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Research Article| Volume 24, P19-24, December 2022

The landscape of digital resources in radiation oncology

Open AccessPublished:September 14, 2022DOI:https://doi.org/10.1016/j.tipsro.2022.08.006
The landscape of digital resources in radiation oncology
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      Abstract

      In recent years, the number of educational medical resources accessible to residents and practicing radiation oncologists online has grown exponentially to include discussion boards, wikis, videos, podcasts, journal clubs, online communities, and interactive experiences to augment medical education. In this review, we identify, catalog, and critically evaluate educational websites, smartphone applications, web-based multimedia, and podcasts for radiation oncologists. Literature searches were conducted over a 2-month period (April to May 2022) using OVID-MEDLINE and PubMed with a combination of relevant search terms. Websites of relevant radiation oncology societies were reviewed for e-learning resources. Internet searches including the Google search engine, application stores, and podcast-publisher websites were conducted to identify digital resources for radiation oncology education. To ensure credibility, resources were assessed by two independent reviewers utilizing the criteria of authority, accuracy, objectivity, currency, depth, and appearance per suggested formats for evaluating digital resources in medical literature. Literature searches using OVID-MEDLINE and PubMed yielded 425 citations. Those pertinent to radiation oncology provide examples of resource development, integrations into curriculum, interactive modules, case studies, and learner experiences. The multilevel search identified 47 free digital education resources including online radiation oncology tutorials, podcasts, videos, slide sets, applications, and other interactive resources, some requiring membership or a fee for full access. The myriad online educational tools available to radiation oncology residents represent excellent resources for continuing education. This review represents the first comprehensive summary of available online education resources for radiation oncologists to guide clinicians who are increasingly reliant on digital resources, especially during the COVID-19 pandemic.

      Keywords

      Introduction

      The education provided by residency programs is considered the keystone in the development of clinical competency, skills required for practice, and preparation for board examination. Various methods of teaching exist in a radiation oncology curriculum [
      • Abrams M.J.
      • Golden D.W.
      • Huang G.C.
      A Call for Reform: Variability and Insufficiency in Radiation Oncology Resident Didactics-a Brief Report and National Survey of Program Directors.
      J Cancer Educ. 2021;
      ]. These include physical classes, didactic lectures, group discussion, webinars, and conferences. The revolution of the internet and ease of accessibility with increasing smartphone usage in the past decade has broadened the availability of resources that one can access for study [
      • Parekh S.G.
      • Nazarian D.G.
      • Lim C.K.
      Adoption of information technology by resident physicians.
      Clin Orthop Relat Res. 2004; 421: 107-111
      ]. Furthermore, the COVID-19 pandemic shifted paradigms in clinical education globally with restrictions imposed in the form of social distancing and curtailment of hands on procedures [
      • Wakefield D.V.
      • Sanders T.
      • Wilson E.
      • Hubler A.
      • DeWeese T.
      • Smith B.D.
      • et al.
      Initial Impact and Operational Responses to the COVID-19 Pandemic by American Radiation Oncology Practices.
      Int J Radiat Oncol Biol Phys. 2020; 108: 356-361
      ,
      • Buckstein M.
      • Skubish S.
      • Smith K.
      • Braccia I.
      • Green S.
      • Rosenzweig K.
      Experiencing the Surge: Report From a Large New York Radiation Oncology Department During the COVID-19 Pandemic.
      Adv Radiat Oncol. 2020; 5: 610-616
      ]. Face-to-face classes and case presentations saw a drastic decrease in attendance, thus limiting trainees' learning opportunities [
      • Kosydar S.
      • Woodfin M.W.
      • Halasz L.M.
      • Apisarnthanarax S.
      • Rengan R.
      • Lo S.S.
      The Impact of COVID-19 on US Radiation Oncology Residents.
      J Cancer Educ. 2021;
      ]. Online tools and platforms such as Zoom, WebEx, and Microsoft Teams have been increasingly utilized for knowledge sharing throughout radiation oncology departments [
      • Gottlieb M.
      • Landry A.
      • Egan D.J.
      • Shappell E.
      • Bailitz J.
      • Horowitz R.
      • et al.
      Rethinking Residency Conferences in the Era of COVID-19.
      AEM Educ Train. 2020; 4: 313-317
      ]. Moreover, the decreased volume of radiation therapy has impacted hands-on training opportunities while decreasing educational opportunities via direct patient care [
      • Hilmi M.
      • Boileve A.
      • Ducousso A.
      • Michalet M.
      • Turpin A.
      • Neuzillet C.
      • et al.
      Professional and Psychological Impacts of the COVID-19 Pandemic on Oncology Residents: A National Survey.
      JCO Glob Oncol. 2020; 6: 1674-1683
      ].
      Amidst this changing landscape of educational opportunities, clinical education has become increasingly reliant on online educational resources [
      • Chen S.Y.
      • Lo H.Y.
      • Hung S.K.
      What is the impact of the COVID-19 pandemic on residency training: a systematic review and analysis.
      BMC Med Educ. 2021; 21: 618
      ]. Online tools, such as radiation oncology-focused websites, podcasts, smartphone applications (apps), and videos, provide useful sources of information and study material for the budding resident and practicing clinician that have become essential [
      • Chick R.C.
      • Clifton G.T.
      • Peace K.M.
      • Propper B.W.
      • Hale D.F.
      • Alseidi A.A.
      • et al.
      Using Technology to Maintain the Education of Residents During the COVID-19 Pandemic.
      J Surg Educ. 2020; 77: 729-732
      ,
      • Riddell J.C.
      • Robins L.
      • Sherbino J.
      • Brown A.
      • Ilgen J.
      Residents' Perceptions of Effective Features of Educational Podcasts.
      West J Emerg Med. 2020; 22: 26-32
      ]. These resources vary in their accessibility, with some content existent behind paywalls, while others information at no cost to the user. With the vast number of open access websites, apps, and varied options available online, it becomes essential to ensure only reputable sources with high-yield content, regular updates, and proper functionality are utilized.
      The purpose of this review is to identify, catalog, and critically evaluate knowledge-providing websites, smartphone apps, videos, and podcasts tailored to radiation oncology.

