Northwestern Feinberg School of Medicine Chicago, IL
K. E. Fink1, S. A. Fleishman1, M. K. Rooney2, and D. W. Golden3; 1Feinberg School of Medicine, Chicago, IL, 2Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, 3Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, IL
Purpose/Objective(s): Patient education is demonstrated to reduce patient anxiety, facilitate shared decision making, and improve treatment outcomes. This scoping review aims to characterize the state of radiation oncology scholarship to identify research trends and knowledge gaps that can guide future efforts in radiation oncology patient education scholarship. Materials/
Methods: A scoping review of the literature was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Scoping Review (ScR) guidelines. PubMed, Google Scholar, and a modified snowball method were used to identify articles describing patient education in radiation oncology. English language articles published after 1/1/1990 that had a primary radiation oncology patient education focus were included. Two independent reviewers (KEF and SAF) performed the search and determined eligibility. A third reviewer (MKR) provided consensus on disputed articles. Results: A total of 1128 references were initially found across two databases and through the modified snowball method. 236 original articles were included in the final analysis. The most common education topic was general overview of treatment (46.2%) followed by treatment logistics (20.3%) and toxicity management (14%). 45.6% of included articles were primarily problem identification or needs assessment (Six-Step phase 1 and 2), 48.7% were implementation focused (Six-Step phases 3-6), and 3.8% included components of both. Of the 115 interventional studies, 51.3% were experimental and 49.6% were observational, with 52 case series (45.2%) and 46 randomized trials (40.0%) as the most prevalent study designs. The most common categories of interventions were verbal (n=47, 40.9%), print (n=39, 33.9%), video (n=25, 21.7%), electronic education (n=13, 11.3%), audio (n=12, 10.4%), and virtual reality (n=10, 8.7%). Reaction (n=50, 43.5%) was the most common Kirkpatrick level of training evaluation followed by results (n=30, 26.1%), learning (n=26, 22.6%), and change in behavior (16, 13.9%). While 52 intervention studies had no direct staff involved, the remaining intervention studies required staff support: nurses (n=37, 32.2%), physicians (n=20, 17.4%), radiation therapists (n=13, 11.3%), and other (n=15, 13%). Some interventions fell into multiple categories, Kirkpatrick levels, or included multiple staff types. 48 studies (41%) detailed educational material that the healthcare professional actively explained or used with the patient. Conclusion: Although there is an encouraging trend of increasing radiation oncology patient education publications over time, this study identifies opportunities to further develop, implement, and evaluate radiation oncology patient education scholarship specifically focusing on interventional (Six Step phase 3-6) studies and evaluating the extent to which they improve patient learning and behavior.
