Implementation of an International Virtual Clinical Research Course for Clinical Oncology Fellows at a Cancer Teaching Hospital in Zambia

PURPOSE/OBJECTIVE(S) Low and middle-income countries (LMICs) are significantly under-represented in cancer research due to a lack of research capacity rooted in historical inequalities. Training in-country physicians in clinical research is one of the most sustainable ways to address the shortage of research in LMICs. As part of an academic partnership between MD Anderson Cancer Center in Houston, TX (MDA) and Cancer Diseases Hospital in Lusaka, Zambia (CDH), an international virtual clinical research course for clinical oncology fellows at CDH was piloted in Fall 2020 to address a significant need for a structured clinical research curriculum. MATERIALS/METHODS The virtual clinical research course took place from August to November 2020 and involved 14 weekly hour-long lectures (13 by MDA faculty, one by CDH faculty) on topics including identifying a research question, study design, clinical trials, research ethics, biostatistics, and scientific writing. The course was attended by 15 clinical oncology fellows. Eight senior fellows were paired with a longitudinal MDA and CDH faculty member and MDA resident/fellow mentor in their area of interest to support a research protocol. Anonymized pre- and post-course surveys were administered with 5-point Likert scale academic self-efficacy inventories and open-ended qualitative questions. Descriptive statistics were used to summarize the findings. RESULTS A total of 12/15 participants (80%) completed the pre-course survey and 11/15 (73%) completed the post-course survey. Average scores pre- and post-course, respectively, for research interest and motivation (5.0, 4.9), comfort reading and evaluating medical literature (3.7, 4.5), developing a study question and design (2.8, 4.0), collecting and managing data (3.3, 4.0), independently performing and publishing research (2.3, 3.7), and satisfaction with mentorship and profession (3.0, 4.2) demonstrated an increase across multiple domains. As of December 2020, there were eight active research proposals led by CDH clinical oncology fellows and there had been 21 meetings and 27 hours of MDA-CDH mentorship time. Positive themes from open-ended feedback included clear lectures, meaningful relationships with mentors, and utility of presenting research proposals for feedback while constructive themes included desire for more teaching on statistical analysis and incorporation of self-assessment modules. CONCLUSION Clinical research is essential to develop effective, evidence-based interventions to the unique cancer care challenges that occur in LMICs. The results from the pilot virtual MDA-CDH research course, which led to improvements in academic self-efficacy scores, support for research proposals led by CDH clinical oncology fellows, and formation of longitudinal mentorship groups demonstrate the feasibility of conducting a virtual longitudinal research workshop model. Continued collaboration and future follow-up will be needed to demonstrate effectiveness and impact.