      Materials and methods

      To identify and evaluate web-based resources for radiation oncology education, a multilevel search was conducted over a 2-month period (April to May 2022). Literature searches were conducted using OVID-MEDLINE and PubMed with the terms “web-based learning,” “computer-assisted instruction,” “e-learning,” “radiation oncology,” “tutorials,” “continuing education,” “virtual learning,” “mobile application,” and “web-based education.”.
      We identified and searched the websites of relevant and reputable radiation oncology societies (American Society of Radiation Oncology [ASTRO], European Society of Radiation Oncology [ESTRO], Radiation Oncology Education Collaborative Study Group, American College of Radiation Oncology, Association of Residents in Radiation Oncology [ARRO], Radiation Oncology Institute [ROI], and Rayos Contra Cancer) for the availability of, or reference to, web-based resources. We performed a Google search using the terms “e-learning,” “tutorials,” “continuing education,” “virtual learning,” “radiation oncology,” “radiation,” “radonc,” “rad onc,” “resident,” “residency,” “education,” “curriculum,” “radiobiology,” “bootcamp,” “online,”, “radbio,” “physics,” “smartphone application,” “app,” “web-based education,” and “video.” The smartphone apps were searched in the Google Play Store and the Apple App Store for Android and iOS devices, respectively. The apps were searched with a focus on their content, functionality, and tools available for academics or radiotherapy planning. Podcasts were searched in Apple Podcasts, Google Play Music, and Spotify. YouTube was also searched for channels dedicated to academic radiation oncology. Channels with fewer than two thousand views were excluded. Contents of these YouTube channels were scrutinized based on the intended audience. Online-video series and podcasts under a common theme or name were categorized as a single digital resource.
      To ensure the credibility of digital resources, all items were assessed by two independent reviewers according to authority, accuracy, objectivity, currency, coverage, and appearance per criteria for evaluating websites and digital media in the medical literature developed by University of North Carolina librarians and outlined in Table 1 [

      University of North Carolina Health Sciences Library. Evaluating Information in the Research Process: Evaluation Criteria. Last updated Apr 5, 2022. Available at https://guides.lib.unc.edu/evaluating-info/evaluate. Accessed on May 1, 2022.

      ].
      Table 1Criteria for evaluating digital resources.
      Adapted from University of North Carolina Health Sciences Library [11].
      AuthorityCan the legitimacy of the organization, group, company or individual be verified?

      Is there any indication of the author’s qualifications for writing on a particular topic?

