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92 Background: To address identified gaps in knowledge and confidence of US-based healthcare professionals (HCPs) when using cyclin-dependent kinase 4/6 inhibitors (CDK 4/6i) to treat metastatic breast cancer (mBC), an adaptive learning program (ALP) was deployed to review guideline recommendations and evidence from randomized clinical trials (RCTs) and real-world data (RWD). Methods: The ALP consisted of reading materials (guideline excerpts, RCTs, RWD, cases) with a virtual tutor that taught. The ALP continued to review necessary content until responders were both correct and confident (conscious competence). Impact on learning was interpreted as greater for learning objectives with the lowest accuracy score (% of correct responses) and higher distance to 100% conscious competency at baseline. Immediately post-ALP, satisfaction, perceived impact on knowledge, confidence and intent to change practice were assessed quantitatively and qualitatively. ANOVA compared continuous measures by profession. Results: Participants (n=261) were physicians (MD, 17%), advanced practice practitioners (APP, 20%), registered nurses (RN, 49%), pharmacists (11%), and other (3%). Mean completion time was 44 minutes and learners' proficiency shifted +64% towards conscious competency. The learning objectives most impacted by the education are shown (Table). Learners most satisfied with the ALP (47% with 9-10 on a 10-point satisfaction scale) appreciated the challenge and reported positive impact on their knowledge and confidence, resulting in intent to change their patient-communication, clinical decisions and interprofessional collaboration when using CDK4/6i. Conclusions: This ALP initiative addressed the educational gaps of US HCPs regarding CDK4/6i in HR+/HER2- mBC by challenging participants to re-consider their knowledge and confidence until conscious competency was demonstrated. Engaged learners found the activity impactful and reported intent to change practice. Future studies should seek to address attrition challenges and assess long term impacts of such programs. Top five learning objectives with lowest-ranking accuracy, by profession. Learning Objectives (LOs) Most Impacted Initial Scores by Profession Final Score ALL MD APP RN PharmD Other Identify appropriate CDK4/6i treatment options for a premenopausal woman with newly diagnosed HR+/HER2- mBC 54 57 53 53 62 52 100 Match RWD sources with their characteristics 56 55 60 55 61 41 100 Interpret results from the landmark CDK4/6i RCTs 58 62 61 53 64 56 100 Interpret RWE related to the use of CDK4/6i in patients who are underrepresented in RCTs* 62 62 63 58 74 65 100 Identify the latest updates from CDK4/6i RCTs 62 60 63 61 62 82 100 Average accuracy score for all 24 LOs 71 72 73 69 74 64 100 *Significantly different between professions (p<0.05; one-way ANOVA). [ABSTRACT FROM AUTHOR]

Numerous targeted therapies are currently available in breast cancer (BC) with gene amplification of the human epidermal growth receptor factor 2 (HER2), while those targeting HER3+ BC are still under clinical investigation. Oncology nurses and advanced practice providers are expected to stay abreast of these advancements to ensure patients with BC receive appropriate therapeutic education. The purpose of this study was to identify the challenges and barriers affecting the care of patients with HER2+ BC, with a focus of on the preparedness of oncology providers to educate and counsel patients on their diagnosis, treatment, and management options. A mixed-methods research study was conducted with semi-structured interviews followed by a quantitative survey. Participants included registered nurses (RNs), nurse practitioners (NPs), physician assistants (PAs), medical oncologists (MOs), and pathologists (PATHs) practicing in the United States. RNs, NPs and PAs were required to have an oncology specialization or a minimum of 2 years of practice in oncology. Interviews transcripts were coded and thematically analyzed in NVivo. Chi- square statistical tests were performed on survey data in SPSS to compare responses by demographic (e.g., profession). Thirty-two (32) interviews and 258 surveys were completed with similar breakdowns by profession. Interviews indicated that RNs, NPs/PAs experienced challenges in educating patients about their molecular diagnosis and available treatment options. Surveys indicated that 70% of RNs rated their skill at sub-optimal levels for explaining to patients the role of HER2+ gene amplification. Sub-optimal skills were reported among 43% of NPs/PAs for realigning patients' assumptions about HER2+ metastatic BC. In addition, 38% and 35% of NPs/PAs rated their skill sub-optimally in explaining to patients the risks and benefits of HER2 monoclonal and HER2-directed antibody drug conjugates, respectively. A similar proportion (33%) rated their skill sub-optimally in assessing patients' level of comprehension for available treatment options. To the co-authors' knowledge, this is the first study assessing the educational needs of oncology nurses in their communications with HER2+ BC patients. Oncology nurses and advanced practice providers would benefit from innovative and impactful professional development interventions designed to help them better understand, interpret/translate, and effectively communicate to patients the continually evolving scientific evidence related to HER2+ BC treatment options and their associated risks/benefits. [ABSTRACT FROM AUTHOR]