigation since 1986, when Maslach developed a survey for its study with 3 subscales that include the symptoms generated by exhaustion and chronic labor stress. Health workers are especially vulnerable to the development of this syndrome, which is greater centers with exposure to patients with severe and/or chronic ailments. Thus, the mental structure maturity level with which the individual functions takes relevance, since it is linked to the quality of judgment of the clinician. Few studies consider this aspect because of the complexity of having the instruments and professionals to assess it. It has been questioned whether Burnout or this occupational exhaustion damages the quality of life of the individual, and if it also negatively impacts their work performance, and the quality of care provided to patients. Methods: Observational, cross-sectional and correlational study. It analyses the relationship between Burnout and the characteristics of the mentalstructural functioning level in oncology staff, and its association with the level of functionality of the mental structures within the work environment. Prior validation of the instrument was conducted, FIAD-15, with acceptable Alpha of 0.81. Results: Data were obtained from 1,060 subjects, including administrative, nursing and medical members of the Oncology Service staff, as well as, students. Out of these, 1,036 subjects answered the questionnaire appropriately and were considered in the analysis. 413 (39.86%) presented Burnout. The prevalence was higher in men (45.17%) than in women (34.56%). A significant association was found between Burnout frequency and levels of mental functioning. On the functionality of the mental structures, 80% had functional, high and intermediate levels, while 20% of the total population showed a borderline level of functionality (severe). In women, Burnout frequency was higher in borderline levels, followed by those of functional and high level. In men, Burnout was higher in those at the borderline level, followed by functional and intermediate; it was much lower in high level subjects. Conclusions: The mental structure functionality levels found in the oncology staff are associated with Burnout; which is lower in men with structures with high functionality and in women in the intermediate level. Subjects with borderline structures suffer greater Burnout. Further studies should be carried out to support these findings in the future and open new lines of research.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10514

Poster Session (Board #93), Sat, 1:15 PM-4:15 PM

Implementation of competency-based medical education in a Canadian medical oncology training program: Lessons from our first year. Anna T. Tomiak, Geordie Linford, Micheline McDonald, Jane Willms, Nazik Hammad; Queen’s University, Kingston, ON, Canada; Department of Oncology, Cancer Center of Southeastern Ontario, Queen’s University, Kingston, ON, Kingston, ON, Canada; Department of Oncology, Cancer Center of Southeastern Ontario, Queen’s University, Kingston, ON, Canada Background: As part of a university wide initiative, CBME was implemented in our MO training program in July 2017. Stages, Entrustable Professional Activity (EPA) assessments and Required Training Experiences established by the Royal College of Physicians and Surgeons of Canada were adopted. MedTech Central, the electronic portfolio developed at our university was used for assessment collection. We share here observations and experiences from our first year of implementation. Methods: Assessment metrics were obtained through MEdTech. Ethics was granted by Queen’s University as part of an ongoing research study on feedback. Lessons learned were compiled from discussions between the Program Director, Residents, Program Administrator, CBME Education Consultant and CBME lead. Results: A total of 195 assessments were completed July 2017-November 2018. 81% were EPA assessments and the remainder multisource feedback, rubrics and field notes. The median number of assessments per faculty was 17 (0-42). 52% of assessments included written “Comments” or “Next steps”. A median of 6 assessments per faculty member included specific or actionable feedback. Lessons learned centered on: 1) Faculty and Resident development and engagement (critical before, during and after implementation); 2) Value of sharing work of CBME (CBME Education Consultant, CBME Lead, Academic Advisors, Competence Committee); 3) Importance of effective communication strategy with stakeholders 4) Importance of collaboration with other training programs at institutional and national levels; 5) Culture change (a slow process); 6) Resident concerns regarding lack of global assessment; 7) Assessment plan challenges (How many observations required?); 8) Burden of CBME (Resident driven assessments or a better balance?) ; 9) Limitations of eportfolio (How to live track and by whom?); 10) Costs 11) Value of continuous quality assurance and improvement. Conclusions: Our first year of implementation was successful in introducing CBME concepts, work based assessments and e-portfolios. Ongoing work is needed, including increasing the number of assessments and quality of feedback.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10515

Poster Session (Board #94), Sat, 1:15 PM-4:15 PM

ASCO Direct GU: A multistakeholder blended-learning project to make global education local. Kurt Miller, Suneil Singh Malhotra, Daina Nanchanatt, Eva Thalmann, Robert A. Van Der Zwart, Steven Joniau; Department of Urology, Charite´ Berlin, Berlin, Germany; Bayer U.S., Whippany, NJ; Bayer HealthCare, Whippany, NJ; Janssen, Pfarrgasse 75, Austria; Quadia Online Video, Hilversum, Netherlands; University Hospitals Leuven, Leuven, Belgium Background: International clinicians (HCPs) often find it difficult to attend North American congresses due to time out of the clinic, institutional travel restrictions, & individual financial burden. HCPs continue to highlight the value of peer to peer scientific exchange at international meetings & peer reviewed journals. Coupled with the dramatic increase of new scientific & clinical data that are rapidly changing clinical paradigms, there is a need for an effective & efficient digital solution to reach as many HCPs as possible. ASCO GU Direct sought to develop an educational program that culled the latest clinical & scientific data from ASCO GU in real time to global HCPs. ASCO GU Direct is a partnership between ASCO, MEDtalks Netherlands, Bayer & Janssen to drive global education locally since 2016. The live connection was broadcast in real time to local digital hubs in Europe, Middle East & Asia, where an expert panel from ASCO GU reviewed key scientific data with local HCPs in real time. HCPs were able to view ASCO presentations & ask questions to the panel despite time zone & geography. Methods: We present results from the surveys done with participating HCPs to understand the effectiveness of this blended program by examining the quality & objectivity of the content, impact on their clinical treatment, & the Net Promotor Score (NPS). Results: To measure quality & objectivity, NPS was calculated based on HCP responses to: “Would you recommend ASCO GU Direct to a colleague.” The NPS was 59 in 17 & 72 in 18 (scale: -100 to +100), showing willingness to recommend the educational program. Conclusions: Providing digital access can effectively & efficiently bridge gaps that would otherwise exist for international HCPs who did not attend ASCO GU. Digital access through this collaboration with live access to experts provides an excellent solution for HCPs who want to remain updated on clinical & scientific data.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10516

Poster Session (Board #95), Sat, 1:15 PM-4:15 PM

TeamX integrative oncology scholars: Harnessing the potentials of students in shaping oncological care. Kin Wai (Tony) Hung, Ka-Kit Hui, Irene S. Kim, Silvia Orvietani Busch; Olive View UCLA Medical Center, Sylmar, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA; UCLA Center for East West Medicine, Santa Monica, CA Background: Teams are critical in delivering patient-centered care amid the challenge of health care workforce shortages. While conventional team-based collaborative care model involves physician and non-physician professionals, roles for pre-professional students in teams are largely educational and arguably underutilized. Methods: In a collaborative effort with the University of California Los Angeles (UCLA) Center for East West Medicine (CEWM), TeamX Health, a 501(c)3 nonprofit organization, designed an innovative, team-based curriculum for pre-professional students with our aims to harness the potentials of students in shaping the present and future delivery of oncological care. Over a 10-week academic quarter, students are challenged to explore the evolving evidence-based specialty of integrative oncology, and delivered as a “capstone project”, a creative solution to problems facing cancer patients today. Results: From April 2018 through October 2018, two 6-student cohorts have completed the curriculum. 10 participants (83%) were undergraduates and 2 (17%) were postgraduate alumni. Participants were selected based on a competitive application process with commitment to engage in the 2-hour weekly learning session. Sessions were taught in team-based learning format, covering topics ranging from cancer prevention, survivorship, symptoms management, nutrition, complementary therapies, integrative medicine models, and informatics. At completion of the curriculum, cohort one launched a health promotion YouTube channel addressing the physical and emotional burden for cancer survivors, and cohort two published a website for patients and caregivers to share their cancer journey serving as a greater social support platform. Conclusions: Redesigning the educational experience for pre-professional students may unlock unexpected possibilities to shape how we learned from and care for our patients. Harnessing the potentials for all levels of stakeholders ought to be part of defining team-based collaborative care.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10517