      Is the information from sources known to be reliable?
      AccuracyAre the sources for factual information clearly listed and verifiable in another source?
      ObjectivityIs the information objective or subjective?

      Is the information biased?

      If there is any advertising on the page; if so, is it clearly differentiated from the information content?
      CurrencyIs the information current?

      How current are the sources or links?
      CoverageDoes the information contain the breadth and depth needed?

      Is the information helpful?

      Is the information in a form that is useful, such as words, pictures, charts, sounds or videos?
      AppearanceDoes the site look well organized?

      Do the links work?

      Does the site appear well maintained?
      * Adapted from University of North Carolina Health Sciences Library

      University of North Carolina Health Sciences Library. Evaluating Information in the Research Process: Evaluation Criteria. Last updated Apr 5, 2022. Available at https://guides.lib.unc.edu/evaluating-info/evaluate. Accessed on May 1, 2022.

      .
      Resources were evaluated on the basis of the six categories outlined and those not meeting all six were not retained. A variety of reasons deemed a resource non-credible, including unclear authorship, biased content, out-of-date content (resources not updated for 5 years or more), and uncertain use of references. These resources were not chosen for inclusion in this review. Traditional resources such as society guidelines, digital textbooks, conference-specific smartphone apps, and peer-reviewed journals were not included. Also excluded were paid courses or those requiring scheduling, question banks, social media content (i.e., Facebook, Twitter, Instagram), industry-sponsored resources, and calculators or nomograms lacking radiation oncology-focused educational materials. This review covers resources unique to general radiation oncology education and does not include additional non-specialty education, such as diagnostic radiology.

      Results

      Literature searches using OVID-MEDLINE and PubMEd resulted in 425 records identified, which were analyzed for references to digital resources and relevance to radiation oncology. The published studies on the use of digital resources for medical education focused on the general use of web-based learning in medical education, the growth of e-learning options, learners’ perception of and satisfaction with online education, and trainee experiences with novel technologies.
      Those articles pertaining to radiation oncology covered a broad range of topics such as radiation oncology curriculum development [
      • Jimenez R.B.
      • Johnson A.
      • Padilla L.
      • Yechieli R.
      • Forman R.
      • Horick N.
      • et al.
      The Impact of an Introductory Radiation Oncology Curriculum (IROC) for Radiation Oncology Trainees Across the United States and Canada.
      Int J Radiat Oncol Biol Phys. 2020; 107: 408-416
      ], surveys reflecting current resource utilization and needs [
      • Ni L.
      • Thomas H.R.
      • Raleigh D.R.
      • Boreta L.C.
      • Park C.C.
      • Braunstein S.E.
      Residents-as-Teachers Curriculum for Radiation Oncology: A Targeted Needs Assessment.
      Int J Radiat Oncol Biol Phys. 2021; 111: 638-642
      ], interventions using digital resources to improve knowledge and treatment planning [
      • Alfieri J.
      • Portelance L.
      • Souhami L.
      • Steinert Y.
      • McLeod P.
      • Gallant F.
      • et al.
      Development and impact evaluation of an e-learning radiation oncology module.
      Int J Radiat Oncol Biol Phys. 2012; 82: e573-e580
      ], how to use contour-specific resources [
      • Sherer M.V.
      • Lin D.
      • Puri K.
      • Panjwani N.
      • Zhang Z.
      • Murphy J.D.
      • et al.
      Development and Usage of eContour, a Novel, Three-Dimensional, Image-Based Web Site to Facilitate Access to Contouring Guidelines at the Point of Care.
      JCO Clin Cancer Inform. 2019; 3: 1-9
      ], and development of critical skills when using novel technologies such as virtual reality [
      • Jin W.
      • Brickhead B.
      • Perez B.
      • Hoffe S.
      Augumented and virtual reality: Exploring a future role in radiation oncology education and training.
      Appl Rad Oncol. 2017; 6: 13-20
      ]. Only a few studies directly related to identification of online resources unique to radiation oncology [
      • Calero J.J.
      • Oton L.F.
      • Oton C.A.
      Apps for Radiation Oncology.
      A Comprehensive Review Transl Oncol. 2017; 10: 108-114
      ,
      • Prisciandaro J.I.
      Review of online educational resources for medical physicists.
      J Appl Clin Med Phys. 2013; 14: 4476
      ].
      Review of the websites of relevant radiation oncology societies revealed the existence of a substantial number of digital resources. The Radiation Oncology Education Collaborative Study Group (ROECSG) website [

      Radiation Oncology Education Collaborative Study Group (ROECSG). Available at https://roecsg.org/. Accessed on May 1, 2022.

