Study design
This study consisted of the ChicaEducation system training module group and traditional training methods group, using survey instruments for data collection. Each group had 30 radiation oncology medical students. Students in the traditional training methods group did not receive ChicaEducation system training. And students in the ChicaEducation system training module group received ChicaEducation system training for two months.
Master of Radiation Oncology at the University of Electronic Science and Technology of China
The radiation oncology is offered as a 3-year postgraduate program, which prepares medical students for subsequent entry into clinical training (Residency Standardized Training). Traditionally, radiation oncology has been undertaken using a combination of didactic lectures tutorials conducted at university, as well as tutorials, practices, and demonstrations conducted in RT departments under the supervision of clinical radiation oncology medical students.
Participants
All 60 radiation oncology medical students at Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China were invited to participate in this study in 2019. All students were the first year of the Standardized Training of Residents. The age of all the students ranged from 23 to 25. Informed consent was obtained from all individual participants included in the study. All data of the questionnaires collected was anonymous.
ChicaEducation system
This system was used to offer networked teaching and training opportunities for medical student education. The integration of the ChicaEducation system could supplement classroom teaching and introduce oncology medical students to virtual radiation therapy environments. Three ChicaEducation system practical sessions were developed: (1) Virtual CT system, (2) Target delineation and radiation treatment planning system, and (3) Linear accelerator simulation system. The learning objectives for each of the sessions are listed in Table 1. In the “Virtual CT systems” practical session radiation oncology students can learn organs at risk in radiation therapy and how to delineate organs at risk accurately according to anatomies. Simulated CT datasets from different anatomical sites of bodies were imported into the ChicaEducation system. The CT data contained four anatomical structures: head and neck, thorax, abdomen, pelvis regions. In the “Target delineation and radiation treatment planning system” practical session radiation oncology students can obtain target delineation and radiation treatment plans of cancers at different sites. Primary and nodal gross tumor volumes (GTVs), and primary and nodal clinical target volumes (CTVs) can be delineated based on the simulated CT images. Many radiation treatment plan systems, including the Eclipse treatment planning system (Varian, California, USA) and the Pinnacle 3 treatment planning system (Philips, Best, Holland) were employed in the ChicaEducation system. The students can see many simulated radiation treatment plans in terms of different dose prescriptions. And the students can perform a radiation treatment plan independently. Through the ChicaEducation system, students’ plans can be evaluated. A better plan can be chosen by comparing different plans. The “Linear accelerator simulation system” practical session can provide an introduction to various quality control (QA) measurements. ChicaEducation system can offer linear accelerators in a life-sized virtual radiotherapy treatment room with immobilization equipment on the treatment couch. It is essential to introduce QA methods to radiation oncology medical students. QA workflows on teaching tools were offered in the ChicaEducation system. Furthermore, the students can perform QA measurements independently in the ChicaEducation system.
Student evaluation of ChicaEducation systems
Evaluations of two group students were conducted using three questionnaires (“Virtual CT system” session, “Target delineation and radiation treatment planning system” session and “Linear accelerator simulation system” session). Sixty students participated in the evaluation, and 60 completed the three questionnaires were received. In the “Virtual CT system” session in table 3, all students were asked to rate their current knowledge on the relationship of anatomy to target delineation and radiation therapy. A score of each item was on a scale of 1–5, with a score of 1 indicating poor and a score of five indicating excellent. In the “Target delineation and radiation treatment planning system” session, some questions were shown in table 4. Students reported that the “Target delineation and radiation treatment planning system” session helped them link the theoretical knowledge to target delineation and radiation treatment planning system. Some simple questions were listed in table 5 in the “Linear accelerator simulation system” session. These questions were asked about the role of the physics of radiology course and validation of radiation treatment.
Statistical Analysis
Continuous variables were expressed as median and range. Statistical data were performed using SPSS 18.0 statistical software. Wilcoxon rank-sum tests were used for continuous variables that were not normally distributed. All tests of significance were two-sided, and the statistical difference was considered significant if P-values were <0.05.