Poster Session (Board #96), Sat, 1:15 PM-4:15 PM

Cross-cultural validation of a medical leadership competencies survey in Latin-American physicians: A multinational study. Max S. Mano, Rafaela Gomes, Carlos H. Barrios, Gustavo Nader Marta, Cynthia Villarreal-Garza, Antonio Luiz Frasson, Cinthya Sternberg, Renan Clara, Sergio D. Simon, Gustavo Werutsky, Fadil Çitaku; Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Latin American Cooperative Oncology Group, Porto Alegre, Brazil; Hospital Sı´rio-Libanes, ˆ S~ ao Paulo, Brazil; Centro de Cancer ´ de Mama, Hospital Zambrano Hellion-Tecnologico ´ de Monterrey, San Pedro Garza Garcı´a, Mexico; Pontifı´cia Universidade do Rio Grande do Sul, Porto Alegre, Brazil; Brazilian Society of Clinical Oncology, Sao Paulo, Brazil; Sociedade Brasileira de Oncologia Clinica (SBOC), Sao Paulo, Brazil; Albert Einstein Hospital, S~ ao Paulo, SP, Brazil; Academy of Leadership Sciences Switzerland, Zurich, ¨ Switzerland Background: Despite the growing complexity in the healthcare sector, physicians rarely receive formal training in leadership skills. In a previous survey, Citaku et el identified a set of leadership competencies (LC) which were evaluated by North-American (NA) and European (EU) leaders involved with medical education. We aim 1) To apply this same survey to a population of Latin-American (LA) physicians from the oncology community and related areas who hold leadership positions of various levels; 2) To compare the results with those of the previous survey and 3) To perform subgroup analyses within the LA cohort. Methods: The survey was sent to close to 8.000 members of contributing medical societies from LA countries. In addition to the 63 questions with 5 possible responses, we also collected data on type of institution (private vs public), country of practice, main specialty, gender, age, years of experience in oncology and years of experience in leadership position. Results: We collected a total of 217 responses on a web-based tool. LA leaders placed the highest value on task-management competencies(91,37% of `important` or `very important` responses vs 87,0% for NA/EU;p , .0001), followed by self-management(87,45% vs 87,55%; p = NS), social responsibility(86,83% vs 87,48%; p = NS), innovation(86,69% vs 85,31%; p = NS) and leading others(83,31% vs 84,71%; p = NS). Social responsibility, which was first in importance in the NA/EU survey, was only third in the LA survey. Subgroup analyses revealed significant interactions which will be fully presented. Conclusions: We successfully applied the survey to a population of LA medical leaders from the oncology community and related areas. LC valued by LA leaders somewhat differ from those valued by their NA/EU counterparts, implying that cultural aspects might influence the perception of desired/required LC. We also detected significant variations in the responses within the LA population. Our data might indicate that current physician leadership training programs should be tailored to suit specific needs and cultural aspects of each region. Further validation of this survey in other clusters of world culture is warranted.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10518

Poster Session (Board #97), Sat, 1:15 PM-4:15 PM

Support structures for female physicians: Motivations and barriers to gender-specific conferences and symposia. Shikha Jain, Stephanie L. Graff, M Swaroop, Nicole C. Woitowich; Rush University Medical Center, Chicago, IL; Sarah Cannon Cancer Institutes HCA Midwest Health, Overland Park, KS; Northwestern University Feinberg School of Medicine, Chicago, IL; Northwestern University, Chicago, IL Background: While nearly half of all medical school graduates are female, women remain underrepresented in the physician workforce. Conferences or symposia designed to address issues relevant to female physicians, such as gender-bias, sexual harassment, and work-life balance are one strategy to improve retention and advancement, yet, limited data exists surrounding their utility. To address this gap, we surveyed a multi-disciplinary group of female physicians to identify motivations or barriers to attendance. Methods: An online survey instrument was distributed nationally via social media and shared by respondents. The survey assessed participants’ demographics, attendance at gender-specific conferences or symposia, motivations or barriers to attendance, and perceived benefits of attendance. Results: Of 792 respondents, 34% had attended a conference or symposia for women in medicine, while 66% had not. Attendees were significantly more likely to hold a leadership position (68% vs. 43%, p , 0.0001), an academic faculty position (74% vs. 56%, p , 0.0001), and have received a professional accolade within the past year (42% vs. 28%, p , 0.0001). Non-attendees were significantly more likely to be the primary caregiver for children or seniors (64% vs. 56%, p = 0.042). Respondents indicated that an interest in discussion topics, a sense of community, and growth of professional network were key motivators in attendance. The majority of respondents indicated that attendance improved their self-advocacy, self-image, and leadership skills. Of those who did not attend, 51% were unaware of such conferences or symposia. Those who were aware, but unable to attend, cited lack of time as the major barrier to participation. Conclusions: The results of this study provide preliminary data surrounding gender-specific conferences or symposia for women in medicine and highlight opportunities for increased engagement. While not causative, attendees share attributes of professional success and report personal and professional benefits. Lack of awareness and access to child/family care are likely major barriers to participation, which can be addressed through strategic initiatives.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10519

Poster Session (Board #98), Sat, 1:15 PM-4:15 PM

Innovation, education, and research: A multidisciplinary survivorship care model. Hira Latif, Patrick Martone, James Edward Shaw, Eric Wisotzky, Asma Ali Dilawari; Medstar Washington Hospital Center, Washington, DC; Georgetown University Hospital, Washington, DC; MedStar National Rehabilitation Network, Washington, DC; MedStar Washington Hospital Center, Washington, DC Background: Advances in early detection, therapeutics, and an aging population are expected to lead to an increase in the number of cancer survivors in the United States to 20 million by year 2026. The Institute of Medicine and Commission on Cancer recommends delivery of survivorship care plans on completion of curative treatment. While models exist for high-quality survivorship care, institutions encounter barriers such as lack of resources and limited training in survivorship. Our institution piloted a unique model combining fellows’ education with guideline-driven recommendations from a multidisciplinary team to provide consolidated survivorship care. Methods: A survey for self-reported competence and experience was conducted amongst the hematology and oncology fellows at the MedStar Washington Hospital Center. A bimonthly clinic staffed by a medical oncologist, oncology fellow and a cancer rehabilitation fellow was initiated in September 2018. Didactic lectures, curriculum syllabus and recommended assessments were established. Screening tools for distress, patients’ confidence in knowledge about survivorship and physical function via PROMIS 20a were administered; clinical assessments including the “6-minute walk test” were used to assess cardiovascular health. Results: Most fellows had not encountered a survivor of lung (16%), GU (0%) and head and neck cancer (33%). Majority of the fellows had never delivered a survivorship care plan. Scores were low in competence and experience in survivorship. By December 2018, 15 patients with 17 diagnoses of cancer were referred to the clinic. 10 were survivors of hematologic malignancies while 7 were of solid tumors. The no-show rate was 40%. Fellows conducted the assessments and were supervised by an oncology attending. Of the 9 patients seen, 4 were referred for physical therapy; additional referrals for psychology and cardiology were frequent. Conclusions: A comprehensive multidisciplinary survivorship clinic focusing on fellows’ education is a feasible model for delivery of survivorship care and aims to bridge the gap in experience and competence of fellows. Future goals include re-assessment of patient-reported outcomes, physical function, and competence of fellows.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10520

