ISRRT_COVID-19_book

questioning to promote their critical thinking. The pivot existed in a paperless environment
where Blackboard Collaborate held the submission box for the plan documentation.
Anecdotally, students reported positive feedback at the end of the CSS confirming that the
change in delivery allowed students more access to and time interacting with the treatment
planning system. Faculty and students were also able to work collaboratively, offering
seamless facilitation within the treatment planning stream.
Treatment Delivery
At the Michener institute we have two fully functional Elekta LINAC emulators that include
CBCT, but without megavoltage generation. Our system includes an XVI imaging system, a
record and verify station, and a MOSAIQ® electronic medical record system customized for
our methodology labs. Prior to the pandemic, students performed treatment setups and
delivery in pairs following provided protocols. One of the innovative aspects of CSS was that
students were patient models from which they could experience the patient perspective
during setup and treatment. This experience addressed learning in the affective domain by
enhancing growth in patient empathy. Debriefing occurred after each session with students
sharing their reflections. Faculty used formative and summative objective structured clinical
evaluations (OSCEs) to assess the student’s readiness for clinic in areas such as
communication, coherence in workflow, clinical skills, and verification and delivery. In the
virtual classroom (GoToMeeting) that we selected, the equipment could not be utilized in a
comparable manner as the pre-pandemic classroom.
As student demonstration of the psychomotor skills in treatment delivery in an online format
was not possible, faculty focused on the critical thinking aspects, employing weekly online
meetings with small groups of students. In preparation for these sessions, faculty prepared a
template for patient case studies for students to use for discussion and analysis of clinical
situations. The cases were site-based and integrated concepts from oncology, radiobiology,
anatomy, and patient care. These concepts drove the discussion format for the technical
delivery aspects of radiation during simulation, planning, and delivery. The cases included a
bank of discrete decision points to promote student preparation.
To simulate treatment setups online, the Virtual Environment Radiation Therapy software
(VERT) became a critical teaching tool for the radiation therapy techniques. As we had never
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