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An Iterative Formative Evaluation of Medical Education for Multiple Myeloma Patients Receiving Autologous Stem Cell Transplant

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Abstract

Multiple myeloma (MM) is an incurable cancer characterized by abnormal plasma cells in the bone marrow, resulting in increased risk of infection. Autologous stem cell transplant (ASCT) is the most effective treatment for MM, but successful transplant requires the patient and caregiver to learn and independently implement medical tasks. The Ready for Transplant (R4T) ethnographic-based formative evaluation includes evaluation of ongoing patient education and the addition of novel supplemental educational videos that patients can review before in-person transplant education. To evaluate R4T, a formative evaluation informed by utilization-orientated evaluation theories, including over 150 hours of ethnographic observation of nurse/patient education (N = 70), plus retrospective and prospective patient (N = 35) and clinician interviews (N = 7) was conducted over 18 months. Through thematic analysis, barriers and facilitators of the patient’s ability to process education surrounding ASCT were identified. Barriers included anxiety surrounding what to expect in ASCT, anxiety surrounding what to expect at the education visit, overwhelming volume of information, lack of medical expertise, and disengaged patients, while facilitators included large social networks willing to help and clinician adjusting script to meet unique needs of the patient. This manuscript represents an iterative method for improving on education that people with MM receive surrounding ASCT. Ultimately, the supplemental video-based education was created to address modifiable social and psychological factors by providing generalized information that could then be tailored during in-person meetings to meet each patients’ individual needs.

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Acknowledgments

The authors would also like to thank Christine Umstead, Endrè Brown, Ivey Jowers, and Laura Lynch White for their expert guidance; Edward Waller for support; and Alison and Abigail Halpin for their invaluable input in preparing this manuscript.

Funding

Research reported in this publication was supported in part by the Intervention Development, Dissemination and Implementation Developing shared resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.

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Authors and Affiliations

  1. College of Education, University of Georgia, 308 River’s Crossing, 850 College Station Road, Athens, GA, 30602, USA

    Sean N. Halpin

  2. School of Medicine, Emory University, Atlanta, GA, USA

    Michael Konomos

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  1. Sean N. Halpin
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Correspondence to Sean N. Halpin.

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This study was approved by an Institutional Review Board following expedited review.

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Halpin, S.N., Konomos, M. An Iterative Formative Evaluation of Medical Education for Multiple Myeloma Patients Receiving Autologous Stem Cell Transplant. J Canc Educ 37, 779–787 (2022). https://doi.org/10.1007/s13187-020-01882-3

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