Poster Session (Board #99), Sat, 1:15 PM-4:15 PM

It starts at the top: An analysis of female representation in academic medical oncology (MO), radiation oncology (RO), and surgical oncology (SO) program leadership positions. Mudit Chowdhary, Akansha Chowdhary, Kirtesh R. Patel, Trevor J. Royce, Neilayan Sen, Parul Nafees Barry, Shikha Jain, Ruta D. Rao, Mia Alyce Levy, Miriam Knoll, Neha Vapiwala, Dian Wang, Barbara Pro, Gaurav Marwaha; Rush University Medical Center, Chicago, IL; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Yale University School of Medicine, New Haven, CT; University of North Carolina School of Medicine, Chapel Hill, NC; Hackensack University Medical Center, Hackensack, NJ; University of Pennsylvania, Philadelphia, PA; Northwestern University, Chicago, IL Background: Female underrepresentation in academic medicine leadership is well-documented; however, oncology specific data are scarce. This study evaluates female leadership representation in academic medical oncology (MO), radiation oncology (RO) and surgical oncology (SO) programs. Furthermore, we examine the impact of female leadership on overall female faculty representation. Methods: A total of 264 (96%) Accreditation Council for Graduate Medical Education actively accredited MO [144 of 153], RO [93 of 94] and SO [27 of 27] training programs were included. The gender of overall faculty and those in leadership positions (program director and departmental chair/division chief) of each program was determined using hospital websites from 10/01/18 to 01/27/ 19. The chi-squared goodness-of-fit test was used to examine whether the observed proportion of females in leadership positions deviates significantly from the expected proportion based on the actual proportion of overall female faculty in MO, RO and SO. Two-sample t-tests were used to compare rates of female faculty representation across each program based on the presence/absence of female in a leadership position for MO, RO and SO. Results: Female faculty representation in MO, RO and SO was 37.1% (1,554/4,191), 30.7% (389/1,269) and 38.8% (212/546), respectively. Female representation in leadership positions was 31.5% (82/260), 17.4% (31/178) and 11.1% (5/45), respectively. The observed proportion of females in leadership positions was significantly lower than the expected proportion of females in leadership positions for RO (17.4% vs. 30.7%, p = .0001) and SO (11.1% vs. 38.8%, p = .0001), and demonstrated a trend towards significance for MO (31.5% vs. 37.1%, p = .063). 47.9%, 33% and 18.5% of MO, RO and SO programs had $1 female in a leadership position, respectively. Programs that had a female in a leadership position had a higher mean percentage of overall female faculty than those that did not: 41.0% vs 35.0% (p = .0006), 36.0% vs 26.0% (p = .0002) and 39.0% vs 32.0% (p = .348) for MO, RO and SO, respectively. Conclusions: Gender disparity exists in academic MO, RO and SO faculty and is magnified at the leadership level. Programs with a female physician in a leadership position are associated with a higher percentage of female faculty.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10521

Poster Session (Board #100), Sat, 1:15 PM-4:15 PM

Medical oncologists’ experience with returning molecular tumor profiling to patients. Subotheni Thavaneswaran, Christine Napier, David Goldstein, Bettina Meiser, Phyllis Butow, David Morgan Thomas, Mandy L. Ballinger, Megan Best; The Garvan Institute of Medical Research, University of New South Wales, Sydney, Australia; Garvan Institute of Medical Research, Darlinghurst, Australia; Prince of Wales Hospital, Randwick, Australia; Psychosocial Research Group, Department of Medical Oncology, Prince of Wales Hospital and Prince of Wales Clinical School, UNSW, Sydney, Australia; Psycho-Oncology Co-operative Research Group (PoCoG), University of Sydney, Sydney, Australia; Chris O’Brien Lifehouse, Camperdown, Australia; Garvan Institute of Medical Research, University of New South Wales, Darlinghurst, NSW, Australia; Psycho-Oncology Co-operative Research Group (PoCoG), Camperdown, NSW, Australia Background: Molecular tumor profiling (MTP) to guide therapy is increasingly being applied in the clinic, although how medical oncologists (MOs) manage this in clinical practice is not fully understood. Methods: An online survey explored MOs’ experience with MTP interpretation, treatment (tx) decisions, identifying resources, and communicating results to patients with cancer. MOs were identified based on their participation in the Australian Molecular Screening and Therapeutics Program. Results: 108 MOs (57% male, median years of practice, 5-9 years, 83% urban-based practice and median age range, 40-49 years) participated from June 2018 – Jan 2019. Most MOs had experience with MTP (90%), and felt it was their role to discuss results. MOs felt confident discussing the process of MTP, the probability of a ‘therapeutically actionable finding’, and results (score 70-75, range 0 least confident 100 completely confident). However, almost two-thirds of MOs needed/wanted assistance with interpretation of results, favouring a Family Cancer Clinic (FCC) helpline, patient information sheets on MTP, and decision aids. In particular, MOs were less confident discussing germline results and their implications (median score 56) but were comfortable (median score 96) to refer to an FCC. Most MOs felt there was sufficient information on the MTP report to understand results. Some preferred to receive ‘all cancer gene variants’ (36%), others only those with clinical actionability (45%), and some only those with therapeutic actionability (19%). Most MOs (85%) wanted to know the full list of genes assayed, tx recommendations, and/or a list of relevant trials. Interestingly, MOs indicated little confidence that MTP would guide useful tx decisions (median score 51) and most reserved it for the tx-refractory setting. A minimal level of evidence supporting treatment was required by 83% of MOs prior to recommending biomarker-guided tx. Conclusions: MOs are increasingly integrating MTP into clinical practice, despite uncertainty about result validity and clinical translation, particularly regarding germline results. Understanding these potential barriers is the first step in developing clinician supports to facilitate clinical translation.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10522

Poster Session (Board #101), Sat, 1:15 PM-4:15 PM

Developing an inspired leader: How to maximize human talent to maximize operating results. Aimee Greeter; Coker Group, Charlotte, NC Background: Healthcare is a personal industry–driven by people, for people. Developing the talent of individuals as leaders is critical to making the entire industry thrive. This session provides practical tools to develop highly competent leaders, who can then develop high-performing organizations. Methods: Using Noel Burch’s framework, this presentation shares effective methods of propelling leaders from uninspired to results-focused performers. With a focus on real-life examples, this interactive session gives instruction on how to maximize human talent as a means to driving enterprise-wide success. The topics to be covered include: (1) Conscious Competence Ladder: What Is It?; (2) Noel Burch’s work; (3) Key tenets of the Ladder; (4) Common misperceptions of the Ladder; (5) Conscious Competence Ladder and Healthcare: Why Does it Matter?; (6) Application of the Ladder to the healthcare industry; (7) Realities of Human Capital in healthcare; (8) “Exercising” Leadership: Is That Even Possible?; (9)Development of leadership as a skill; (10) Four-Step Process to Leadership Development in Healthcare: But How Do We Do That?; (11) Application of Leadership: But Won’t This Be Hard?; (11) Common pitfalls in leadership development; (12) Success Stories: Has Anyone Ever Even Done This in Healthcare?; (13) Conclusions, Q&A: What Happens Next? Results: This session will enable participants to: (1)Describe the Conscious Competence Ladder model and its relevance to healthcare organizations; (2) Authenticate leadership as a skill that can be developed, and understand how to mature that skill within healthcare leaders using an efficient four-step process; and (3) Provide practical, effective methods to help people understand, process and use leadership skills to maximize the success of their peers, patients and community. Conclusions: In Q4 2017, for the first time ever, healthcare passed both manufacturing and retail as the United States’ largest employer. Simply put, there are now more health care laborers than any other industry. In sheer numbers alone, this is impressive. But, more impressive is the need to utilize and motivate this work force. Using effective and appropriate tools (such as those to be provided in this presentation), this massive healthcare work force can be empowered to drive significant benefits for an organization, its patients and its broader community.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10523

Poster Session (Board #102), Sat, 1:15 PM-4:15 PM

From presentation to paper: Gender disparities in oncological research. Willemieke P.M. Dijksterhuis, Charlotte I. Stroes, Wan Ling Tan, Suthinee Ithimakin, Antonio Calles, Jorge Barriuso, Sjoukje Oosting, Daniela Kolarevic, Andrew J.S. Furness, Ivana Bozovic, Carlos Alberto Gomez-Roca, Hanneke W.M. Van Laarhoven; Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands; National Cancer Centre Singapore, Singapore, Singapore; Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Dana-Farber Cancer Inst, Boston, MA; The Christie NHS Foundation Trust, Manchester, United Kingdom; Department of Medical Oncology, University Medical Center Groningen, Groningen, Netherlands; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia; The Royal Marsden NHS Foundation Trust, London, United Kingdom; Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France Background: Gender discrepancies have been identified in authorships of scientific publications, grant applications, and peer review in many disciplines, including oncology. The exact share of women presenting results of oncological studies at large conferences is unknown, while the oral presentation of a study at such a podium enhances the international visibility and recognition of the presenting person. Therefore, we aim to identify gender-based differences in contributions to presentations at two major oncological conferences. Methods: We collected consecutive abstracts presented at the plenary sessions of the American Society of Clinical Oncology (ASCO) Annual Meetings and presidential sessions of the European Society for Medical Oncology (ESMO) Congresses. Sex of the presenters and abstract authors, study results (positive vs. negative), and subsequently published papers were identified. Chi square tests were used to compare the distribution of sex over time. The association between presenter’s or last author’s sex and study outcome and impact factors were analyzed using Chi square tests and Mann-Whitney U tests, respectively. Results: Of available abstracts presented at ASCO between 2011 and 2018 (N = 34), and ESMO between 2008 and 2018 (N = 132), presenters were female in 24% and 21%, respectively. Female last authors were seen in 21% and 20% of these ASCO and ESMO abstracts. Of all contributing authors to these ASCO (N = 569) and ESMO (N = 1851) abstracts, 31% and 27% were female, respectively. The distribution of male and female ASCO and ESMO presenters (P = 0.580, P = 0.707, respectively) and abstract authors (P = 0.429, P = 0.062) was similar over the years. Of all abstracts, sex of the presenter or last abstract author were not associated with study outcomes (P = 0.718, P = 0.4331), nor with impact factor of subsequently published papers (P = 0.209, P = 0.661). Conclusions: There is a clear gender disparity in the presentation of oncological research at two main conferences, with less than a third of abstract authors female and less than a quarter of these studies presented by a woman. The lack of visibility of female researchers at presentations on these conferences could impair the acknowledgement for their research, opportunities in their academic career, and even hamper heterogeneity and outcomes in research.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10524

