Duke Cancer Care Experience: a longitudinal, multidisciplinary oncology curriculum for medical students.

Introduction

Cancer prevalence is increasing in the United States with over 2 million new cancer diagnoses in 2024 [ 1 ]. Additionally, in a study performed by the American Society of Clinical Oncology, the overall demand for oncologists was expected to rise by 40% from 2012 to 2025 leading to a major shortage in the oncology workforce. Of note, although 13% of the US population is Black and 18% is Hispanic, only 2.3% of practicing oncologists identify as Black and only 5.8% identify as Hispanic [ 2 ]. In order to meet the growing demand of cancer care, there is an increasing need for highly competent, compassionate, and diverse physicians in all medical specialties who are aware of the special needs of patients with a current or prior diagnosis of cancer. To educate, develop, and inspire medical students to pursue a career in oncology, early exposure to clinical oncology and access to mentorship are essential and have been shown to influence specialty choice and career trajectories among medical students [ 3 , 4 ]. However, a majority of medical school curricula do not include a robust oncology-focused pre-clinical education, and many medical schools include minimal direct exposure to sub-specialty clinics in the first year. Feedback from other workshop-based graduate electives have demonstrated student desire for electives to be offered earlier in their graduate programs for more time for knowledge reinforcement [ 5 ]. Additionally, there exists limited literature on the impact of longitudinal, discipline-focused educational programs on student knowledge and self-efficacy with topics related to the discipline, and impact on career choices. To respond to these needs, we developed the Cancer Care Experience (CCE) course at Duke University School of Medicine to foster early student exposure to oncology. The course not only addressed students’ needs but also provided an opportunity for junior faculty and fellows to participate in the teaching enterprise of the medical center, giving them an opportunity to plan and implement educational programs and mentor future clinicians. In this manuscript we describe this course, its evaluation and perceived impact, as well as the incorporation of the early career clinician educators in planning and implementing the course.

Background on the Cancer Care Experience

The Cancer Care Experience (CCE) at Duke University School of Medicine (DUSOM) is a multi-faceted, multi-disciplinary elective that introduces first year medical students to the fundamental concepts of cancer care with the goal of improving student comfort level in caring for patients with cancer and inspiring young learners to pursue careers in oncology, while offering an opportunity for residents and fellows to engage in student teaching and curriculum development.

The design and implementation of the CCE curriculum was informed by literature on the science of learning and principles of adult learning, including andragogy, experiential learning, and distributed practice [ 6 , 7 ]. These frameworks emphasize active learner engagement, relevance to real-world practice, and longitudinal reinforcement of knowledge to support durable learning [ 6 , 7 ]. Experiential learning has been shown to be an effective approach by facilitating active learning through real-world experiences in which learners interact with, become involved in, and critically evaluate what they are learning in authentic clinical contexts [ 8 ]. This principle encourages active engagement and improves motivation for learning. While it is important that learners engage in the course material, it is equally important that they have adequate time to develop the required skills and learn to apply their knowledge. Thus, the principle of distributed practice, referring to spacing instruction over a prolonged period, is paramount to this course to improve knowledge acquisition and retention [ 9 ].

To allow for experiential learning distributed over time, the CCE includes various intentional formats, timings and spacing to optimize learner education. Students participate in seven didactic sessions across a six-month semester and complete a minimum of three half-day oncology clinic shadowing experiences. This structure allows learners to reflect on didactic content and apply newly acquired knowledge and skills during clinical encounters. CCE’s instructional methods include interactive lectures, small-group discussions, role-play exercises, patient panels, longitudinal case-based learning, and clinic-based shadowing experiences. Learners interact with faculty across multiple oncology subspecialties during shadowing experiences following patients longitudinally to reinforce clinical reasoning and patient-centered care principles.

Components of the Cancer Care Experience

The CCE is a six-month longitudinal elective consisting of seven in-person sessions spaced approximately three to four weeks apart along with clinical shadowing experiences. Each session integrates didactic instruction, panel discussions, and small-group breakout activities aligned with session-specific learning objectives. The 40 students are broken up into 5 small groups. Each group of 8 students is assigned to learn a particular cancer type (breast, lung, multiple myeloma, prostate, and leukemia) in their small groups through the lens of reviewing a real patient case. They are given aliquots of the patient history as it pertains to each didactic session throughout the semester, and during the last session, they meet with their assigned patient face-to-face to hear their story and ask questions about their experience. In parallel, students shadow oncology providers in clinic for a minimum of three half-day sessions throughout the semester. The overview of the curriculum is shown in Table 1 . Of note, during the peak of the COVID pandemic, these sessions were able to be adapted to a virtual format with great success, which also allowed for multi-institution participation [ 10 ].

