title: A Prostate Fossa Contouring Instructional Module: Implementation and Evaluation.
abstract: OBJECTIVE
  Radiation oncology trainees frequently learn to contour through clinical experience and lectures. A hands-on contouring module was developed to teach delineation of the postoperative prostate clinical target volume (CTV) and improve contouring accuracy.
  
  
  METHODS
  Medical students independently contoured a prostate fossa CTV before and after receiving educational materials and live instruction detailing the RTOG approach to contouring this CTV. Metrics for volume overlap and surface distance (Dice similarity coefficient, Hausdorff distance (HD), and mean distance) determined discordance between student and consensus contours. An evaluation assessed perception of session efficacy (1 = "not at all" to 5 = "extremely"; reported as median[interquartile range]). Non-parametric statistical tests were used.
  
  
  RESULTS
  Twenty-four students at two institutions completed the module, and 21 completed the evaluation (88% response). The content was rated as "quite" important (4[3.5-5]). The module improved comfort contouring a prostate fossa (pre 1[1-2] vs. post 4[3-4], p<.01), ability to find references (pre 2[1-3] vs. post 4[3.5-4], p<0.01), knowledge of CT prostate/pelvis anatomy (pre 2[1.5-3] vs. post 3[3-4], p<.01), and ability to use contouring software tools (pre 2[2-3.5] vs. post 3[3-4], p=.01). After intervention, mean DSC increased (0.29 to 0.68, p<0.01) and HD and mean distance both decreased, respectively (42.8 to 30.0, p<.01; 11.5 to 1.9, p<.01).
  
  
  CONCLUSIONS
  A hands-on module to teach CTV delineation to medical students was developed and implemented. Student and expert contours exhibited near "excellent agreement" (as defined in the literature) after intervention. Additional modules to teach target delineation to all educational levels can be developed using this model.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: jgunther@mdanderson.org.
authors.forename: Jillian R
authors.initials: JR
authors.lastname: Gunther
authors.affiliation: Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois.
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Liauw
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Seungtaek
authors.initials: S
authors.lastname: Choi
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
authors.forename: Abdallah S R
authors.initials: AS
authors.lastname: Mohamed
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Nikhil G
authors.initials: NG
authors.lastname: Thaker
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Clifton D
authors.initials: CD
authors.lastname: Fuller
authors.affiliation: Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Stepaniak
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Prajnan
authors.initials: P
authors.lastname: Das
authors.affiliation: Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Golden
mesh_terms: D002983:Clinical Competence / Q000706:statistics & numerical data*; D003479:Curriculum; D004521:Educational Measurement / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000532:radiotherapy*; D018787:Radiation Oncology / Q000193:education*; D061089:Radiotherapy, Image-Guided / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013337:Students, Medical / Q000706:statistics & numerical data*; D013781:Texas; D055815:Young Adult
keywords: Medical education; contouring; prostate fossa; radiation oncology