Poster Session (Board #103), Sat, 1:15 PM-4:15 PM

Creation and development of the National Cancer Control Plan in Russia. Alexander Petrovsky, Sergei Tjulandin, Alexey Tryakin, Ivan S. Stilidi, Mikhail Davydov, Maria Avksentieva, Yulia Ledovskih; Federal State Budgetary Institution "N.N. Blokhin National Medical Research Center of Oncology" pf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russian Federation; Federal State Budgetary Institution N.N. Blokhin National Medical Research Center of Oncology pf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russian Federation; Federal State Budgetary Institution «N.N. Blokhin National Medical Research Center of Oncology» pf the Ministry of Health of the Russian Federation (N.N. Blokhin NMRCO), Moscow, Russian Federation; Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation, Moscow, Russian Federation Background: The absence of the National Cancer Control Plan (NCCP) did not allow to develop pncology in Russia. Methods: Since 2015 experts of the N.N. Blokhin Russian National Comprehancive Center and Russian Oncology Association has initiated the creation of a National Anti-Cancer Strategy. Results: In 2016, the working group presented the first version of this Strategy to the professional community for wide discussion, which was transferred to the Russian Ministry of Health after a broad discussion in 2017. This strategy included prevention, screening, early diagnosis, treatment, rehabilitation and palliative care in patients with malignant tumors. In parallel, we created National Clinical Cancer Guidelines, which were approved by the professional community, and then we submited them to the Ministry of Health in 2017. Also in the period of 2017-2018, updated principles of creating clinical and statistical groups (CSG) were developed based on the calculation of the real costs of each type of surgery, radiation therapy and drug treatment. More than 1,000 different standards we established for each case of hospitalization and their cost has been calculated. Then, based on these calculations, we ranked four types of treatment (surgery, radiation therapy, chemotherapy and chemoradiation), each of which has 3, 5, 10 and 6 levels, respectively. These calculations formed the basis of the NCCP approved by the Government and the President starting from 2019 with an unprecedented additional level of funding of almost 1 trillion rubles (an increase of almost two times). The major goal of the Russian NCCP is to decrease mortality level from 202 to 185 (8,5%) per 100 000 population by the year of 2024. Conclusions: The fffort of the professional community with due consideration and consolidation with the Ministry of Health allows implementation of the NCCP on a national level.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10525

Poster Session (Board #104), Sat, 1:15 PM-4:15 PM

Working together in cancer care: An academic community partnership for a diverse patient population. Naomi Ko, Mayah Burgess, Lindsay Demers, Vaishali Sanchorawala, Gretchen Gignac, Frederick Thurston Drake, Michael Ryan Cassidy, Emily Baiyee, Stephanie Lee, Beverly Moy; Boston Medical Center, Boston, MA; Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA; Massachusetts General Hospital Cancer Center, Boston, MA Background: The Massachusetts General Hospital Cancer Care Equity Program conducted a qualitative survey health assessment in the inner-city communities of Boston to study Black Bostonian patients’ perceptions of the barriers to cancer care. Findings revealed a level of mistrust toward large cancer centers and a request for more interactions with their trusted community health providers. At a subsequent community forum geared toward soliciting solutions to improve relationships with academic medical centers, community members recommended that academic oncologists increase engagement with their community health center (CHC) clinicians with a cancer lecture series. Methods: Academic oncologists from Massachusetts General Hospital and Boston Medical Center met with the leadership at two CHCs prior to the creation of the cancer lecture series. Feedback on how to best support CHC providers was established and a cancer care lecture series was created with continuing medical education (CME) credit provided. Five in-person lectures were given at each CHC. Topics included: Consultative Hematology, Breast Cancer, Prostate Cancer, Thyroid Cancer, Colon Cancer and Adrenal Masses. Survey evaluations (summative and formative) were distributed to all participants. An online portal was established to provide ongoing CME to providers. Results: Six academic physicians specializing in cancer care provided lectures at two CHCs. Currently, we have 176 surveys completed from both CHCs. Thus far, 98.3% surveys have indicated that the lectures have been “Excellent” or “Above Average,” and all participants have responded that the objectives of each presentation have been met. We have developed a website to provide ongoing CME for the lectures that were given: http://bucme.org/cancercare. Conclusions: This project aims to improve cancer care education and communication between providers from academic cancer centers and primary care providers at CHCs that care for a diverse and vulnerable patient population.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10526

Poster Session (Board #105), Sat, 1:15 PM-4:15 PM

Training of oncologists: Results of a global survey. Divyanshi Jalan, Fidel Rubagumya, Wilma M. Hopman, Verna D. Vanderpuye, Gilberto Lopes, Bostjan Seruga, Christopher M. Booth, Scott R. Berry, Nazik Hammad; Queen’s University, Kingston, ON, Canada; Rwanda Military Hospital, Kigali, Rwanda; Center for Radiotherapy, Accra, Ghana; Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL; Institute of Oncology Ljubljana, Ljubljana, Slovenia; Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; Department of Oncology, Cancer Center of Southeastern Ontario, Queen’s University, Kingston, ON, Canada Background: While several studies have highlighted the global shortages of oncologists and their workload, few have studied the characteristics of current oncology training. Methods: An online survey was distributed through a snowball method via national oncology societies and a pre-existing network of contacts to cancer care providing physicians in 57 countries. Countries were classified into low- or lower-middle-income countries (LMICs), upper-middle-income countries (UMICs), and high-income countries (HICs) based on World Bank criteria. Results: 273 physicians who trained in 57 different countries responded to the survey; 33% (90/273), 32% (87/273), and 35% (96/273) in LMICs, UMICs and HICs respectively. 60% of respondents were practicing physicians and 40% were in training. The proportion of trainees was higher in LMICs (51%; 45/89) and UMICs (42%; 37/84), than HICs (19%; 28/96; P = 0.013). A higher proportion of respondents from LMICs (37%; 27/73) self-fund their core oncology training compared to UMICs (13%; 10/77) and HICs (11%; 10/89; P , 0.001). Respondents from HICs were more likely to complete an accepted abstract, poster and publication from their research activities compared to respondents from UMICs and LMICs (abstract: 37/72 (51%) from HICs, 18/66 (27%) from UMICs, 24/65 (37%) from LMICs, P = 0.014; poster: (42/72 (58%) from HICs, 28/ 66 (42%) from UMICs, 13/65 (20%) from LMICs, P , 0.001; publication: 43/72 (60%) from HICs, 32/66 (49%) from UMICs, 24/65 (37%) from LMICs, P = 0.029). Respondents identified several barriers to effective training including skewed service to education ratio and burnout. With regards to preparedness for practice, mean scores on a 5-point Likert scale were low for professional tasks like supervision and mentoring of trainees, leadership and effective management of an oncology practice, and understanding of healthcare systems irrespective of country grouping. Conclusions: Investment in training by the public sector would be vital to decreasing the prevalence of self-funding in LMIC. Gaps in research training and enhancement of competencies in research dissemination in LMIC require attention. Instruction on cancer care systems and leadership need to be incorporated in training curricula in both LMICs and HICs.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10527

