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The onset of the COVID-19 pandemic led to the widespread adoption of virtual information sessions to provide medical students with information about residency programs. These sessions have continued in Radiation Oncology (RO), yet no research has assessed whether students find sessions useful or desire their continuation with elective restrictions now lifted. We hypothesized that sessions would inform influential elements of students' residency decisions and students would wish for their continuation despite lifted elective restrictions. An anonymous survey utilizing 5-point Likert scales and descriptive feedback was developed to assess medical student (MS) and residency program member (RPM) perspectives on information sessions. Surveys were distributed between September – December 2023 to medical students who registered for Canadian RO virtual information sessions during the 2022-2023 CaRMS cycle. CARO members were contacted through an email list inviting staff and residents who attended sessions to participate in the project. Quantitative data was interpreted with descriptive statistics. Of the 25 MS who registered for sessions, 18 completed the survey, while 17 RPM participated. 100% of MS and RPMs agreed or strongly agreed that sessions were useful and should continue despite elective restrictions being lifted, though significantly more RPMs strongly agreed that sessions were useful (4.82 vs. 4.5, p = 0.045) and should continue (5.00 vs. 4.67, p = 0.008). Sessions being free to attend and providing greater exposure to more programs than would otherwise be possible were the most endorsed benefits from MS (100% and 94% agree or strongly agree) and RPMs (100% agree or strongly agree). The three most strongly endorsed ways to improve sessions from both MS and RPM was having sessions for different time zones, having more resident interactions, and only having residents present for sessions. MS reported that the most influential factors in choosing their first-choice program were hearing positive resident experiences, a culture of supporting resident wellbeing, and program location. The most reported downsides of sessions from MS were the pressure to attend and repetitive information (50% and 50% agree or strongly agree). In contrast, only 12% of RPM agreed that pressure to attend was a possible downside, and only 24% agreed or strongly agreed that information was repetitive. We report the first evidence in support of the utility and desired continuation of virtual program information sessions in RO, from both medical students and residency program members. Responses support numerous benefits to sessions, with limited detriments. We recommend continuing these sessions and results can inform programs on how to optimize their implementation. [ABSTRACT FROM AUTHOR]

Procedural anxiety of cancer treatments may negatively impact patients and treatments. Environment modification with Virtual Reality (VR) is increasingly used across medicine to minimize procedural anxiety. We hypothesized that intrafraction VR use during external beam radiotherapy (EBRT) would improve radiotherapy experience and physiological measures of distress. At our single institution between May – October 2023, adult patients receiving EBRT without contraindications to wearing a VR headset were eligible. Participants had heart rate recorded before and after EBRT and completed a post-EBRT survey for one treatment without intervention, and one using VR. Participants completed the Radiotherapy Experience Questionnaire (RTEQ) and additional questions regarding VR. Mean pre- and post-EBRT heart rate and RTEQ theme scores were compared between conditions using paired samples t -test. Fifty-two participants completed the project. Between pre- and post-EBRT there was a significant decrease in heart rate with VR (80.35 bpm vs. 71.79 bpm; P < 0.0001*), but not in the control condition (78.90 bpm vs. 78.10 bpm; P = 0.44). Post-EBRT heart rate was significantly lower with VR than without (71.79 bpm vs. 78.10 bpm; P < 0.01*). RTEQ responses showed participants had significantly lower situational unease (1.46 vs. 2.02; P < 0.001*), a more beneficial situational response (1.55 vs. 2.12; P < 0.01*), and improved environment acceptance (1.30 vs. 1.60; P < 0.01*) when using VR. Most endorsed VR as comfortable (94%), improved treatment experience (86%), and would recommend its use to others (86%). We report the first evidence of impacts of intrafraction VR use during EBRT. Physiological measures of distress and patient perspectives suggest VR can minimize procedural anxiety, is well tolerated, and improves the overall treatment experience. VR should be considered as a tool for managing RT treatment anxiety. Further research should explore modifying this tool for patients unable to wear headsets and determining where the most clinically significant benefits can be found. [ABSTRACT FROM AUTHOR]

