Hi Everyone, 

Today’s post is a reflection on the evolution of my education dilemma. My initial idea has remained the same, however, components have been added on to strengthen its creation. The feedback from peers have been greatly appreciated and have provided me with valuable suggestions that I plan to incorporate into my project. For one, it was suggested to look into Continuing Medical Education (CME) accreditation, to help with adherence to the webinar. This is a great suggestion that I am looking into and I believe will facilitate participation. This raises a very important consideration of participation in educational technologies. Not only does the design of the actual project matter, but how it will facilitate participation as well and how to tailor the design to this. This was a theme that I saw throughout the development of my project, and the feedback provided to others. For instance, I have considered length of the webinar. Oncologists are very busy, thus I know time will be a barrier. In my design, I am trying to balance including all the important content with minimizing the time to avoid having time as a barrier. Altogether, when designing education technologies, it is important to consider the target audience and their unique needs to facilitate participation.

Moreover, through the development of this education dilemma my awareness of technologies and their uses in teaching/education have changed drastically. Thinking through the best way to address my Moreover, through the development of this education dilemma my awareness of technologies and their uses in teaching/education have changed drastically. Thinking through the best way to address my educational dilemma has allowed me to develop a tool belt of knowledge of the types of technologies available. I have thought through the advantages and disadvantages of each, which has allowed me to be more confident in assessing which technology is most appropriate for a given educational dilemma. I started out wanting to do webinars and still believe this is the best option to address my educational dilemma, however I think it can be complimented with other tools. Webinars have been well perceived by participants and healthcare providers in cancer education, with ratings of satisfaction and interest in participation of future webinars (Chiswell et al., 2018; Cueva & Thomas, 2017). Previous webinar delivery has done live webinars, that resulted in low live participation (Chiswell et al., 2018). I think having the webinars recorded rather than live will facilitate greater participation from oncologists. However, in doing this a live Q and A is lost. To compensate for this, I am thinking to supplement the webinar with a discussion forum such as slack. This will not only facilitate a Q and A but allow for deeper discussion amongst oncologists. For instance, they can discuss their experiences in practice and offer each other best practices; a separate channel for this topic can be created. Overall, my initial idea has not changed drastically but the consideration of additional tools to supplement it has been incorporated. 

 All in all, working on this educational dilemma has allowed me to gain greater appreciation for educational technologies, which will inform my future practice as a student, teaching assistant and researcher. In research, I will incorporate technology in my projects as best fits; this is very valuable as technology can facilitate interventions reaching more people. As a student, I can use the technology to facilitate my own learning and find online/educational technology resources to supplement my course materials. Finally, as a teaching assistant, I will incorporate technology with my students. For instance, I am an anatomy lab demonstrator and often have students emailing me questions. In the future, I will create a slack channel for my lab section and have them post their questions there. I will encourage them to answer each other’s questions, as this will help their own learning. I can also use this forum to post questions/case studies for their review, as well as share resources to aid their studying. This is valuable as time is limited in lab. Having a medium such as slack will facilitate more discussion for the students and time to ask questions while they are studying at home/over break. 

Chiswell, M., Smissen, A., Ugalde, A., Lawson, D., Whiffen, R., Brockington, S., & Boltong, A. (2018). Using webinars for the education of health professionals and people affected by cancer: processes and evaluation. Journal of Cancer Education, 33(3), 583-591.

Cueva, M., & Thomas, M. K. (2017). Reflecting on the importance of webinars in cancer education. Journal of Cancer Education, 32(2), 417-418.

Physical activity has profound benefits for cancer patients; however, cancer patients are not getting enough PA to achieve these health benefits ^1,2,3(image of checklist showing the cancer-related health outcomes benefits by PA – Table 1). Oncologists hold a unique position, as they are highly trusted by patients and patients would be more motivated to exercise if recommended by their oncologist ^4. However, oncologists do not regularly discuss PA with patients ⁵.

Not only do patients benefit, but so do oncologists. What’s in it for oncologists? Exercise has the potential to improve oncologists planned course of treatment and treatment effectiveness. 

1. There is potential for exercise to improve treatment tolerance, specifically some evidence of improved chemotherapy completion rate; increased intensity of dose and reduced dose adjustments ^1,6.
2. There is strong evidence demonstrating improved survival for breast, prostate and colon cancer ³. This has yet to be established for other cancer types but may have the same effect. 
3. Preliminary evidence in animal studies shows the potential role in exercise altering tumor biology, such as improved vascularization of tumors which could improve delivery of chemotherapies to tumors. There is also evidence of tumor suppressor genes being activated and increased apoptosis of tumors, among other impacts on the hallmarks of cancer ². 