Poster Session (Board #106), Sat, 1:15 PM-4:15 PM

Oncology fellows’ knowledge and current practice regarding outpatient oncology and palliative care. Amy Johnson, Erin V. Newton, Lyle Fettig, Amber Comer; Indiana University School of Medicine, Indianapolis, IN; IU Simon Cancer Center, Westfield, IN; Indiana University, Indianapolis, IN Background: Patients with advanced cancers often suffer from a number of symptoms and need guidance when discussing treatment goals as their diseases’ progress. Palliative care competencies include the assessment and management of both physical and psychological symptoms, as well as, the conduct of goals of care conversations and advanced care planning. Palliative medicine is subspecialty that specially addresses these needs in patients with advanced cancers, but is not universally available. Oncology fellowship training must include these competencies and there is little evidence regarding the palliative care educational experiences of oncology fellows. This study examines fellows’ experiences with palliative care education and fellows’ attitudes about concurrent palliative care in the outpatient setting. Methods: An electronic nationwide survey of medical oncology fellows was conducted in the second half of the academic year in 2018. Results: 43 of 191, 22.5%, of oncology fellows contacted at 17 institutions responded. 96% of fellows indicated they would strongly agree or agree with having a Palliative Care team in their future outpatient clinics. 93% of fellows agree or strongly agree with being comfortable managing cancer related pain, but only half agree or strongly agree with being comfortable managing depression and anxiety. 91% agree or strongly agree they are comfortable with discussions about transitions to best supportive care, while only 31% of fellows always or often assist patients in completing advance care documents. 70% of fellows are always, often, or sometimes receiving feedback on their communication and symptom management skills. Conclusions: Oncology fellows fell comfortable with some aspects of palliative care more than others. Fellows in this survey report feeling comfortable with goals of care conversations and pain management, but are not as comfortable managing other symptoms like depression and anxiety. Respondents are not universally assisting patients in advanced care documentation and only two-thirds of responding fellows are receiving frequent feedback on their communication and symptom skills. There is a consensus among responding fellows about a desire to have palliative care embedded in their future clinics.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10528

Poster Session (Board #107), Sat, 1:15 PM-4:15 PM

Choosing oncology as specialization: Medical students’ perception after clinical rotation in cancer center. Omar Orlando Castillo Fernandez, Maria Lim, Lilian Hayde Montano, Gaspar Perez-Jimenez, Jhonattan Cama~ no, Enrique Mendoza, Yamileth Pereira; Instituto Oncologico Nacional, Panama City, Panama; Universidad de Panama, Panama City, Panama Background: Cancer is a leading cause of death worldwide and the demand for oncologist and palliative care specialists is increasing dramatically. Two years ago, The Universidad de Panama incorporated Oncology in the curriculum in order to face the shortage of professionals involved in cancer care. Little information is available concerning young medical students desire to pursue a career in oncology.The aim of this study is to evalute medical students perception about Oncology as a specialization field. Methods: An electronic survey was sent to medical students from Universidad de Panama after finishing Oncology rotation the last 2 years. Chi square and Mann Whitney U tests were used to compare variables. Results: 145 questionnaries were responded (40%). 60% female and 40% male. Median age was 25 years old. Clinical rotation during Oncology practices were: 37% in Medical Oncology, 24% in Surgical Oncology, 21% in Radiation Oncology and 18% in Palliative Care. 20% (29) of students are highly motivated to pursue a career in Oncology. 8 in Radiation Oncology. 8 in Surgical Oncology, 8 in Medical Oncology and 5 in Palliative Care. Variable associated with a oncology preference were: male gender (p=0.007), lack of human resources (p=0.009), contact with patients and family (p=0.005), good experience with mentor (p=0.002), nature and complexity of disease (p,0.001). Potential emotional burden was negatively asssociated (p=0.004) with oncology preference. 66% of students acknowledged that clinical rotation changed positively their perception about cancer patient care and a third of students haved not rule out the possibility to choose Oncology in the near future. Conclusions: Early exposition to medical student to cancer care might help to reduce the global shortage of oncologist and palliative specialists.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10529

Poster Session (Board #108), Sat, 1:15 PM-4:15 PM

Satisfaction of general versus specialized continuity clinic in hematology oncology fellowship training: A survey. Sama Imran Ilyas, Martina Cathryn Murphy, Jennifer Michelle Duff, Julia Lee Close; UFCOM, Gainesville, FL; Shands/Univ of Florida, Gainsville, FL; University of Florida, Dept. of Medicine, Division of Hematology and Oncology, Gainesville, FL; University of Florida, Gainesville, FL Background: At the University of Florida (UF), oncology fellows participate in two general types of continuity clinic as part of their training. One clinic at the Veterans Hospital (VA) allows them to care for patients in a general clinic setting that encompasses a variety of hematology oncology diagnoses. The other clinic, located at the university site, is disease or system specific (such as breast or GI clinic). Considerable research supports the value of continuity clinic in residency and fellowship training, but the differences in having a general versus specialized clinic for oncology fellows have not been explored. The purpose of this study is to investigate the perceived differences of general versus specialized continuity clinics by recent oncology graduates from UF, and what features of a continuity clinic they feel were most important for an effective and meaningful experience. Methods: An anonymous survey was sent to the last six graduating classes of oncology fellows at UF. The survey contained short demographic questions, followed by five open ended questions pertaining to both continuity clinic experiences. Graduates were asked about their opinions of both the general and specialized clinics during their training at UF. Survey responses were reviewed and coded for common themes. Results: The most common themes that emerged from the surveys were concerning autonomy, supervision, and the diversity of cases and patient population. A majority of respondents felt they had more autonomy and personal responsibility at the VA general clinic, but less direct supervision than at the specialized clinics. They also believed they got a broader exposure of different disease types at the VA general clinic. Surveyed participants also commented on the quality of educational seminars and activities, preceptor expertise and teaching, and ability to observe cutting edge practice and clinical trials. Eleven out of thirty surveys were returned and we anticipate a greater than 50% response for the final poster. Conclusions: Graduated oncology fellows from UF believe that there is a balance that exists between having autonomy and ownership of their patients versus having adequate supervision. Many believe that having “controlled autonomy” and “as much independence as is safe for patients” is key to a meaningful continuity clinic experience during oncology fellowship training.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10530

Poster Session (Board #109), Sat, 1:15 PM-4:15 PM

A novel qualitative methodology study to characterize discrimination and inclusion among hematology/oncology trainees. Rahma M. Warsame, Gladys Asiedu, Ashok Kumbamu, Sharonne Hayes, Carrie A. Thompson, Timothy J. Hobday, Katharine Andress Rowe Price; Mayo Clinic, Rochester, MN Background: Learner wellbeing may be adversely affected by the experience of discrimination. Eliciting details from this vulnerable population about these experiences is a challenge. This study characterizes trainee experiences of discrimination and inclusion to inform graduate medical education (GME) policies and practice. Methods: Anonymous semi-structured, private phone interviews were conducted with fellows after informed consent. No identifying information was exchanged and the interviewer had no supervisory role over learners. Demographic information was obtained via anonymous online survey. Results: Of 29 fellows approached, 20 consented; 17 interviewed (10 men; median age 32 years). Racial & ethnic distribution: 6 Asian, 2 Black, 2 Multi-racial, 4 White, 3 Hispanic/Latino. All fellows reported discriminatory behavior that they either experienced or witnessed. Incidents of discriminatory behavior towards trainees were more common from patients (pts) (n = 41) than staff (n = 12). Discrimination from pts included requesting a different physician based on accent (n = 13), race (n = 11), perceived avoidance of a trainee considered “different” (n = 11), sex (n = 5), & ethnicity (n = 4). Six trainees were aware of policies against pt discrimination but only 1 trainee reported an incident. Trainees did not report because of the nature of incidents (micro aggressions that are difficult to characterize) and sense of futility of reporting. Discriminatory behavior from staff was based on perceived micro aggressions (n = 4), sex (n = 3), ethnicity (n = 3), ageism (n = 1), and sexual orientation (n = 1). Impact on trainees ranged from negative (personal anguish) to positive (motivation to improve communication). Coping mechanisms included debriefing with family/trainees and focusing on good pt experiences. Trainees felt that having diverse co-fellows, involvement on committees, and supportive program leadership promoted inclusivity. Conclusions: Our study found that discriminatory behavior towards trainees is common. Our methodology allows for honest & safe discussions. GME programs must assess their learning climate with respect to bias/inclusivity & develop appropriate processes.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10531