      ] provides links to various external and internal educational resources including medical physics lectures, statistics seminars, content series geared toward medical students, board study review, and an introductory radiation oncology curriculum (IROC) designed for new resident orientation. It additionally hosts its presentations from conferences and slide sets with video. A site map outlines available resources and topics [

      Radiation Oncology Education Collaborative Study Group (ROECSG). ROECSG Web Resources. Available at https://roecsg.org/web-resources/. Accessed on May 1, 2022.

      ,

      Radiation Oncology Education Collaborative Study Group (ROECSG). ROECSG Educational Content. Available at https://roecsg.org/content/. Accessed on May 1, 2022.

      ].
      ASTRO’s website [

      American Society for Radiation Oncology (ASTRO). Available at https://www.astro.org/. Accessed on May 1, 2022.

      ] provides a wide variety of information from patient-focused resources to clinical guidelines for practitioners. Clinician-focused information includes links to external sites of interest (i.e., eContour), video courses on radiobiology and medical physics, and educational seminars often requiring membership and additional fees for full access. Included within ASTRO’s website is a page dedicated to the ARRO, an organization that provides webinars, monthly newsletters, resident e-learning resources, and collaborative opportunities. ASTRO additionally provides links to ROhub [

      American Society for Radiation Oncology (ASTRO). ROhub. Available at http://rohub.astro.org/. Accessed on May 1, 2022.

      ], discussion forum that requires membership for access, as well as RTAnswers [

      American Society for Radiation Oncology (ASTRO). ASTRO RT Answers. Available at https://www.rtanswers.org/. Accessed on May 1, 2022.

      ], a patient-focused website addressing common concerns for patients undergoing radiation therapy.
      ROI’s website [

      Radiation Oncology Institute (ROI). Available at https://www.roinstitute.org/. Accessed on May 1, 2022.

      ] provides links to their mobile application, RO Toolbox, which is available through the Apple App Store and Google Play Store. Additionally, they provide links to previously identified resources from ASTRO including the ARRO del Regato Webinars, which provide in-depth instruction on contouring, treatment planning, and other disease site-specific instruction.
      The ESTRO website [

      European Society for Radiation Oncology (ESTRO). Available at https://www.estro.org/. Accessed on May 1, 2022.

      ] primarily offers scheduled online and in-person courses for in-depth training, such as FALCON, an ESTRO project to improve homogeneity in counting among radiation oncologists. No freely available resources are directly linked through ESTRO, outside of the scheduled courses offered, and reference links to external content are not available.
      The ACRO’s website [

      American College of Radiation Oncology (ACRO). Available at https://acro.org/. Accessed on May 1, 2022.

      ] offers a monthly podcast, webinars (membership required), and online videos published through YouTube with disease site-specific educational materials as well as conference slides and presentations.
      Rayos Contra Cancer’s website [

      Rayos Contra Cancer Center. Available at https://www.rayoscontracancer.org/. Accessed on May 1, 2022.

      ] offers unique content that is internally produced and distributed through a Youtube channel. This content encompasses various topics from a brachytherapy planning curriculum to guides on contouring head-and-neck target volumes. They also provide links to useful educational resources for contouring, medical physics, study materials, and anatomy review.
      Online digital resources identified from this review that included education and teaching resources on a variety of topics pertinent to radiation oncology are listed in Table 2. In total, 344 education and teaching resources were reviewed and critiqued to formulate the 47 resources identified. An extensive description of each resource is beyond the scope of this review; however, direct links and categorical tags are provided for readers’ further review.
      Table 2Categorized list of digital radiation oncology resources (see reference list for links).
      Resource NameLast UpdateMaterial Covered (Tags separated by,)WebiOS - appAndroid - appOnline-VideoYoutube ChannelPodcastFile Format (i.e.,.pdf,.ppt,.csv)Free/PaidMembership or Account Required
      Contouring and Radiation Planning
      Applied Virtual Anatomy for Radiation Oncology

      Applied Virtual Anatomy for Radiation Oncolgoy (AVARO). Available at http://www.avaroproject.net/. Accessed on May 1, 2022.

