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Attitudes and perceptions of radiologists towards online (virtual) oncologic multidisciplinary team meetings during the COVID-19 pandemic—a survey of the European Society of Oncologic Imaging (ESOI)
Objectives
To explore radiologists’ opinions regarding the shift from in-person oncologic multidisciplinary team meetings (MDTMs) to online MDTMs. To assess the perceived impact of online MDTMs, and to evaluate clinical and technical aspects of online meetings.
Methods
An online questionnaire including 24 questions was e-mailed to all European Society of Oncologic Imaging (ESOI) members. Questions targeted the structure and efficacy of online MDTMs, including benefits and limitations.
Results
A total of 204 radiologists responded to the survey. Responses were evaluated using descriptive statistical analysis. The majority (157/204; 77%) reported a shift to online MDTMs at the start of the pandemic. For the most part, this transition had a positive effect on maintaining and improving attendance. The majority of participants reported that online MDTMs provide the same clinical standard as in-person meetings, and that interdisciplinary discussion and review of imaging data were not hindered. Seventy three of 204 (35.8%) participants favour reverting to in-person MDTs, once safe to do so, while 7/204 (3.4%) prefer a continuation of online MDTMs. The majority (124/204, 60.8%) prefer a combination of physical and online MDTMs.
Conclusions
Online MDTMs are a viable alternative to in-person meetings enabling continued timely high-quality provision of care with maintained coordination between specialties. They were accepted by the majority of surveyed radiologists who also favoured their continuation after the pandemic, preferably in combination with in-person meetings. An awareness of communication issues particular to online meetings is important. Training, improved software, and availability of support are essential to overcome technical and IT difficulties reported by participants.
Key Points
• Majority of surveyed radiologists reported shift from in-person to online oncologic MDT meetings during the COVID-19 pandemic.
• The shift to online MDTMs was feasible and generally accepted by the radiologists surveyed with the majority reporting that online MDTMs provide the same clinical standard as in-person meetings.
• Most would favour the return to in-person MDTMs but would also accept the continued use of online MDTMs following the end of the current pandemic.
Journal Article
Involvement of radiologists in oncologic multidisciplinary team meetings: an international survey by the European Society of Oncologic Imaging
Objectives
Multidisciplinary tumour boards (MTBs) play an increasingly important role in managing cancer patients from diagnosis to treatment. However, many problems arise around the organisation of MTBs, both in terms of organisation-administration and time management. In this context, the European Society of Oncologic Imaging (ESOI) conducted a survey among its members, aimed at assessing the quality and amount of involvement of radiologists in MTBs, their role in it and related issues.
Methods
All members were invited to fill in a questionnaire consisting of 15 questions with both open and multiple-choice answers. Simple descriptive analyses and graphs were performed.
Results
A total of 292 ESOI members in full standing for the year 2018 joined the survey. Most respondents (89%) declared to attend MT-Bs, but only 114 respondents (43.9%) review over 70% of exams prior to MTB meetings, mainly due to lack of time due to a busy schedule for imaging and reporting (46.6%). Perceived benefits (i.e. surgical and histological feedback (86.9%), improved knowledge of cancer treatment (82.7%) and better interaction between radiologists and referring clinicians for discussing rare cases (56.9%)) and issues (i.e. attending MTB meetings during regular working hours (71.9%) and lack of accreditation with continuing medical education (CME) (85%)) are reported.
Conclusions
Despite the value and benefits of radiologists’ participation in MTBs, issues like improper preparation due to a busy schedule and no counterpart in CME accreditation require efforts to improve the role of radiologists for a better patient care.
Key Points
• Most radiologists attend multidisciplinary tumour boards, but less than half of them review images in advance, mostly due to time constraints.
• Feedback about radiological diagnoses, improved knowledge of cancer treatment and interaction with referring clinicians are perceived as major benefits.
• Concerns were expressed about scheduling multidisciplinary tumour boards during regular working hours and lack of accreditation with continuing medical education.
Journal Article
A step-wise approach for establishing a multidisciplinary team for the management of tuberous sclerosis complex: a Delphi consensus report
Background
Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disorder associated with mutations in
TSC1
and
TSC2
genes, upregulation of mammalian target of rapamycin signaling, and subsequent tumor formation in various organs. Due to the many manifestations of TSC and their potential complications, management requires the expertise of multiple medical disciplines. A multidisciplinary care approach is recommended by consensus guidelines. Use of multidisciplinary teams (MDTs) has been shown to be beneficial in treating other complex diseases, such as cancer. In a lifelong disease such as TSC, an MDT may facilitate the transition from pediatric to adult care. However, little guidance exists in the literature regarding how to organize an MDT in TSC.