Poster Session (Board #110), Sat, 1:15 PM-4:15 PM

Targeting B-cell malignancies: Impact of an educational curriculum on BTK inhibitors. Lauren Willis, Mindy Tanzola, Richard Caracio, Katie S. Lucero, Bijal D. Shah, Jennifer Ann Woyach, Richard R. Furman, Michael Wang, Jennifer R. Brown; Medscape, LLC, New York, NY; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; The Ohio State University Comprehensive Cancer Center, Columbus, OH; Weill Cornell Medical College, New York, NY; The University of Texas MD Anderson Cancer Center, Houston, TX; Dana-Farber Cancer Institute, Boston, MA Background: We sought to determine if a curriculum of online continuing medical education (CME) activities could improve hematologists/oncologists (hem/onc) knowledge and competence related to clinical decision making in the use of BTKi in patients with B-cell lymphomas. Methods: An expert panel identified knowledge/competence gaps related to the use of Bruton’s tyrosine kinase inhibitors (BTKi) in B-cell lymphomas. A clinical practice assessment (CPA) survey was launched May 2018 to further assess baseline educational needs. Based on the needs identified, 7 activities were posted online between MayDec 2018. Multiple-choice questions were asked before and after participation in each activity and were grouped into learning topics. Mean knowledge/competence was calculated for the CPA and across all 7 activities. The impact of education was examined using a pre/post design. Statistical significance was assessed using a chi-square statistic (P , .05 level). Results: For all topics except foundational/ differentiating BTKi, the audiences participating in the baseline CPA and the other 7 activities, were similar or lower at pre-test, suggesting that learning needs continued until our education addressed them. All changes from pre-to-post-test were significant (P , .001). The largest relative percent change from pre- to post-test was seen with knowledge of resistance mechanisms for BTKi as well as knowledge/competence managing AE of BTKi. Post-test there was a high level of knowledge about the selectivity seen with 2nd generation BTKi. Conclusions: This analysis shows that online CME, utilizing many different formats (video, text, panel discussions) can significantly improve the knowledge and competence of hem/oncs in multiple areas surrounding the use of BTKi for the treatment of B-cell lymphomas. Results also suggest the following areas warrant further education: awareness of clinical trial safety and efficacy data for BTKi and mechanisms for resistance to BTKi.

Learning Topics (n = 1001 hem/oncs) Adverse Events (AE) Clinical Trial Data Foundational/Differentiating BTKi Resistance Selectivity Confidence Utilizing BTKi (1-none to 5-very)

Average % Correct CPA (baseline)

Average % Correct Pre-Test (7 activities)

Average % Correct Post-Test (7 activities)

Pre-Post-CME Relative % Change

69% 49% 37% 38% 55% 3.1

46% 50% 59% 36% 59% 2.9

84% 69% 85% 65% 82% 3.4

82% 37% 45% 84% 38% 17%

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10532

Poster Session (Board #111), Sat, 1:15 PM-4:15 PM

Enhancing evidence-based medicine skills in oncology training with cognitive technology. Chun-You Chen, Hui-Chun Hung, Hsin-Yi Chiu, Po-Li Wei, Pih-Lian Kuo, Jeng-Fong Chiou, Anita Preininger, Irene Dankwa-Mullan, Sarah Kefayati, Metasebya Solomon, Gretchen Jackson, Kyu Rhee, Yun Yen; Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan; Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; IBM Watson Health, Nashville, TN; IBM Watson Health, Cambridge, MA; IBM Watson Health, San Francisco, CA; IBM Watson Health, San Jose, CA; IBM Watson Health, Southbury, CT; TMU Research Center of Cancer Translational Medicine, Taipei Medical University, Taipei, Taiwan Background: Evidence-based medicine (EBM) requires applying literature evidence to inform practice. Students from Taipei Medical University Hospital, trained in EBM concepts, participated in a preliminary study using Watson for Oncology (WfO), an evidence-based decision-support system to enhance the EBM skills of medical students. Methods: A class of 50 medical students compared traditional search methods (TSM) and WfO in a workshop divided into 2 sequential sessions on colon and lung cancer, respectively. All students were trained on WfO, and 2 groups of 25 students each were randomly assigned to either TSM or WfO in the first session. Those groups were then assigned to the alternate approach in the second session. Students completed a profile that included their clinical experience with each cancer type. Students used either WfO or TSM to help answer a series of questions related to colon or lung cancer. Students then completed a survey of attitudes towards the technology, followed by a constructed-response learning assessment without the aid of TSM or WfO. Assessments were scored and results compared using a Mann-Whitney U Test; outcomes at two different experience levels, based on student profiles, were compared using a Kruskal-Wallis test. Results: In this preliminary study, more than 70% of students reported limited clinical experience with either cancer. On the colon cancer assessment, students in the WfO group performed significantly better than the TSM group (p = 0.0001); there was no significant difference detected for lung cancer. Students with more clinical experience felt that TSM was easier to learn than WfO (p= 0.005); students with less experience felt that WfO was clearer and more understandable than TSM (p= 0.002). Conclusions: These preliminary results are consistent with better learning outcomes for students using WfO in the colon cancer module. Students with more clinic experience reported that TSM was easier to learn than WfO, however it is unknown if this might be due to a potentially greater familiarity with TSM in this more experienced group. More studies are needed to determine what features, if any, of WfO can facilitate EBM approaches in oncology education.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10533

Poster Session (Board #112), Sat, 1:15 PM-4:15 PM

Online education about immunotherapy for melanoma: Outcomes over time. Kinjal Parikh, Katie S. Lucero, Patti Repetto, Haleh Kadkhoda, Charlotte Warren, Jacqueline Gearhart, Jeffrey S. Weber; Medscape Oncology, New York, NY; Medscape Education, New York, NY; Society for Immunotherapy of Cancer (SITC), Milwaukee, WI; Laura and Isaac Perlmutter Cancer Center, NYU Langone Medical Center, New York, NY Background: The indications and use of immune checkpoint inhibitors (ICIs) for the treatment of melanoma have grown since the first drug approval in 2011. The expanding evidence base and number of indications challenges clinicians to stay up to date with how best to integrate these agents into treatment pathways. The objective of this study was to assess trends over time in oncologists’ knowledge, competence, and confidence using ICIs in the treatment of melanoma. Methods: A series of online continuing medical education (CME) activities about the role of ICIs in the treatment of melanoma was launched in April 2014; 18 included multiple-choice knowledge/competence questions and a confidence question assessed on a 5-point Likert-type scale before and immediately after the activity. Activities that had at least 30 oncologists participate pre/post are included in this analysis. A pre-/post-assessment study design was used, and educational effect was assessed with Chi-square tests. Analyses were conducted to examine trends in knowledge, competence, and confidence over four years on a quarterly basis. Weighted averages in each of the outcomes were calculated by quarter. Results: A total of 92,373 learners participated from April 2014-March 2018, including 57,432 physicians, of whom 11,922 were oncologists. The average increases from pre- to post-test for knowledge- (12 activities), competence- (11 activities), and confidence-based (9 activities) questions were 21%, 15%, and 6%, respectively (P , 0.01 for all comparisons). The absolute increase in knowledge from pre-test in 2014 (48%) to post-test in 2018 (78%) was 30 percentage points; and for competence, 6% (from 62% in 2014 to 68% in 2018). The mean confidence rating pre-test in 2015 was 2.51 versus 3.37 post-test in 2018. Conclusions: Online CME improves oncologists’ knowledge, competence, and confidence using ICIs in the treatment of melanoma. As new data emerge and indications expand, new educational activities are necessary to reinforce existing knowledge, close persistent gaps, and increase oncologists’ confidence using ICIs in this clinical setting.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10534

Poster Session (Board #113), Sat, 1:15 PM-4:15 PM

Non-oncologist physician knowledge of radiation therapy at an urban community hospital. Evan Siau, Hernando Salazar, Jonathan Klein; St. Barnabas Hospital - CUNY School of Medicine, New York, NY; St. Barnabas Hospital - CUNY School of Medicine, Bronx, NY; Albert Einstein College of Medicine and St. Barnabas Hospital, Bronx, NY Background: Appropriate referral for radiation therapy (RT) is crucial for cancer care. Previous work suggests that many non-radiation oncologists who care for cancer patients are uncomfortable referring for RT. We surveyed physicians in a community hospital in Bronx, New York to assess their training in RT and understanding of RT. Methods: Invitations to complete an online questionnaire were sent to all faculty and resident physicians at St. Barnabas Hospital. The questionnaire asked about previous training in oncology, RT knowledge self-rating and an objective knowledge assessment of RT indications and effectiveness. Statistical analysis used Pearson chi-square and Fisher’s exact test for categorical variables and Student’s t-test and ANOVA for interval variables. Results: 247 participants received the invitation email, and 87 responded (35% response rate). Among responders, 19 were attending physicians (22%) and 66 (76%) were residents (2 failed to disclose). 51 respondents (59%) were from Internal Medicine (IM) and 20 (24%) from Emergency Medicine. 72% of respondents reported caring for . 5 cancer patients in the past month, but 45% (37% of IM respondents) never refer patients for RT. 71% of respondents stated they received no formal radiation oncology training in medical school, and 47% reported no oncology training at all. Pluralities believed themselves to be “somewhat knowledgeable” about RT indications (49%), benefits (53%), and side effects (55%). Objective assessment mean score was 6.2/12 (median 7) for all respondents. IM respondents scored higher than others (mean 7.7 vs 3.5; p , 0.001), but only 28% of IM respondents (0% of others) scored 10/12 or higher. Scores did not differ between attending and resident physicians (p = 0.75), resident PGY level (p = 0.43), or receiving oncology training in medical school (p = 0.54). Factors cited by . 50% as affecting RT referral decisions either “somewhat” or “a lot” were: type of cancer, patient wishes, family wishes, poor functional status, and life expectancy. Conclusions: Many physicians are unaware of RT effectiveness or indications, which may affect referral patterns. Previous oncology training was not associated with higher knowledge scores.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10535

