The Rectal Cancer Seminal Advances Preceptorship

Provider: Monash Institute for Health and Clinical Education

in partnership with AGITG (Australasian Gastro-Intestinal Trials Group)

“The Preceptorship” is an interactive learning model developed by Professor Eva Segelov covering landmark clinical trials in specific cancers, with mentorship from experts in the field. It has been applied in the areas of lung, colorectal, upper gastro-intestinal and prostate cancers to aid trainees and junior consultants in understanding of the evolution of management and evidence behind contemporary clinical practice.

Areas to be covered include screening, multimodality management of early, locally advanced and metastatic disease and supportive care. Download Flyer HERE.

Features:

Significant pre-work then a 1 ½ day face-to-face meeting
The program is targeted to trainees and junior consultants (first 5 years of practice) in medical, radiation, surgical oncology and palliative care
The program is adapted from Harvard short-course.
Methodology with a maximum of 40 participants with 6-8 (multidisciplinary)
Preceptors who are considered experts in the field of clinical trials in the tumour stream
Content and learning is participant centered with the seminal studies and MDT cases nominated by the participants themselves
The majority of the course is composed of the ‘seminal papers’ sessions, where participants cover landmark clinical trials and seminal papers for the designated tumour type, including management of early and advanced disease, screening, multimodality management and supportive care
Each participant prepares a six-minute presentation on their nominated two seminal clinical trial papers, covering trial design, results and implications on practice. Many studies are prepared and uploaded by more than one participant, facilitating a peer learning experience. Participants do not know in advance who will give which presentation on the meeting day. All participants will present at least once. After each presentation, the preceptors give comments about the study and its impact on clinical practice. Typically around 50 seminal papers are covered
Clinical papers and presentations are kept in a Moodle online learning management system for review by all participants and preceptors prior to the program. This valuable resource is retained indefinitely
The face-to-face meeting includes an ‘ask the expert” session and ends with an MDT
Timelines for the entire process are set well in advance. Applicants are required to list their chosen seminal papers as well as reasons for applying and learning objectives. Deadlines are given for uploading of papers, uploading of presentations, feedback from preceptors and finalisation of presentations

What it is not: This is not a “cancer 101” course and does not comprehensively cover known ‘facts’. It is specifically focused on clinical trials and how these have influenced current treatment. Knowledge such as staging, clinicopathological presentation is assumed.

Preceptor’s role: Preceptors are specialists from multidisciplinary background with expertise in the tumour subtype of the Preceptorship and the role of clinical trials. Each preceptor is assigned a group of 6-8 participants, with a diversity of specialty and training levels.

Prior to the Seminal Advances Preceptorship: Preceptors are required to join Moodle. Each Preceptor then reviews the two PowerPoint presentations made by each participant in their group. The Preceptor provides detailed individual feedback via email for the participant to review/revise their presentation prior to the Preceptorship, including
commenting on the effectiveness of the presentations (must stick to presentation guidelines eg length, critical features exemplars are given). This is required at least 2 weeks prior to the face-to-face meeting.

During the Preceptorship: The Convenor coordinates presentations given by participants to cover the seminal clinical trials in chronology. After each trial is presented, the Convenor facilitates comments from the Preceptors on the paper, such as its clinical significance, trial critiques, practical application and put the trial result in perspective of the overall treatment landscape. After each major section (eg adjuvant therapy, neoadjuvant therapy), the Preceptor facilitates a “pathway discussion” at their own table clarifying application of the trial data to day to day management and synthesizing trial findings into current best evidence-based practice. Preceptors also participate in the Ask the Expert session in case discussions as part of a Multidisciplinary team meeting. One of the notable features of the Preceptorship is the ‘banter’ between Preceptors, acknowledging different approaches to same pieces of evidence. This helps balance the intensity of the course.

Timing Activities:

8 weeks prior:
- Allocated 6-8 participants for your group
- will be evenly mixed in terms of training level and demographics
- Participants will be given access to Moodle via email
4-6 weeks prior Review and comment on the 2 presentations per participant from
your group:
- Go to Moodle and search for the participant
- Email back the participant with your comments
During Preceptorship:
- Comment on clinical trials as they are presented by participants during the main program
- Leading discussion in own group on treatment pathways
- Ask the Expert panel
- MDT panel