Table 1 Overview of the Cancer Care Experience Curriculum Session Title Session Leads Instructional Content & Strategies Clinical Experience Primary Care and Cancer Prevention Primary Care Physicians • Primary care physicians share their role in cancer care • Small group, case-based review of cancer screening guidelines Introduction to assigned clinic preceptor Cancer Diagnosis Radiologists Pathologists • Interactive lectures on radiology and pathology in cancer diagnosis Assigned patient with relevant history and presentation Patient Communication Palliative Care Physicians • Lecture on breaking bad news to patients • Small-group case-based discussion and practice in delivering bad news Clinic shadowing experience #1 Cancer Treatment Medical Oncologists Radiation Oncologists • Lecture on therapies managed by radiation and medical oncology • Training in radiation oncology contouring Assigned relevant treatment history of assigned patient case Patient-centered and Supportive Care in Oncology, Hospice, and Palliative Care Palliative Care Physicians • Introduction to palliative care and symptom management • Discussion of hospice services Clinic shadowing experience #2 Future Directions and Oncology Research Medical Oncologists PhD Scientists • Panel on oncology research Clinic shadowing experience #3 Cancer Survivorship Patients • Patient and family stories • Q&A Session Meet real patient

In order to enhance students’ experiences, they are asked to indicate their preferred subspecialty from a list that includes medical oncology, radiation oncology, surgical oncology, gynecologic oncology, pediatric oncology, and palliative care. Preceptors are recruited via e-mail to host a student in their clinic for a minimum of three half-day sessions. Students are then matched with preceptors based on their area of interest and faculty availability. Students shadow in clinic to experience a “day in the life” of an oncologist and the opportunity to meet with real patients. Students are not formally evaluated by clinic preceptors as the clinical experience is purely for enrichment of each student’s educational experience – however, feedback can be shared with students based on history taking and physical exam skills to assist with development. This is an exciting opportunity for these students so early in their medical school careers.

Resident and fellow educator development

CCE is intentionally designed to support resident and fellow development as clinician-educators. With the growing recognition of clinician-educator career pathways in academic medicine, trainees increasingly seek structured opportunities to develop skills in teaching, curriculum design, and small-group facilitation. The CCE incorporates residents and fellows as course leaders, small-group facilitators, and content developers, providing experiential teaching opportunities outside of traditional ward-based instruction. This dual-purpose structure allows the course to simultaneously address gaps in undergraduate oncology education while fostering early-career educator skill development among trainees.

In this study, we describe the structure of the CCE and evaluate its association with first-year medical students’ self-reported oncology-related comfort, empathy-related attitudes, and perceptions of career relevance following course participation.

Methods

Study design

This study was a single-group pre–post educational electronic survey evaluation of first-year medical students enrolled in the CCE elective at Duke University School of Medicine. Enrollment in the CCE is offered to first year medical students on a first-come, first-served basis up to 40 students. Data presented were collected for the 2023–2024 and 2024–2025 academic years. The DUSOM IRB reviewed the design, consent process, and evaluation of the program.

Participants were asked to complete a Pre-Program Questionnaire (See Appendix A) prior to the first didactic session and a Post-Program Questionnaire (See Appendix B) at the conclusion of the final didactic session. Following the completion of the 2025 cohort of CCE, an additional follow-up survey was sent to all applicants who participated in the course from 2020 to 2025 to gather additional feedback. These surveys were collected anonymously electronically using Qualtrics with a student-generated ID code known only to the student respondent.

Pre- and post-program questionnaires

The Pre- and Post-Program questionnaires were designed with four main components. The first component assessed comfort level with various aspects of caring for patients with an emphasis on cancer-related proficiencies. Both Pre- and Post-Program questionnaires asked students to rate their comfort levels with 15 different aspects of patient-care, most of which were oncology-related. These questions, ranging from a comfort-level score of 0-100, were grouped into three domains: “Knowledge-Based”, “Clinical/Technical”, and “Psychosocial”, and were designed to be broad to cover a range of aptitudes required as an oncologist.

