Cognitive Processes Involved in Radiation Oncology Contouring: Protocol Analysis to Evaluate Framework and Develop Interventions to Improve Resident Education (ACRO Dr. Luther Brady Educational Grant Project)
Faculty and Abstracts
Purpose: To describe the discrete actions, mental procedures, and cognitive processes utilized in radiation target volume delineation and to investigate how those processes develop over the course of radiation oncology residency training. Currently, no literature exists utilizing protocol analysis of radiation planning, nor does literature exist investigating the cognitive processes of radiation oncologists during planning. Therefore, this pilot study represents the first known foray into further describing the radiation planning process as it pertains to individuals and specifically to resident education. We aimed to formally evaluate the contouring process using verbal and visual data to reveal the processes and actions that might otherwise remain concealed from observation, and then utilize these processes to improve trainee contouring education and outcomes. By asking experts and trainees to participate, comparisons could be drawn between these groups to determine techniques or cognitive behaviors that experts versus novices employ during treatment volume delineation.
Methodology: We asked radiation oncology resident trainees and radiation oncology faculty experts to participate in an examination of the radiation volume contouring process using a verbal protocol analysis. They will contour a post-lumpectomy breast and regional lymph node case while thinking aloud and describing their steps in words including discrete actions, mental procedures, cognitive processes, and utilized resources. A rubric will be created and expert process will be compared to trainee process. Verbal reports will be coded to identify themes in the “think aloud” process. Results of this analysis will be used to create educational materials focused on critical steps in the process of contouring a breast cancer case. Residents will be asked to complete a survey both before and after review of provided educational materials to assess comfort with contouring of the cases.