Let U( t)= e be a C-group on a Banach space X. Let further $\phi\in C^{\infty}_{c}(\mathbb {R})$ satisfy ∑ ϕ(⋅− n)≡1. For α≥0, we put which is a Banach algebra. It is shown that ∥ U( t)∥≤ C(1+| t|) for all t∈ℝ if and only if the generator B has a bounded ${ E^{\alpha}_{\infty}}$ functional calculus, under some minimal hypotheses, which exclude simple counterexamples. A third equivalent condition is that U( t) admits a dilation to a shift group on some space of functions ℝ→ X. In the case U( t)= A with some sectorial operator A, we use this calculus to show optimal bounds for fractions of the semigroup generated by A, resolvent functions and variants of it. Finally, the ${ E^{\alpha}_{\infty}}$ calculus is compared with Besov functional calculi as considered in Cowling et al. (J. Aust. Math. Soc., Ser. A, 60(1):51-89, ) and Kriegler (Spectral multipliers, R-bounded homomorphisms, and analytic diffusion semigroups. PhD-thesis). [ABSTRACT FROM AUTHOR]

Effective documentation serves as a cornerstone for communication and patient care, especially in radiation oncology (RO). Studies have shown room for improvement in documentation practices, and although documentation guidelines exist, it is uncertain if RO physicians are aware of or adhere to them. We aimed to assess RO resident physicians' medicolegal knowledge and the impact of an educational intervention on documentation practices. Grading rubrics for consultation and progress notes were created using guidelines, comprising of a fundamental score and total score. Residents from two institutions attended a didactic seminar on medicolegal documentation. Pre- and post-seminar, an electronic anonymous survey was used to assess resident knowledge and perspectives and random resident consultation and progress notes were scored. Mean documentation and survey item scores from pre- and post-seminar were compared. Fourteen resident physicians participated and completed surveys, and 48 consultation notes and 40 progress notes were analyzed. No participant had prior education specific to RO documentation, nor were any aware of available resources. Post-seminar, participants' medicolegal documentation knowledge significantly increased (86.61% vs. 95.54%, p = 0.001), as did the fundamental score (83.64% vs 89.29%, p = 0.041) and total scores of consultation notes (69.82% vs. 78.98%, p = 0.001) and total score of progress notes (55% vs. 75.19%, p < 0.001). Our seminar significantly enhanced residents' medicolegal knowledge and quality of documentation, and surveys revealed a lack of speciality specific documentation education. This combined with findings from other studies and participant opinions suggest that resident physicians would benefit from such training during residency., (© 2024. The Author(s) under exclusive licence to American Association for Cancer Education.)

In an era of increasing virtual communication, we aimed to investigate current formats used by radiation oncology residents for reviewing radiation treatment plans with attendings, preferences for formats, and reasons contributing to preferences. Residents enrolled in Canadian radiation oncology programs received questionnaires examining training level, typical review formats, preferred format, and reasons for preference. Analysis excluded PGY-1s due to insufficient exposure. Fifty-two residents participated. National response rate was 55%. Overall, hybrid review was the most used format (77%). Virtual review was the most preferred format (44%). Preference for virtual review was most common among junior residents (57%), while in-person review was most preferred by senior residents (45.4%). Few residents typically use their preferred format (35%). Reasons for preference varied between groups in convenience (p < 0.01), interactivity (p < 0.01), and teaching quality (p = 0.04). The persistence of e-learning suggests that virtual treatment planning education will continue to some degree. Junior residents prefer virtual review, while a clearly preferred review format was less apparent among senior residents. Preferences are multifactorial, and the trends seen in reasons for preference between formats may reflect advantages inherent to each. Progress is still needed in optimizing treatment planning education, as suggested by few residents using their preferred format. Residents and staff should collectively decide which educational format for treatment planning best meets educational needs., (© 2023. The Author(s) under exclusive licence to American Association for Cancer Education.)

Research shows decreased brain region activity in the right temporo-parietal junction (rTPJ) in people with migraine headache relative to headache-free controls when performing an orienting visuospatial attention task. Functional inactivation of the rTPJ has been associated with rightward performance deviations on laterality-based attention Landmark (LM) and greyscale (GRE) tasks in individuals with unilateral neglect and heightened activation in the rTPJ is associated with leftward deviation, known as pseudoneglect, in controls on these tasks. Given this, we investigated whether migraineurs would lack the leftward deviation found in headache-free controls on visuospatial attention tasks. 36 migraineurs and 38 controls were presented with LM and GRE tasks. Response bias scores showed a significant difference in responses between groups ( p  = 0.036) on the GRE, a luminance-based task, but not on the LM, a size-based task ( p  = 0.826). This study is the first to show laterality-based attentional differences in migraineurs, as compared to controls. Specifically, migraineurs were found to have smaller leftward biases on luminance-based visuospatial attention tasks, as compared to controls, aligning with previous research suggesting that migraine may be having an impact on a variety of attention tasks in migraineurs in between headache attacks.