The Educational NET Preceptorship – A contemporary educational model for understanding NET management through seminal advances in care

“The Preceptorship” is an interactive learning model developed by Professor Eva Segelov covering the evolution of modern therapy through the chronological understanding of landmark clinical trials in specific cancers, with mentorship from experts in the field. It has been applied in the areas of lung, prostate, upper gastrointestinal and colorectal cancers as a contemporary educational learning experience for both trainees and consultants using modern adult educational pedagogy. Analysis of feedback for the Colorectal Preceptorships won the “Best of the Best Oral Presentations” for Educational Papers at the Clinical Oncological Society of Australia Annual Scientific Meeting 2014.

Features:

  • Significant pre-work then an intensive 2 day face-to-face meeting
  • Target participants are NET physicians
  • Adapted from Harvard short-course methodology, course is designed for 25-50 participants with 6-8 (multidisciplinary). Preceptors are experts in the field (key opinion leaders) with experience of clinical trials and patient management in the tumour stream
  • Content and learning is participant-centered with the seminal studies and MDT cases nominated by the participants themselves
  • A significant and novel part 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 (surgery, liver directed therapy, targeted agents, chemotherapy, and supportive care).
  • For the seminal paper session: each participant prepares a six-minute presentation on each of 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 dedicated subcategorised Dropbox 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.

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 5-6participants.

Preceptorship schedule:

Day 1

Morning session: Setting the scene

Lecture: Update on current management of NET

Lecture: Understanding current guidelines in NET

Lecture: Current challenges in NET care

Resource provided: Two CME accredited slide kits- Diagnosis of NETs and Treatment of NETs- as a self-access educational program. These programs have been developed by multidisciplinary NET experts and been delivered over 30 times in Canada with excellent feedback.

Mid-morning and afternoon sessions:

Seminal papers in NET care: this is a facilitated interactive session covering the major clinical trials and publications influencing NET care. Papers are selected in advance and presented by the conference participants, having received feedback from the CommNETS preceptors for their presentations in advance of the face to face meeting. The key findings from each paper are presented and then discussed with the preceptors commenting on the impact of the results on clinical practice. This session forms the basis of multiple Preceptorships in various tumour types that Prof Segelov has run in Australia/Aotearoa New Zealand for multiple cooperative trials groups, including AGITG, ANZUP, and ALTG, with excellent feedback regarding participant engagement, learning, mentorship and relationship building.

Day 2

Morning session: NET MDT – case presentations from participants with mentors as the expert panel.

Afternoon session: Quiz the expert panel discussion- the preceptors will form an expert panel to address pre-submitted as well as spontaneous questions.

Summary Lecture: Future directions for NET care

Prior the Preceptorship

  1. Applicants fill in an online survey stating why they wish to attend, what their key learning objectives are, what their experience is in caring for NET patients and which papers they are nominating within the specified categories, from a list prepared by the Preceptors. Excellent English is required as each participant will need to present and be part of group discussions.
  2. Once notified that they are accepted onto the program and advised which of the nominated papers they have been allocated to present, applicants are invited to join the Preceptorship to upload their chosen paper. They proceed to develop their PowerPoint presentations based on strict adherence to the pre-specified format (exemplars and templates are provided). These are uploaded by the applicant according to the pre-specified due date.
  3. Each applicant will receive detailed email feedback on their presentations from their Preceptor. Then applicant should revise the presentation and can ask for further feedback. A final version of the PowerPoint presentations is required by the specified date (around 2 weeks prior to the face-to-face meeting).

During the Preceptorship – seminal paper sessions

The Convenor coordinates presentations given by participants to cover the seminal papers in chronological order.  After each paper is presented, the Convenor facilitates comments from the Preceptors on the paper, such as its clinical significance, trial critiques, practical application and placement of the paper in perspective to the overall NET treatment landscape. After each major section (e.g. adjuvant therapy, neo-adjuvant 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.

Two CommNETs Preceptorships have been hosted in collaboration with Novartis.  These learning events have brought together clinicians in multiple regions of the globe to review seminal NET research and the evolution of NET clinical trials, discuss current best practice in NETs, and explore the potential for advances in neuroendocrine cancer care led by expert preceptors.

Preceptorships:

Sao Paulo, Brazil 2018

A total of 12 delegates from Canada, Colombia, Ecuador, Mexico and Brazil attended the second Preceptorship hosted by CommNETs in November 2018.

Preceptors:

  • Dr Simron Singh, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada (Convenor)
  • Dr Tim Asmis, Ottawa Hospital Cancer Centre, Canada (Committee)
  • Dr David Chan, Royal North Shore Hospital, Sydney, Australia (Committee)
  • Dr Rachel Riechelmann, A.C. Camargo Cancer Centre, Brazil
  • Dr Tiago Felismino, A.C. Camargo Cancer Centre, Brazil
  • Dr Juan O’Connor, Institute Alexander Fleming, Argentina

Singapore 2017

A total of 21 delegates from Singapore, China, South Africa, Thailand, Pakistan, Australia, Taiwan and Egypt attended the first Preceptorship hosted by CommNETs in November 2017.

Preceptors:

  • Prof Eva Segelov, Monash University, Monash Health, Australia (Convenor)
  • Dr Simron Singh, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada (Committee)
  • Dr David Tai, National Cancer Centre, Singapore (Committee)
  • Dr Tim Asmis, Ottawa Hospital Cancer Centre, Canada
  • Dr Chris Jackson, Dunedin Hospital, New Zealand
  • Dr Calvin Law, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Canada

“I participated in the CommNETs Preceptorship on ‘Seminal advances in neuroendocrine tumour (NET)’ held in Singapore in November 2017. Through my participation I had the opportunity to learn about all the recent advances in this space. The format of the Preceptorship was fantastic with a very warm and friendly introduction session. All participants were required to deliver presentations on how the treatment of NET has advanced over the years – this was a key element of the learning process. On the second day we were split into smaller groups and had one subject specialist in each group. We discussed all possible presentations of NET and how to manage it. This made a great revision and helped us apply all the knowledge that we had learned the previous day.

The Preceptorship also gave me an opportunity to network. Following the Preceptorship I have emailed the Convenors for their opinion on NET cases and their timely and valuable input has been of great help in my patient care”.

Dr Zarka Samoon, Medical Oncologist

Aga Kham University Hospital, Karachi, Pakistan

(now the AGITG Research Fellow located in Sydney, Australia)

“The organizers (CommNETs) organized a very special training course on NETs. At the Preceptorship, the attendees are both trainees and lecturers of others. We share our learning experiences and introduce our practical experience to others. Especially grateful, the organizers invited several mentors with both rich clinical experience and professional knowledge, who gave a wonderful review of each attendee’s presentations. I really appreciate the contribution they have made to this training session and looking forward to seeing everyone next time”.

Dr Wen-Quan Wang, MD, PhD
Department of Pancreatic and Hepatobiliary Surgery

Pancreatic Cancer Institute, Fudan University, Shanghai, China

 

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