The second survey section identified any potential changes in empathy before and after the CCE program, assessed by a shortened, interpersonal reactivity index (IRI) assessment tool [ 11 , 12 ]. The full IRI is a validated, 28-question empathy scoring questionnaire that uses a 5-point Likert Scale [ 11 , 12 ], and is subdivided into four scales: 1) the perspective-taking scale, 2) the fantasy scale, 3) the empathic concern scale, and 4) the personal distress scale [ 13 ]. Rather than administering the full 28-item instrument, this survey used a previously established shortened IRI format that was created and previously used by the Association of American Medical Colleges (AAMC) in the Medical School Year Two Questionnaire (Y2Q) and Graduation Questionnaires (GQ) [ 13 ]. Because this abbreviated format does not represent the full 28-item validated IRI, findings are interpreted descriptively as empathy-related attitudes rather than as validated IRI scores.

The third survey section assessed which components of the CCE curriculum were most valuable to students. Students were asked to rank 23 statements as true or false on a scale of 0-100 that assessed a) the direct perceived effect of CCE as a whole on the development of specific competencies, or b) attitudes and opinions regarding specific aspects or components of the CCE. This was included so that student feedback could be collected and possibly inform how future curriculum components were adjusted. Following the completion of the 2025 cohort of CCE, an additional follow-up survey was sent to all applicants who participated in the course from 2020-2025 to gather additional feedback on the curriculum.

Lastly, the fourth survey section assessed any observed impact on specialty choice as a result of engagement with the CCE curriculum. Although causal inferences could not be made, specific questions administered in the post-program survey allowed for descriptive analysis of whether the course may be increasing student interest in oncology as a career. Additionally, students listed their top 3 career choices before and after the course. Free-text specialty responses to these questions were manually reviewed and categorized as oncology-related if they explicitly referred to oncology or a clearly cancer-focused field, including oncology, medical oncology, hematology-oncology, surgical oncology, radiation oncology, gynecologic oncology, pediatric oncology/pediatric hematology-oncology, neuro-oncology, head and neck oncology, breast medical oncology, breast surgery, and palliative care.

Statistical analysis

Participant enrollment data were tabulated by cohort year, and counts and percentages were reported to characterize the study sample and survey response patterns. Participant responses to questions regarding intended medical specialty were summarized using frequency tables. For analytic purposes, specialties were further categorized into “Oncology” or “Non-Oncology” based on a predefined list provided by the study investigators. The primary quantitative analyses were descriptive.

For the comfort-level question set, which included 15 survey items scored out of 100, summary statistics were calculated for each item separately, including the number of respondents (N), mean, standard deviation (SD) and median, for both pre- and post-program surveys within each cohort year. Analyses were performed separately for each cohort year to assess consistency in response patterns and so that any obvious changes in perceptions due to year-to-year curriculum updates could be observed. The abbreviated IRI empathy assessment question set, which consisted of 8 different questions, was analyzed descriptively at the item level for the 2023 and 2024 cohorts. Items were scored on a 5-point Likert scale, and weighted mean item scores were calculated separately for pre- and post-course responses using aggregated category counts. Negatively worded items were reverse-coded so that higher scores indicated a more empathy-concordant response. Because the instrument was modified, analyses were restricted to descriptive comparisons rather than formal scale validation or inferential paired testing. The post-CCE attitudes and program value ratings question set, which included 23 survey items scored out of 100, responses were analyzed similarly to the comfort-level question set, with counts and summary statistics reported for each item. An exploratory descriptive analysis was conducted for the career-choice question set: counts of all oncology-related specialties that fell within students’ top 3 specialty list were tallied to assess whether there were observable differences pre- and post-CCE. All statistical analyses were performed in RStudio version 4.5.1.