Methods
To discuss the best approach to assembling an MDT, this project was initiated in October 2017 with a meeting of 12 physicians from various specialties and various countries. Following this first meeting, the experts generated statements on the most important aspects to implement in establishing an MDT for TSC by 3 rounds of selection using a Delphi process via electronic correspondence. Finally, TSC patient advocates reviewed the findings and provided additional insights from a patient perspective.
Results
A 3-step roadmap was recommended, starting with identifying a single individual to begin organizing care (Step 1), then establishing a small core team (Step 2), and finally, establishing a larger multi-disciplinary team (Step 3). Because of the multisystemic nature of TSC, the MDT should include specialists such as a neurologist, a neurosurgeon, a nephrologist, a urologist, a pulmonologist, an ophthalmologist, a cardiologist, a dermatologist, a geneticist, and a psychiatrist/psychologist. The MDT should recommend a care plan for each patient based on the individual’s needs and in consultation with him/her or his/her family. Some of the most important aspects of an MDT that were agreed upon included identifying a case manager to help coordinate care, providing access to health care professionals of varying specialties, and including a lead physician who takes medical responsibility for patients’ overall care.
Conclusions
The results of our consensus provide guidance to support the initiation of an MDT in TSC.
Journal Article
Qualitative evaluation of a standardized patient clinical simulation for nurse practitioner and pharmacy students
This article describes a qualitative evaluation of an interprofessional educational experience for nurse practitioner and pharmacy students using standardized patients and physicians role-playing physicians in clinical scenarios. This experience included the development of two clinical scenarios; training of standardized patients, providers, and faculty facilitators; pre-briefing preparation; partial facilitator prompting simulations; and facilitated debriefings. Forty-six students participated in the formative simulation. Small groups of students and faculty facilitators worked through two clinical scenarios that were based on the expected emergence of the patient-centered medical homes. The scenarios incorporated different interprofessional communication modes, including in-person, telephonic, and video-conferencing. Time-in/time-out debriefings were incorporated to provide guidance to students about how to engage in interprofessional collaboration. After completion of the scenarios, facilitated group debriefings allowed for reflection on communication strategies and roles. Immediately following the learning activity, 30 volunteer focus group participants provided comments anonymously in a semi-structured format. Conventional content analysis was used to identify overarching themes. Participants expressed improved understanding of individual roles, increased confidence, and a better sense of interprofessional support. The educational experience themes included the benefits of a realistic nature of the simulation and the need for improved student orientation to roles and expectations prior to the clinical simulations.
•Evaluation of partial facilitator prompting interprofessional clinical simulations.•Nurse practitioner students & pharmacy students experienced two clinical scenarios.•Content analysis of data conducted from semi-structured focus group transcripts.•Students improved understanding of roles, interprofessional support & confidence.•Realistic clinical scenarios & improved student orientations are recommended.
Journal Article
Challenges facing interdisciplinary researchers: Findings from a professional development workshop
Interdisciplinary research is the synergistic combination of two or more disciplines to achieve one research objective. Current research highlights the importance of interdisciplinary research in science education, particularly between educational experts within a particular science discipline (discipline-based education researchers) and those who study human learning in a more general sense (learning scientists). However, this type of interdisciplinary research is not common and little empirical evidence exists that identifies barriers and possible solutions. We hosted a pre-conference workshop for Discipline-Based Educational Researchers and Learning Scientists designed to support interdisciplinary collaborations. We collected evidence during our workshop regarding barriers to interdisciplinary collaborations in science education, perceptions of perceived cohesion in participants’ home university departments and professional communities, and the impact of our workshop on fostering new connections. Based on participants’ responses, we identified three categories of barriers, Disciplinary Differences , Professional Integration , and Collaborative Practice . Using a post-conference survey, we found an inverse pattern in perceived cohesion to home departments compared to self-identified professional communities. Additionally, we found that after the workshop participants reported increased connections across disciplines. Our results provide empirical evidence regarding challenges to interdisciplinary research in science education and suggest that small professional development workshops have the potential for facilitating durable interdisciplinary networks where participants feel a sense of belonging not always available in their home departments.
Journal Article