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. 2024 Aug 30;150(8):407.
doi: 10.1007/s00432-024-05908-x.

Tumor board simulation improves interdisciplinary decision-making in medical students

Kevin Fink  1   2   3 , Marie Forster  4 , Matthias Oettle  4   5 , Marcel Büttner  6 , Chukwuka Eze  1 , Lukas Käsmann  1   7 , Amanda Tufman  8   7 , Diego Kauffmann-Guerrero  8   7 , Toki A Bolt  8 , Julia Kovacs  9 , Jens Neumann  10 , Johannes Mücke  1 , Sonja Heuser  4 , Stefanie Corradini  1 , Franziska Walter  1 , Maximilian Niyazi  6   11 , Claus Belka  1   12   2 , Martin Dreyling  3 , Martin R Fischer  4 , Daniel F Fleischmann  13   14   15   16
Affiliations

Tumor board simulation improves interdisciplinary decision-making in medical students

Kevin Fink et al. J Cancer Res Clin Oncol. .

Abstract

Introduction: Training of interdisciplinary clinical reasoning and decision-making skills, essential in daily clinical practice in oncological specialties, are still underrepresented in medical education. Therefore, at LMU University Hospital Munich, we implemented a didactically modified tumor board simulation with experts from five different disciplines (medical oncology, pathology, radiation oncology, radiology, and surgery) presenting patient cases into a one-week course on the basic principles of oncology. In this survey, we examined the self-assessed impact of our course on the interdisciplinary decision-making skills of medical students.

Methods: Between November-December 2023 and January-February 2024, we surveyed two cohorts of medical students in the third year of medical school in our one-week course before and after participating in the tumor board simulation. The objective was to evaluate the self-assessed knowledge in interdisciplinary clinical decision-making, in integrating ethical considerations into clinical reasoning, and in comprehension of various professional viewpoints in interdisciplinary decision-making. Knowledge was assessed using a five-step Likert scale from 1 (no knowledge) to 5 (complete knowledge).

Results: The survey was answered by 76 students before and 55 after the simulation, equaling 60-70% of all 100 course participants. Mean knowledge level regarding principles of interdisciplinary clinical decision-making improved significantly in all of the following exemplary aspects: purpose and procedure of tumor boards in clinical practice (from 2.4 ± 1.1 to 4.0 ± 1.0, Spearman's ρ = 0.6, p < 0.001), principles of dealing with ethical challenges in oncology (from 2.4 ± 1.1 to 3.4 ± 1.0, ρ = 0.4, p < 0.001), and principles of shared decision-making in oncology (2.7 ± 1.1 to 3.7 ± 1.0, ρ = 0.4, p < 0.001). Students reported that their skills in clinical decision-making and ability to discuss oncological patient cases from different professional viewpoints improved due to the teaching course.

Conclusion: By employing our interdisciplinary one-week course and a didactically modified tumor board simulation featuring experts from various oncological disciplines, medical students' comprehension of interdisciplinary clinical decision-making in oncology improved significantly.

Keywords: Decision-making; Medical education; Oncology; Tumor board simulation.

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Conflict of interest statement

M.D. received research support from Abbvie, Bayer, BMS/Celgene, Gilead/Kite, Janssen, Lilly, and Roche. M.D. received Speakers Honoraria from Astra Zeneca, Beigene, Gilead/Kite, Janssen, Lilly, Novartis, and Roche. M.D. is part of the Scientific Advisory Board of Abbvie, Astra Zeneca, Beigene, BMS/Celgene, Gilead/Kite, Janssen, Lilly/Loxo, Novartis, and Roche. No other disclosures were reported. The project was financially supported by the medical faculty of the LMU Munich and the Virtuelle Hochschule Bayern (vhb).

Figures

Fig. 1
Fig. 1
Impact of the teaching format on students’ self-assessed knowledge levels in the item group of interdisciplinary decision-making in tumor boards in general. Green: before course; red: after course. Knowledge level was assessed on a five-point scale from 1 [very little knowledge] to 5 [very much knowledge]. (a) Radar chart of the mean rating before and after the teaching course. (b) Boxplot of students’ responses, rhombus displays the respective mean rating, and the p-value was calculated using the Wilcoxon test
Fig. 2
Fig. 2
Impact of the teaching format on students’ self-assessed knowledge levels in the item group of expert viewpoints in interdisciplinary decision-making in tumor boards. Green: before course; red: after course. Knowledge level was assessed on a five-point scale from 1 [very little knowledge] to 5 [very much knowledge]. (a) Radar chart of the mean rating before and after the teaching course. (b) Boxplot of students’ responses, rhombus displays the respective mean rating, and the p-value was calculated using the Wilcoxon-test
Fig. 3
Fig. 3
Impact of the teaching format on students’ self-assessed knowledge levels in the item group of ethical aspects and considerations in oncology. Green: before course; red: after course. Knowledge level was assessed on a five-point scale from 1 [very little knowledge] to 5 [very much knowledge]. (a) Radar chart of the mean rating before and after the teaching course. (b) Boxplot of students’ responses, rhombus displays the respective mean rating, and p-value was calculated using the Wilcoxon test
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