Results

Reported comfort in knowledge, psychosocial, and clinical/technical domains

Among enrolled students, 36/40 (90%) in 2023 and 39/40 (98%) in 2024 completed both pre- and post-program surveys. Across both cohorts, post-program mean comfort ratings were higher than pre-program ratings for all 15 surveyed cancer care topics (see Table A1, Appendix). Across both cohorts, mean self-reported confidence scores increased from pre- to post-course for all 15 items. This pattern was consistent in 2023 and 2024 and was observed across all three domains of “Knowledge Development”, “Psychosocial Development”, and “Clinical/Technical Skills” (Fig. 1 ). Absolute increases in mean scores ranged from 15.90 to 41.95 points in 2023 and from 11.03 to 34.06 points in 2024, with some of the largest gains seen in describing patient experiences in the survivorship period, understanding how oncologists care for patients, and understanding clinical settings in which patients with cancer receive care.

Fig. 1 Pre-Course and Post-Course comfort levels with knowledge, psychosocial, and technical skills from 2023–2024

Self-reported assessments of empathy development

The abbreviated IRI empathy assessment results remained relatively consistent between the pre- and post-course surveys (Fig. 2 ). There was a modest increase in the percentage of those who agreed or completely agreed with the following statements: "when I’m upset at someone, I usually try to “put myself in their shoes” for a while" (2023: pre 85%, post 93%, 2024: pre 81%, post 91%), "before criticizing somebody, I try to imagine how I would feel if I were in their place" (2023: pre 82%, post 93%, 2024: pre 86%, post 94%), and "I would describe myself as a pretty soft-hearted person" (2023: pre 79%, post 83%, 2024: pre 76%, post 86%).

Fig. 2 2023–2024 Shortened IRI - Weighted avg. Likert empathy scores. *Reverse coded

Reported perceptions regarding course content

The post program survey also assessed the student’s perception of each aspect of the course, including their acquisition of knowledge of content/materials taught in the course (Fig. 3 ). Students indicated a high level of confidence in the materials/content that were covered in the didactic curriculum. Interestingly, students found it valuable to meet real patients during the final session (2023: mean 77, 2024: mean 67.59) but did not find following a real patient case throughout the course to be as meaningful (2023: mean 63, 2024: mean 47.84). The small group breakout sessions (2023: mean 85, 2024 mean: 78.94) and clinical shadowing experiences (2023: mean 85, 2024: mean 78.09) were well received. Importantly, students reported that the course helped them feel more prepared for patient-centered clinical encounters relevant to clerkship training (2023: mean 97, 2024: mean 94.58). Students also noted that the program impacted their anticipated career choice (2023: mean 91, 2024: mean 83.06) and how they approached patients (2023: mean 87, 2024: mean 81.56).

Fig. 3 Student ratings of program value, divided into two categories: clinical knowledge/skills development and program value

In the follow-up survey sent out in 2025 to prior CCE participants, a total of 71/216 (32.8%) participants responded. 50.7% (36/71) of participants who responded reported that they anticipated a career in oncology, and 74.6% (53/71) of follow-up respondents noted that CCE had influenced their thinking about career choice. Of the 71 participants that responded, 98.6% (70/71) reported that they would recommend CCE to other medical students. Participants were asked to describe the impact of CCE on their time as a medical student via free text response. A total of 55/71 (77.5%) respondents included a free text response. One participant stated “CCE provided the right content to foster my interest in treating cancer patients, and that has continued throughout my medical training.” Others detailed the course’s “rewarding and educational experience” and “hematology / oncology was not given much focus in the curriculum (prior to CCE), so engaging in the field was valuable.” Another CCE participant, although they concluded that they did not have an intention in pursuing oncology as a field, stated, “I had a great experience participating in CCE. CCE made me want (to build) a longitudinal relationship with patients.” Common themes identified by participant responses are highlighted below in Table 2 .

Table 2 Common qualitative themes identified from follow-up survey sent to course participants, 2020–2025 Theme % Of Respondents Mentioning Theme Example Quote Introduction to Oncology and Cancer Care 29/71 (40.8%) “Incredible experience with valuable exposure to the field of oncology.” Empathy and Patient- Centered Perspective 27/71 (38.0%) “Appreciated the opportunity to listen to actual cancer patients tell their stories.” Multidisciplinary Approach to Cancer Care 16/71 (22.5%) “The program gave me better insight into … the importance of multidisciplinary collaboration in (patient) care.”