      		2020Contouring and Radiation PlanningYNNYNNYFreeY
      ARRO del Regato Webinars

      Radiation Oncology Institute (ROI). ACCO Research and Education - ARRO del Regato Webinars. Available at https://www.roinstitute.org/Research-and-Education/ARRO-del-Regato-Webinars. Accessed on May 1, 2022.

      		2022Contouring and Radiation Planning, General ReferenceYNNYNNNFreeN
      Dosepedia

      DOSEPEDIA. The Dosimetry Encyclopedia. Available at https://dosepedia.com/. Accessed on May 1, 2022.

      		2021Contouring and Radiation PlanningYNNYYNNFreeN
      eContour

      eCounter. Available at https://econtour.org/. Accessed on May 1, 2022.

      		2022Contouring and Radiation PlanningYNNNNNNFreeY
      EduCase

      EduCase. Availalbe at https://www.educase.com/. Accessed on May 1, 2022.

      		2020Contouring and Radiation PlanningYNNNNNNFree/PaidY
      I Treat Safely

      I Treat Safely. Available at https://i.treatsafely.org/. Accessed on May 1, 2022.

      		2020General reference, ContouringYNNYNNYFreeY
      IGRT Online

      IGRT Online. Available at https://igrtonline.com/. Accessed on May 1, 2022.

      		2021Contouring and Radiation PlanningYNNNNNNFreeY
      Michigan Medicine GI Contouring Atlas

      University of Michigan Radiation Oncology. Contouring Atlas for GI Radiotherapy Planning. Available at https://medicine.umich.edu/dept/radonc/education-training/resources-references/contouring-atlas-gi-radiotherapy-planning. Accessed on May 1, 2022.

      		2022Contouring and Radiation Planning, Case VignettesYNNNNNYFreeN
      NRG / RTOG Oncology Contouring Atlases

      NRG Oncology. Center for Innovation in Radiation Oncology. Available at https://www.nrgoncology.org/About-Us/Center-for-Innovation-in-Radiation-Oncology. Accessed on May 1, 2022.

      		2022Contouring and Radiation PlanningYNNNNNYFreeN
      Indicates that an account is not mandatory, but full access is dependent on account creation.
      ProKnow Contouring Accuracy

      ProKnow Systems. ProKnow Contouring Accuracy. Available at https://proknowsystems.com/contouring. Accessed on May 1, 2022.

      		2020Contouring and Radiation PlanningYNNYNNYFreeY
      Prostatdoodle

      Prostadoodle. Available at https://prostadoodle.com/. Accessed on May 1, 2022. [.

      		2022Contouring and Radiation PlanningYNNNNNYFreeN
      Quality Assurance Review Center / Imaging and Radiation Oncology Core

      Quality Assurance Review Center (QARC) / Imaging and Radiation Oncology Core (IROC). Available at https://www.qarc.org/. Accessed on May 1, 2022.

      		2022Contouring and Radiation PlanningYNNNNNYFreeN
      Rayos Contra Cancer YouTube

      Rayos Contra Cancer. Rayos Contra Cancer YouTube Channel. Available at https://www.youtube.com/c/RayosContraCancer. Accessed on May 1, 2022.

      		2022Contouring and Radiation Planning, Brachytherapy, Physics, General Reference, Online videoYNNYYNNFreeN
      Radiobiology / Medical Physics
      Applied Sciences of Oncology (ASO) distance-learning course

      IAEA Learning Management System. The Applied Sciences of Oncology (ASO) distance-learning course. Available at https://elearning.iaea.org/m2/course/index.php?categoryid=45. Accessed on May 1, 2022.

      		2021Radiobiology, Medical PhysicsYNNYNNYFreeY
      ASTRO Radiation Physics

      ASTRO. Radiation Biology Physics. Available at https://www.astro.org/Affiliate/ARRO/Resident-Resources/Educational-Resources/Webinars/Radiation-Biology-and-Physics. Accessed on May 1, 2022.

      		2020Medical Physics, Online VideoYNNYNNYFreeN
      ASTRO Radiobiology Lectures

      ASTRO Radiobiology Lectures. Available at https://www.astro.org/Affiliate/ARRO/Resident-Resources/Educational-Resources/Webinars/Radiation-Biology-and-Physics. Accessed on May 1, 2022.

