Towards a Postgraduate Oncology Training Model for Family Medicine: Mixed Methods Evaluation of a Breast Oncology Rotation

Abstract

Background: Family physicians have low knowledge and preparedness to manage patients with cancer. A breast oncology clinical rotation was developed for family medicine residents to address this gap in medical education.

Objectives and methods: A breast oncology rotation for family residents was evaluated using a pre-post knowledge questionnaire and semi-structured interviews comparing rotation (RRs) versus non-rotation (NRRs) residents. Quantitative and qualitative data were collected via a pre-post knowledge questionnaire and semi-structured interviews, respectively.

Analysis: Quantitative data were analysed using descriptive statistics and paired t-tests to compare pre-post-rotation knowledge and preparedness. Qualitative data were coded inductively, analysed, and grouped into categories and themes. Data sets were integrated.

Results: The study was terminated early due to the COVID-19 pandemic. Six RRs completed the study; 19 and 2 NRRs completed the quantitative and qualitative portions, respectively. RRs' knowledge scores did not improve, but there was a non-significant increase in preparedness (5.3 to 8.4, p = 0.17) post-rotation. RRs described important rotation outcomes: knowledge of the patient work-up, referral process, and patient treatment trajectory; skills in risk assessment, clinical examination, and empathy, and comfort in counseling.

Discussion and conclusion: Important educational outcomes were obtained despite no change in knowledge scores. This rotation can be adapted to other training programs including an oncology primer to enable trainee integration of new information.

Keywords: breast cancer; breast oncology; communication; family medicine residents; knowledge; medical education; mixed methods; program evaluation; rotation evaluation; skills; survivorship.