Poster Session (Board #114), Sat, 1:15 PM-4:15 PM

Collaborative learning workshops to optimize integration of cancer immunotherapies in the community setting. Latha Shivakumar, Tara Perloff, Lorna Lucas; Association of Community Cancer Centers, Rockville, MD; Association of Community Cancer Centers (ACCC), Rockville, MD Background: The expanding armamentarium of immunotherapies available to treat patients with cancer poses a challenge to community practitioners. They need guidance around the practical issues that they must navigate to provide immunotherapy safely and effectively in their own communities. Methods: The Association of Community Cancer Centers (ACCC) implemented collaborative learning workshops focused on best practices for implementing cancer immunotherapies in the community setting with respect to care coordination, monitoring and management of immune-related adverse events (irAEs), and access to care. The workshops were held between April and June of 2018 in community cancer centers. A multidisciplinary steering committee including two medical oncologists, an oncology nurse, and an oncology pharmacist, led this initiative. The workshops started with a 45-minute open discussion section where the faculty posed questions to the learners to understand their specific institutional challenges. The faculty took cues from the initial discussion and focused the remainder of the education on addressing the challenges and barriers that were uncovered, rather than merely summarizing recent clinical data. The faculty discussed clinical case scenarios and presented clinical evidence for the various treatment decisions. At the end of the workshop, the instructors collaborate with the learners to draft an action plan for incorporating changes into their practice. Participants were surveyed at 3 and 6 months following participation in the workshop to report on the status of their action plans. Results: After participating in the workshops, almost 100% of the participants reported being confident in their ability to make changes in their practice. The responses of the participants to the postactivity assessment revealed a 11% relative increase in knowledge and competence and the participants were up to 14.7% more likely to receive evidence-based management with immunotherapies based on effect size calculations. At the 3-month follow-up, the participating sites had already implemented over 30% of the action items listed in their plans and at the 6-month follow-up, 100% of the action items drafted by learners were implemented as planned. Conclusions: The collaborative learning workshops were successful in inducing changes in knowledge, competence, and performance among the intended target audience of community oncology practitioners.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10536

Poster Session (Board #115), Sat, 1:15 PM-4:15 PM

Medical oncology trainees’ perceptions of their education and preparedness for independent practice. Geordie Linford, Nazik Hammad, Nancy Dalgarno, Nicholas Cofie, Ravi Ramjeesingh, Anna T. Tomiak; Department of Oncology, Cancer Center of Southeastern Ontario, Queen’s University, Kingston, ON, Kingston, ON, Canada; Department of Oncology, Cancer Center of Southeastern Ontario, Queen’s University, Kingston, ON, Canada; Queens University, Office of Health Sciences Education, Faculty of Health Sciences, Kingston, ON, Canada; Queens University, Department of Professional Development & Educational Scholarship, Kingston, ON, Canada; Nova Scotia Cancer Centre, Dalhousie University, Nova Scotia, NS, Canada; Queen’s University, Kingston, ON, Canada Background: This original research assesses Canadian Medical Oncology (MO) residents’ perceptions and satisfaction with their education and preparedness for practice prior to initiation of Competency Based Medical Education (CBME). Methods: Digital surveys were sent to MO residents in Canadian training institutions yearly from 2014–2017. Because of lower than expected response rates, invitations were subsequently extended to recent graduates completing training between 2009–2014. Ethics and funding were granted by Queen’s University. Results: A total of 71 surveys were received with representation from 11 training programs. Preparedness for Practice: Current trainees and recent graduates ranked preparedness for practice similarly in all assessment domains except Medical Expert (trainee mean 3.50, graduate mean 4.45, p=0.004; 1=not prepared, 5=well prepared). Means for the combined cohort shown in table. Usefulness of teaching modalities: Participants ranked learning in a clinical setting as most useful (6.53/8, 1=least useful, 8=most useful) and educational sessions by residents (4.24/8) and Journal Club (3.74/8) as least useful. Most participants felt their training was a shared learner-teacher responsibility (56.1%) or was learner-centered (22.5%). Quality of teaching: Participants reported similar levels of satisfaction with teaching across domains except for Manager which scored lowest (3.46/5, 1=poor, 5=excellent). Self-assessment of skills: Participants were most satisfied by their ability to assess their own performance and competence at the end of training (7.16/ 10, 1=not satisfied, 10= very satisfied). The degree to which their programs set expectations about required knowledge, skills, or attitudes at various points in training (6.63/10) and participants abilities to self-assess these skills during their training (6.64/10) scored lower. Conclusions: Participants reported low satisfaction with their ability to self-assess during their training and their training programs’ ability to communicate expectations. Transition to CBME training may address these issues, and follow-up is required. Medical Expert 3.91

Communicator Collaborator Manager 4.36

4.4

3.72

Health Advocate 4.04

Scholar Professional 4.07

4.63

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10537

Poster Session (Board #116), Sat, 1:15 PM-4:15 PM

FitFirms: A wellness option for oncology trainees. Bhavana Pathak, Ann M. Eapen, Jason A. Zell; The University of California, Irvine, Orange, CA; University of California, Irvine, Orange, CA; UC Irvine Health, Chao Family Comprehensive Cancer Center, Orange, CA Background: Burnout in oncologists has been rising over the past decade. Burnout leads to poor patient outcomes and poor physician health. Younger oncologists are at higher risk for burnout. The Firm System was designed by Victor McKusick at the Johns Hopkins hospital in 1975 to integrate faculty and trainees into clinical and psychologically supportive cohorts. Here we describe an adapted Firm System called the FitFirms, which focused on social connectivity and altruistic service as means to combat burnout in oncology trainees. Methods: We divided the Hematology and Oncology Division of an academic Comprehensive Cancer Care center into four cohorts of faculty-fellow teams called FitFirms. Each FitFirm was named after a notable local or national female leader in the field of cancer medicine—The Henrietta Lacks Firm, The Jane Wright Firm, The Padmini Iyer Firm, and The Rita Mehta Firm. The faculty and fellows interacted on an at-minimum quarterly basis in casual social events and/or community service-oriented events for 15 months. The social events included group dinners, bowling, paint and game nights. The service events included participation in 5K walk/run fundraiser for our institution’s cancer center and support of a National Cancer Survivors Day event for US Veterans. A didactic discussion series was created to explore concepts of resiliency, work-life balance, and the role of art in medicine—mentored by faculty across the spectrum of oncologic disciplines (Surgical Oncology, Gynecologic Oncology, Palliative Care, and Health Communication). The Maslach Burnout Inventory survey was used to survey the oncology trainees before and after the interventions. Results: Nine pre-intervention surveys were collected with 78% of trainees describing themselves as on the burnout spectrum of feeling either ineffective, overextended, disengaged, or burned out (22% engaged). After 15 months, 10 post-intervention surveys were collected in which 60% of trainees described themselves on the burnout spectrum (40% engaged). Conclusions: The FitFirms are a novel system using social capital to reduce the problem of burnout in oncology trainees by engaging in social connectivity and altruistic service through faculty-mentored, historically-named divisional cohorts.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10538

