Optimizing a Hematology/Oncology Curriculum for Internal Medicine Residents: A Two-Institution Modified Delphi Study

Although hematology/oncology (H/O) topics are essential for clinicians, many internal medicine (IM) residents perceive inadequate H/O education. This perception may be due to the lack of a standardized H/O curriculum. To address this gap, we aimed to achieve consensus about the most important H/O topics for IM residents to learn.

In 2023, we conducted a 2-round modified Delphi study of IM generalists and H/O specialists at the University of California, San Francisco and Stanford University. In round 1, participants rated the importance of H/O topics on a 5-point scale (1 = very unimportant; 5 = very important). In round 2, participants viewed their own ratings vs. the group mean and could change their ratings. We used a content validity index (CVI, the percentage of respondents who rated the topic ≥ 4) of ≥ 75% to identify the most important topics. We calculated the effect sizes of between-group rating differences using Cohen's d.

The round 1 and 2 response rates were 70% (92/132) and 77% (71/92), respectively. Ninety-one of the 239 topics met the CVI threshold (41 classical hematology, 14 malignant hematology, and 36 solid oncology), of which only 4 out of 91 (4%) had a large effect size, indicating agreement between generalists and specialists. There were 14 topics with a CVI of 100%, including deep venous thrombosis/pulmonary embolism, iron deficiency anemia, advance care planning, and management of end-of-life issues.

With input from IM generalists and H/O specialists, we identified the most important H/O topics for IM residents, which can guide curriculum development.