Assessing Pediatric Resident Knowledge and Comfort with Radiation Therapy Concepts: A Cross-Sectional Survey to Inform Curricular Development

Summary: Pediatric cancer remains prevalent and is frequently encountered by pediatricians in both inpatient and outpatient settings. Between 2003 and 2019, the incidence of pediatric cancer increased by 0.5%. As radiotherapy (RT) is a common component of treatment for many pediatric cancers, pediatric residents must develop a foundational understanding of RT concepts to effectively manage these patients during treatment and in long-term follow-up care. A cross-sectional, anonymous survey was conducted at a single institution among Pediatrics residents, categorized as “Junior” (PGY1-2) or “Senior” (PGY3-4). The survey assessed for comfort with inpatient RT indications, understanding of late RT effects, and implementing screening guidelines in patients who have received RT, as well as satisfaction with current pediatric RT-related didactic curriculum using a 5-point Likert scale. Five multiple-choice questions (MCQ) were also included to gauge resident knowledge of basic RT concepts. Fisher’s exact test was used to assess associations between training level and Likert responses, and Mann-Whitney-U analysis was performed to compare MCQ performance between groups. Of the 108 residents in the Pediatrics program, 27 survey responses were collected (34% response rate). Respondents consisted of 17 Juniors (63%) and 10 Seniors (37%). For comfort with pediatric inpatient RT indications, most Juniors and Seniors selected extremely or somewhat uncomfortable (11/17, 65% and 8/10, 80%, respectively). For comfort with understanding RT late effects, most Juniors and Seniors selected extremely or somewhat uncomfortable (11/17, 65% and 5/10, 50%). For comfort with implementing screening guidelines, most Juniors and all Seniors selected extremely or somewhat uncomfortable (13/17, 76% and 10/10, 100%). For satisfaction with the curriculum pertaining to inpatient RT indications, the majority of Juniors selected neutral (9/17, 53%), followed by extremely or somewhat dissatisfied (7/17, 41%), and extremely satisfied (1/17, 6%). All Seniors responded extremely or somewhat dissatisfied (10/10, 100%). For satisfaction with the curriculum pertaining to the primary care of patients who received RT, most Juniors and all Seniors selected extremely or somewhat dissatisfied (9/17, 53% and 10/10, 100%). There were no significant associations between Junior or Senior status and Likert responses for any survey item detected on Fisher’s exact test. Across all five MCQs, Juniors had a 73% correct response rate (62/85), and Seniors had an 86% correct response rate (43/50). No significant differences between Junior and Senior scores for any MCQ were found on Mann-Whitney U analysis. Despite performing well on knowledge assessments, pediatrics residents across all training levels expressed low comfort with RT concepts and dissatisfaction with the current didactic curriculum. These gaps highlight the need for targeted education to better prepare residents to care for pediatric patients undergoing or having completed RT. Structured RT-focused instruction is warranted to address these deficiencies, ensuring residents are equipped to deliver high-quality, patient-centered oncology care. Katherine Halper, MD (Presenting Author) - UCLA; Rojine T. Ariani (she/her/hers), MD, MS (Co-Author) - Department of Radiation Oncology, UCLA; Trudy Wu, MD (Co-Author) - University of California, Los Angeles; Jessica Eby, MD (Co-Author) - UCLA