Preparing tomorrow’s medical specialists for participating in oncological multidisciplinary team meetings: perceived barriers, facilitators and training needs

Abstract

Introduction The optimal treatment plan for patients with cancer is discussed in multidisciplinary team meetings (MDTMs). Effective meetings require all participants to have collaboration and communication competences. Participating residents (defined as qualified doctors in training to become a specialist) are expected to develop these competences by observing their supervisors. However, the current generation of medical specialists is not trained to work in multidisciplinary teams; currently, training mainly focuses on medical competences. This study aims to identify barriers and facilitators among residents with respect to learning how to participate competently in MDTMs, and to identify additional training needs regarding their future role in MDTMs, as perceived by residents and specialists. Methods Semi-structured interviews were conducted with Dutch residents and medical specialists participating in oncological MDTMs. Purposive sampling was used to maximise variation in participants’ demographic and professional characteristics (e.g. sex, specialty, training duration, type and location of affiliated hospital). Interview data were systematically analysed according to the principles of thematic content analysis. Results Nineteen residents and 16 specialists were interviewed. Three themes emerged: 1) awareness of the educational function of MDTMs among specialists and residents; 2) characteristics of MDTMs (e.g. time constraints, MDTM regulations) and 3) team dynamics and behaviour. Learning to participate in MDTMs is facilitated by: specialists and residents acknowledging the educational function of MDTMs beyond their medical content, and supervisors fulfilling their teaching role and setting conditions that enable residents to take a participative role (e.g. being well prepared, sitting in the inner circle, having assigned responsibilities). Barriers to residents’ MDTM participation were insufficient guidance by their supervisors, time constraints, regulations hindering their active participation, a hierarchical structure of relations, unfamiliarity with the team and personal characteristics of residents (e.g. lack of confidence and shyness). Interviewees indicated a need for additional training (e.g. simulations) for residents, especially to enhance behavioural and communication skills. Conclusion Current practice with regard to preparing residents for their future role in MDTMs is hampered by a variety of factors. Most importantly, more awareness of the educational purposes of MDTMs among both residents and medical specialists would allow residents to participate in and learn from oncological MDTMs. Future studies should focus on collaboration competences.

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“…These issues regarding MDTM dynamics and the pivotal role of the MDTM coordinator have been acknowledged [ 43 – 47 ]. The role of personal qualities and nontechnical skills in managing MDTMs has been emphasized, and specific leadership training for MDTM chairs has been recommended [ 3 , 48 , 49 ].…”

Pros and cons of streamlining and use of computerised clinical decision support systems to future-proof oncological multidisciplinary team meetings

“…Interviews had a median duration of 38.7 minutes and lasted between 27 and 72 minutes. It is worth noting that the interviews were also conducted to gain insight into the current perceived quality of MDTMs and whether they serve educational purposes for residents ( 29 , 39 ). These findings are beyond the scope of this article.…”

Learning from Adaptations to the COVID-19 Pandemic: How Teleconsultation Supported Cancer Care Pathways at a Comprehensive Cancer Center in Northern Italy

“…Based on the key role of MTD meetings in affecting patient outcomes, meetings discussing newly diagnosed cancer cases and/or cases of recurrence are widely recognized as the gold standard in CCP management and as a platform to achieve clinical integration [17,23,24]. However, factors still exist that influence the quality and functioning of MDT meetings with regard to members' compliance and attendance, discrepancies between workload and health care professional resources, equipment availability, meeting format, communication practices, and the lack of awareness regarding the educational functions for residents [25][26][27]. To date, solutions able to overcome these barriers are still lacking, and such solutions are required in order to reach a standardized model by which an MDT meeting should be conducted [28].…”