      		2022Radiobiology, Online videoYNNYNNFreeN
      EMITEL e-Encyclopaedia of Medical Physics and Multilingual Dictionary of Terms

      EMITEL. e-Encyclopaedia of Medical Physics and Multilingual Dictionary of Terms. Available at http://www.emitel2.eu/emitwwwsql/encyclopedia.aspx. Accessed on May 1, 2022.

      		2022Medical PhysicsYNNNNNNFreeN
      HiPhy Physics

      HiPhy RadOnc. Available at https://www.youtube.com/channel/UCqhfGkQOCGRhlkskR4wYphg. Accessed on May 1, 2022.

      		2022Radiation Oncology Physics, Online VideoNNNYYNNFreeN
      Routledge Textbooks Radiation Oncology Physics

      Routledge Textbooks Radiation Oncology Physics. Available at https://routledgetextbooks.com/textbooks/9781138591707/interactive-videos.php. Accessed on May 1, 2022.

      		2022Radiation Oncology PhysicsYNNYNNFreeN
      RSNA Physics Modules

      Radiological Society of North America (RSNA). Physics Modules. Available at https://www.rsna.org/education/trainee-resources/physics-modules. Accessed on May 1, 2022.

      		2022Medical PhysicsYNNNNNNFreeY
      General Radiation Oncology Resources
      Accelerated Education Program

      Accelerated Education Program (AEP). Available at https://www.youtube.com/user/AEPEducation/videos. Accessed on May 1, 2022.

      		2019General Reference, Discussion, ContouringYNNYYNNFreeN
      ARROCase

      ASTRO. ARROCase. Available at https://www.astro.org/Affiliate/ARRO/Resident-Resources/Educational-Resources/ARROCase. Accessed on May 1, 2022.

      		2022Case VignettesYNNNNNYFreeN
      ASTRO

      American Society for Radiation Oncology (ASTRO). Available at https://www.astro.org/. Accessed on May 1, 2022.

      		2022General referenceYNNYNNYFree/PaidN
      Indicates that an account is not mandatory, but full access is dependent on account creation.
      Introductory Radiation Oncology Curriculum (IROC)

      Radiation Oncology Education Collaboration Study Group (ROECSG). Introductory Radiation Oncology Curriculum (IROC). Available at https://roecsg.org/iroc/. Accessed on May 1, 2022.

      		2019General Reference, Online videoYNNYYNYFreeN
      Learn Oncology

      LearnOncology. Oncology Education Modules. Available at https://www.learnoncology.ca/. Accessed on May 1, 2022.

      		2022General ReferenceYNNYNYNFreeN
      National Cancer Grid

      National Cancer Grid (NCG). Available at https://ncgeducation.in/. Accessed on May 1, 2022.

      		2021General Reference, Radiobiology, Contouring and Radiation Planning, Medical PhysicsYNNYNNYFreeY
      OncologyPro

      OncologyPro. Available at https://oncologypro.esmo.org/. Accessed on May 1, 2022.

      		2022General ReferenceYNNYNNNFreeY
      QuadShot News

      QuadShot News. Available at http://www.quadshotnews.com/. Accessed on May 1, 2022.

      		2022General Reference, DiscussionYNNNNNNFreeN
      Radiation Oncology Education Collaborative Study Group

      Radiation Oncology Education Collaborative Study Group (ROECSG). Available at https://roecsg.org/. Accessed on May 1, 2022.

      		2022General Reference, Statistics, Medical Physics, Radiobiology, Introductory curriculumYNNYYNNFreeN
      Radiation Oncology Virtual Education Rotation

      Radiation Oncology Virtual Education Rotation (ROVER). Available at https://www.radoncvirtual.com/rover. Accessed on May 1, 2022.

      		2022General reference, Case VignettesYNNYNNNFreeN
      RSNA Case Collection

      Radiological Society of North America (RSNA). RSNA Case Collection. Available at https://cases.rsna.org/search. Accessed on May 1, 2022.

      		2022Case VignettesYNNNNNNFreeY
      RadOnc Calc

      RadOncCalc. Available at https://play.google.com/store/apps/details?id=co.redcanvas.rad_onc_calc&hl=en_US&gl=US and https://apps.apple.com/us/app/rad-onc-calc/id1494077153. Accessed on May 1, 2022.

      		2021General Reference, CalculatorNYYNNNNFreeY
      RadOnc Tables

      RadOnc Tables. Available at https://radonctables.com/. Accessed on May 1, 2022.