Poster Session (Board #117), Sat, 1:15 PM-4:15 PM

Believe the H.I.P.E.: Hematology-Oncology Inter Professional Education to improve provider collaboration at an inpatient tertiary medical center. Richard Lewis Martin, Anna Hux, Ryan Miller, Mario Davidson, Leora Horn, Jill Gilbert; Vanderbilt University Medical Center, Nashville, TN; Vanderbilt University School of Medicine, Nashville, TN Background: With projected provider shortages and increasing pharmaceutical complexity, Advanced Practice Providers (APPs) and Pharmacists are becoming increasingly utilized members of hematology/ oncology teams. Despite significant interdependence in practice, inter-professional training remains rare. Medical IPE has been shown to improve learning satisfaction and attitudes, however, IPE has seldom incorporated inter-professionalism into content development nor has it been evaluated in terms of sustainability. Methods: We developed a pilot IPE curriculum consisting of six, 1-hour long, casebased sessions. A preparation phase required a lead APP, Fellow, and Pharmacist to collectively build a case around three teaching points; 1) diagnosis, 2) treatment, and 3) coordination of care. The APP and Pharmacist presented the case while the Fellow moderated to ensure active participation among all groups. Surveys on collaboration, interaction, interest, and connection, as well as open-ended comments on strengths and areas for improvement were collected after each session ( . 80% completion rate). Results: With 3 of 6 sessions completed (02/19), attendance was stable, averaging 10 of 18 (Fellow), 5 of 8 (APP), and 3 of 6 (Pharmacist). Sessions were rated an average of 4.6/5 on collaboration, 4.5/5 interactive, 4.7/5 application, 4.3/5 communication, and 4.2/5 professionalism. 69% of attendees reported being more likely to attend future conferences. 65% reported feeling more connected to the care team. The most common suggestion for improvement was giving more teaching opportunities to the APPs. Session leaders were initially recruited but quickly transitioned to eager volunteers. Conclusions: Our IPE curriculum shows promising initial sustainability with perceived high marks in collaboration and applicability. Incorporating inter-professionalism into content development and longitudinal delivery to providers in practice provides a novel approach to educating IP teams. Future steps include ensuring continued sustainability, conducting qualitative and quantitative analysis, and dissemination to other units.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10539

Poster Session (Board #118), Sat, 1:15 PM-4:15 PM

Using blended learning to improve education on clinical pathways for breast cancer management in Nigeria: Preliminary results. Kelechi Ngozi Eguzo, Nofisat Ismaila, Usenime Akpanudo, Oluoha Chukwuemeka, Aniekan Jacob, Mfonobong Udoekong, Charles Adeyinka Adisa; Marjorie Bash Foundation, Aba, Nigeria; ASCO, Alexandria, VA; Harding University, Searcy, AR; Abia State University, Uturu, Nigeria; Obong University, Obong Ntak, Nigeria; Abia State University Teaching Hospital, Umungasi, Nigeria Background: Most Nigerian clinicians lack adequate skills and resources in screening, diagnosis, and managing women with breast cancer. The absence of locally-sensitive clinical pathways in hospitals in Abia State impact patient outcomes and clinicians job satisfaction. Blended learning (BL), a combination of online and face-to-face teaching methods, has been used in other settings to improve the competencies of clinicians. Research seeks to develop and evaluate a BL course that will train clinicians in Abia State on using NCCN breast cancer management guidelines, and to develop and implement locally-sensitive clinical pathways. Methods: The course is divided into four online modules delivered via Google Classroom and a workshop module to be delivered in 3 cities. Course evaluation involves an objective-focused method, following a mixed-methods design. Data collection includes preand-post-tests, course evaluation and focus group discussions. Data analysis involved descriptive statistics and t-test. Comments deductively analyzed to identify common themes. A sample size of 107 individuals is required to identify a moderate effect size for the BL course. Results: Forty-three participants (physicians=15, Nurses=28) have been recruited for cohort 1, with average age of 44 (69.9) years. Most participants have never taken an online class (65%) but use mobile phones (60%) to access the course. With a maximum of 20 points in each test, there is a pattern of improvement in the post-tests performance compared with the pre-tests. Table shows mean scores. Most participants have expressed satisfaction with the course. Conclusions: Results show improvement in learning. More participants are being recruited. The workshops will hold at after the online modules. Module

Pre-test

Post-test

p-value

Introduction Diagnosis Treatment Guidelines

11.61 10.21 11.54 12.27

14.26 14.65 17.84 17.08

0.325 0.004 ,0.001 ,0.001

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

10540

Poster Session (Board #119), Sat, 1:15 PM-4:15 PM

Implementing a quality improvement curriculum for medical oncology residents: A pilot study at the Ottawa Hospital Cancer Centre. Stephanie Yasmin Brule; The Ottawa Hospital Cancer Centre, Ottawa, ON, Canada Background: With increasing cancer care costs and demands in Canada, quality improvement (QI) efforts are urgently needed. Yet no formal QI education exists in the Canadian Medical Oncology setting. We created an Oncology-specific QI curriculum and sought to assess its feasibility and efficacy among Medical Oncology residents. Methods: In this prospective, pre-experimental pilot study using a pre-post curriculum design, Medical Oncology residents at The Ottawa Hospital Cancer Centre participated in a new QI curriculum. It consisted of four 2-hour sessions encompassing a combination of didactic and interactive learning. The primary measures were self-assessment of confidence in QI skills with the Self-Assessment Program (SAP) and objective assessment of QI knowledge with the revised QIKAT (QIKAT-R). The SAP and QIKAT-R were completed at baseline and post-curriculum. The primary outcome was feasibility of the educational approach. Results: Five Medical Oncology participated, while four (80%) completed the assessments at both timepoints. Self-assessment in the skills needed to execute a process improvement project improved with participation in the curriculum. Mean SAP scores improved from 19.6 pre-curriculum to 33.5 post-curriculum. SAP scores improved for each of the 10 quality improvement skills evaluated. Objective assessment using the QIKAT-R also improved postcurriculum, with a mean score of 17 pre-curriculum and 24 post-curriculum. Mean scores of each domain of “Aim, Measure, and Change” evaluated by the QIKAT-R improved. Conclusions: Selfassessed confidence and objective knowledge in QI concepts in Medical Oncology residents improved after participation in this Oncology-specific QI curriculum. Feasibility of this approach was demonstrated, and therefore a larger scale study will be implemented in the future.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

PROFESSIONAL DEVELOPMENT

TPS10541

Poster Session (Board #120a), Sat, 1:15 PM-4:15 PM

Simulated patient encounter to assess and improve fellows’ ability to manage chemotherapy infusion reactions. Danielle Elise Zimmerman; University of Florida Health, Gainesville, FL Background: Medical educators have adopted simulation-based exercises (SBEs) because studies of their use in the aviation industry and other technical fields have shown that they reduce human error. While use of simulation has increased in undergraduate and graduate medical education, it hasn’t been used as frequently in educating subspecialty fellows. Fewer than 5% of participants in a survey of different subspecialists indicated that simulations were part of their fellowship curriculum (1) even though simulation-based training is an ACGME program requirement (2). Chemotherapy infusion reactions (CIRs) occur with about 5% of all cytotoxic chemotherapies and even more frequently with biologics (3). These CIRs present significant morbidity and cost. HFS improves knowledge and confidence in medical trainees (4). Therefore, I designed a high fidelity simulation (HFS)-based curriculum to measure fellows’ current medical knowledge and provide a mechanism for gaining increased understanding and confidence. Across subspecialty graduation medical education, only one SBE with IRs has been performed, and that project aimed only to measure existing knowledge (5). This project aims to measure oncology fellows’ knowledge of and confidence in CIR management, measure attitudes regarding SBEs, measure improvement in knowledge following the SBEs, and assess for changes in behavior (management of CIRS) that may occur following these interventions. Methods: The HFS takes place in the VA Hospital Interdisciplinary Simulation and Education Center, which consists of a programmable mannequin that can “talk” through a speaker and convey physical exam signs in an “outpatient clinic.” Participants will interact with the mannequin, who will be a patient experiencing a paclitaxel infusion reaction. An evaluator will be grading the participant’s actions with an OSCE style checklist. Immediate debriefing will be followed by a didactic. Participants will complete postintervention surveys regarding their confidence in and knowledge of management of CIRS. Participants will later be evaluated on their attitudes regarding the simulation, their knowledge of CIR management, and will also provide critique of the same interaction done by another provider. These HFS-based activities will allow evaluation of fellows’ current knowledge of and comfort with CIRS, fellows’ attitudes regarding the intervention, improvement in knowledge occurred following the intervention, and anticipated change in management.

© 2019 American Society of Clinical Oncology. Visit abstracts.asco.org and search by abstract for disclosure information.

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