These are just some of the profound ways exercise can impact course of treatment, with evidence in this field continuing to emerge. 

A webinar series would be an effective and efficient method to train oncologists on PA for cancer survivors, so they can improve treatment. These webinars will address knowledge of the PA guidelines, types, amounts, intensity and timing ². It will also address, contraindications, safety, and strategies to assess, advice and refer patients ³. Knowledge is powerful and this knowledge can help oncology profoundly. 

Interested in learning more? Please visit https://oncologypapractices.law.blog. Your feedback and suggestions are valuable!

Appendix

Table 1. Benefits of Exercise for Cancer-Related Health Outcomes (Schmitz et al., 2019)

References 

1. Campbell, K. L., Winters-Stone, K. M., Wiskemann, J., May, A. M., Schwartz, A. L., Courneya, K. S., … & Morris, G. S. (2019). Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Medicine & Science in Sports & Exercise, 51(11), 2375-2390.
2. Patel, A. V., Friedenreich, C. M., Moore, S. C., Hayes, S. C., Silver, J. K., Campbell, K. L., … & Denlinger, C. (2019). American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Medicine & Science in Sports & Exercise, 51(11), 2391-2402.
3. Schmitz, K. H., Campbell, A. M., Stuiver, M. M., Pinto, B. M., Schwartz, A. L., Morris, G. S., … & Patel, A. V. (2019). Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA: a cancer journal for clinicians, 69(6), 468-484.
4. Jones, L. W., Courneya, K. S., Fairey, A. S., & Mackey, J. R. (2004). Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Annals of Behavioral Medicine, 28(2), 105-113.
5. Hardcastle, S. J., Kane, R., Chivers, P., Hince, D., Dean, A., Higgs, D., & Cohen, P. A. (2018). Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Supportive Care in Cancer, 26(11), 3711-3719.
6. Bland, K. A., Zadravec, K., Landry, T., Weller, S., Meyers, L., & Campbell, K. L. (2019). Impact of exercise on chemotherapy completion rate: a systematic review of the evidence and recommendations for future exercise oncology research. Critical reviews in oncology/hematology.

Physical activity has many benefits for the overall health of cancer survivors, counteracting negative treatment-related side-effects and improving quality of life, survival, cancer recurrence and risk for secondary cancers ¹. However, cancer survivors physical activity levels are low, not allowing them to achieve these health benefits. Oncologists hold a unique position, as they are highly trusted members in a cancer survivors care team. This unique role has the potential to have more influence in changing the behaviour of cancer survivors and increasing their physical activity levels ². However, oncologists and oncology healthcare providers (OHP) lack knowledge, competence and confidence discussing physical activity with cancer survivors ^{3, 4}. Thus, the educational dilemma is educating oncologists and OHP on physical activity for cancer survivors. The importance of this is to increase providers confidence and competence to have discussions about physical activity with cancer survivors.

To address this dilemma, I plan to develop a webinar series that can be used to educate oncologists and OHP on the benefits of physical activity for cancer survivors, barriers and facilitators to cancer survivors being active, as well as strategies for having these conversations with survivors to facilitate this discussion.  

References

1. Patel, A. V., Friedenreich, C. M., Moore, S. C., Hayes, S. C., Silver, J. K., Campbell, K. L., … & Denlinger, C. (2019). American College of Sports Medicine roundtable report on physical activity, sedentary behavior, and cancer prevention and control. Medicine & Science in Sports & Exercise, 51(11), 2391-2402.
2. Jones, L. W., Courneya, K. S., Fairey, A. S., & Mackey, J. R. (2004). Effects of an oncologist’s recommendation to exercise on self-reported exercise behavior in newly diagnosed breast cancer survivors: a single-blind, randomized controlled trial. Annals of Behavioral Medicine, 28(2), 105-113.
3. Hardcastle, S. J., Kane, R., Chivers, P., Hince, D., Dean, A., Higgs, D., & Cohen, P. A. (2018). Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Supportive Care in Cancer, 26(11), 3711-3719.
4. Nadler, M., Bainbridge, D., Tomasone, J., Cheifetz, O., Juergens, R. A., & Sussman, J. (2017). Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators. Supportive Care in Cancer, 25(7), 2297-2304. doi: 10.1007/s00520-017-3640-9