      		2022General Reference, Literature reviewYYYNNNYFreeN
      Indicates that an account is not mandatory, but full access is dependent on account creation.
      RO Toolbox

      Radiation Oncology Institute (ROI). RO Toolbox. Available at https://apps.apple.com/us/app/ro-toolbox/id968361326 and https://play.google.com/store/apps/details?id=org.roinstitute.rotoolbox&hl=en_US&gl=US. Accessed on May 1, 2022.

      		2021General Reference, Toxicity Scales, CalculatorNYYNNNNFreeY
      The Med Net

      The Med Net. Available at https://www.themednet.org/. Accessed on May 1, 2022.

      		2022Case Vignettes, ForumYNNNNNNFreeY
      University of Cincinnati Cancer Center Statistics Seminar Series

      University of Cincinnati Cancer Center. Radiation Oncology Seminar Series. Available at https://radonced.edublogs.org/. Accessed on May 1, 2022.

      		2020Statistics, Online videoYNNYYNNFreeN
      WikiBooks

      WikiBooks. Radiation Oncology. Available at https://en.wikibooks.org/wiki/Radiation_Oncology. Accessed on May 1, 2022.

      		2022General reference, Literature reviewYNNNNNNFreeN
      Podcasts
      Advances in Radiation Oncology Podcasts

      Advances in Radiation Oncology Podcasts. Available at https://www.advancesradonc.org/content/podcast. Accessed on May 1, 2022.

      		2022Podcast - GeneralYNNNNYNFreeN
      American College of Radiation Oncology Podcasts

      American College of Radiation Oncology (ACRO). ACRO Podcasts. Available at https://acro.org/page/acropodcast and https://www.youtube.com/c/AmericanCollegeofRadiationOncology. Accessed on May 1, 2022.

      		2022Webinars, Podcast - GeneralYNNYYYNFreeN
      Indicates that an account is not mandatory, but full access is dependent on account creation.
      Hormesis

      Hormesis Podcast. Available at https://www.hormesispodcast.com/. Accessed on May 1, 2022.

      		2020Podcast - Medical PhysicsYNNNNYNFreeN
      Practical Radiation Oncology Podcast

      Practical Radiation Oncology (PRO) Podcast. Available at https://www.practicalradonc.org/content/podcast. Accessed on May 1, 2022.

      		2022Podcast - GeneralYNNNNYNFreeN
      Rad-Cast

      RadCast. Available at https://anchor.fm/radcast. Accessed on May 1, 2022.

      		2020Podcast - GeneralYNNNNYNFreeN
      Radioactive Podcast

      Radiation Research Society. RADIOactive Podcast. Available at https://podcasts.apple.com/us/podcast/radioactive-podcast/id1370981794. Accessed on May 1, 2022.

      		2021Podcast - GeneralYNNNNYNFreeN
      Red Journal Podcasts

      International Journal of Radiation Oncology Biology Physics. Red Journal Podcast. Available at https://www.redjournal.org/content/podcast. Accessed on May 1, 2022.

      		2022Podcast - GeneralYNNNNYNFreeN
      The Accelerators Podcast

      The Accelerators. The Accelerators Podcast. Available at https://podcasts.apple.com/us/podcast/the-accelerators-podcast/id1582752362. Accessed on May 1, 2022.

      		2022Podcast - GeneralYNNNNYNFreeN
      The Fraction

      The Fraction. Available at https://www.stitcher.com/show/the-fraction. Accessed on May 1, 2022.

      		2019Podcast - GeneralNNNNNYNFreeN
      * Indicates that an account is not mandatory, but full access is dependent on account creation.

      Discussion

      The COVID-19 pandemic introduced an unexpected dilemma in the field of medical education, forcing educators and trainees to adapt in-person teaching to digital platforms. Alternative modes of education and the use of online resources for on-demand access and knowledge sharing continue to become increasingly adopted. Previously published literature focuses on the integration of e-learning resources into trainee education [
      • Jimenez R.B.
      • Johnson A.
      • Padilla L.
      • Yechieli R.
      • Forman R.
      • Horick N.
      • et al.
      The Impact of an Introductory Radiation Oncology Curriculum (IROC) for Radiation Oncology Trainees Across the United States and Canada.
      Int J Radiat Oncol Biol Phys. 2020; 107: 408-416
      ,
      • Alfieri J.
      • Portelance L.
      • Souhami L.
      • Steinert Y.
      • McLeod P.
      • Gallant F.
      • et al.
      Development and impact evaluation of an e-learning radiation oncology module.
      Int J Radiat Oncol Biol Phys. 2012; 82: e573-e580
      ,
      • Gillan C.
      • Papadakos J.
      • Brual J.
      • Harnett N.
      • Hogan A.
      • Milne E.
      • et al.
      Impact of high-fidelity e-learning on knowledge acquisition and satisfaction in radiation oncology trainees.
      Curr Oncol. 2018; 25: e533-e538
      ] or smartphone specific resources [
      • Calero J.J.
      • Oton L.F.
      • Oton C.A.
      Apps for Radiation Oncology.
      A Comprehensive Review Transl Oncol. 2017; 10: 108-114
      ,

      Gillespie EF, Panjwani N, Mundt AJ, Murphy JD. eContour: Evidence-Based Interactive Contouring Resources at the Point of Care. Contemporary Radiation Oncology, June 2016. Available at https://www.onclive.com/view/econtour-evidencebased-interactive-contouring-resources-at-the-point-of-care. Accessed on May 1, 2022.

      ,
      • Malik M.
      • Valiyaveettil D.
      • Joseph D.
      Optimizing e-learning in oncology during the COVID-19 pandemic and beyond.
      Radiat Oncol J. 2021; 39: 1-7
      ]; however, no prior publications have provided information on the availability of e-learning resources. This report represents the first comprehensive compilation and analysis of reputable resources available to radiation oncology trainees and instructors.
      This review identified 47 free digital resources for radiation oncology education that are currently available online. As outlined in Table 2, a variety of online resources exist. Many specific aspects of radiation oncology education, such as contouring tutorials, disease site-specific lessons, case vignettes, introductory courses, medical physics lectures, and radiobiology videos were available at the time of this analysis. Internet searches and a review of the websites of specialty societies were the most useful sources for the identification of numerous digital resources, including introductory courses, podcasts, webinars, slide sets, and mobile apps.
      Although a comprehensive identification strategy was used, the results of this study are not exhaustive of all available online resources. While the internet provides a wealth of instructional resources, locating reliable sources for learning can be daunting. During data gathering, synthesis, and compilation of this review, spanning a 2-month duration, several websites were found to no longer be active, had broken redirect links, and lacked functional account creation abilities. These findings highlight another limitation of these dynamic resources. Furthermore, an additional inherent weakness in the systematic evaluation of open access resources is the wide variety of rubrics proposed to assess the quality of these modern educational resources and, thus, the potential for inconsistency and weakness in critiquing their educational utility [
      • Abrams M.J.
      • Golden D.W.
      • Huang G.C.
      A Call for Reform: Variability and Insufficiency in Radiation Oncology Resident Didactics-a Brief Report and National Survey of Program Directors.
      J Cancer Educ. 2021;
      ]. In this analysis, the evaluation criteria published by UNC Health Sciences Library were utilized due to generalizable criteria that could be universally applied across various multimedia resources. Additionally, some of the resources require registration or society membership to access; however, many of the educational resources are free of charge, highlighting the benefit of open access in facilitating on-demand education. Despite uniform evaluation of all resources, concerns exist regarding the content and validity of the information shared. It is upon the end user to ascertain whether the information provided is credible or not, for which we advise the use of criteria like that outlined in Table 1. The compilation of resources presented herein represent a curated and comprehensive list of available digital resources produced by publishers with strong reputations for accuracy and expertise.

      Conclusion

      This review represents the first known comprehensive review of the vast number of digital educational resources for radiation oncologists: both practicing clinicians and trainees. Digital resources exist in a variety of e-learning formats, including tutorials, self-directed learning modules, slide sets, podcasts, and videos. As identified by the literature review performed in this study, e-learning is being actively integrated into radiation oncology training programs. Web-based and digital resources serve as adjunct knowledge tools for educators and trainees. Awareness of available web-based education resources will enhance radiation oncology residency education and clinical competence, and likely represent the future of medical education as they allow for self-directed and supplementary education.

      Declaration of Competing Interest

      The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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      Article info

      Publication history

      Published online: September 14, 2022
      Accepted: August 22, 2022
      Received in revised form: August 11, 2022
      Received: June 1, 2022

      Identification

      DOI: https://doi.org/10.1016/j.tipsro.2022.08.006

      Copyright

      © 2022 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy & Oncology.

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