Potential influence of CCE on specialty choice

Across the 2023 and 2024 cohorts (Fig. 4 ), the total number of oncology-related specialty selections across students’ top three career choices was similar before and after CCE participation (49 pre-course vs. 47 post-course). In 2023, totals were unchanged (21 pre vs. 21 post), whereas in 2024 there was a slight decrease (28 pre vs. 26 post). These findings, seen in Fig. 4 , suggest relative stability in oncology-related career interest at the group level, with modest shifts in rank-order distribution rather than a clear increase in overall oncology interest, despite favorable qualitative comments about oncology exposure and mentorship. Qualitatively, a few sample comments included “This elective has helped me realize how valuable it is to form longitudinal relationships with patients and their families. It’s something I didn’t know I valued!”, “I think this course has helped me feel more sure about wanting to have a career in oncology”, “This course has made me realize the extent of care that oncologists are responsible for and how this must be a team approach. These aspects have made me more likely to consider a future career in oncology”, and “This course has strongly motivated me to pursue a specialty related to oncology”.

Fig. 4 Students ranking oncology-related subspecialties within their top 3 choices

Discussion

Cancer prevalence continues to rise in the United States, and a projected shortage of oncologists further highlights the need to educate students who aspire to become future oncologists and care for patients affected by cancer [ 1 , 2 ]. The CCE at DUSOM aims to address these challenges by educating, developing, and inspiring a diverse group of medical students to pursue careers in oncology, while providing early exposure to clinical oncology and mentorship. Duke’s CCE elective offers a structured, longitudinal and patient-centered approach to addressing gaps in oncology education within the current medical curriculum and promotes early clinical experience for first-year medical students. In addition, CCE provides residents and fellows with opportunities to refine their teaching skills and promote career interests in academia and curriculum design. Feedback from resident and fellows who engaged in the course highlighted that this was a valuable experience to learn how to prepare curricular materials and allowed for an opportunity to teach first year medical students that was otherwise lacking. This novel program is multi-disciplinary in nature to model oncological care in a real-world setting.

Current literature supports early specialty exposure, active mentorship, and diverse learning modalities as factors that contribute to specialty selection and long-term knowledge retention [ 8 , 9 ]. Student feedback highlighted the clinical experiences, multidisciplinary teaching, and interactive assignments as valuable components of the course, underscoring the benefit of integrating oncology education into medical school curriculums.

Oncology education and knowledge development

The CCE incorporates experiential and distributed learning strategies to enhance knowledge acquisition and retention for medical students, a model consistent with the principles of adult learning theory [ 8 , 9 ]. Through engagement in case-based learning, longitudinal clinic shadowing, and repeated exposure to oncology topics throughout the course, students integrate oncology principles into their medical training. Self-assessment data reported by students indicated improvements in confidence with each of the categorized domains, including communication, empathy-related tasks, and increased understanding of the responsibilities of multidisciplinary cancer care. It is important to note that some of the measured outcomes were specifically oncology-focused, whereas others reflected broader clinical competencies developed in an oncology context. Accordingly, the observed gains may reflect both increased oncology literacy and more general development in communication, empathy, and relational care. These results suggest that this type of educational model may be effective in non-oncologic contexts; similar programs developed for other subspecialties could be effective for developing particular skills and competencies. Specifically, students reported increased comfort levels with their ability to care for oncology patients, delivering bad news, managing the emotional impacts of a cancer diagnosis to a patient, identifying common issues patients experience while undergoing treatment, among others highlighted in Fig. 1 . The six-month longitudinal structure of didactics and clinical development sessions encouraged engagement with oncology topics over time, reinforcing retention, and allowed for better integration into the medical curriculum. These findings are further supported by prior studies which showed that tying experiential learning with patient contact is effective for both development of medical knowledge and emotional engagement [ 14 ].

Empathy development

Prior studies have shown that empathy tends to decline during early medical training [ 15 , 16 ]. However, the CCE demonstrated stability at minimum, and potentially modest improvements in empathy assessment scores based on the administered shortened IRI item set. These findings suggest that incorporating structured patient exposure, prolonged mentorship, and longitudinal contact with individuals with cancer early in training may contribute to growth during a period classically associated with erosion of empathy. Consequently, early emphasis on empathy development may lead to downstream benefits and optimize patient-centered care. The validated IRI scale was shortened for the purposes of this study and so may have limited sensitivity in the detection of subtle changes over this shorter study time period. Future evaluations would benefit from pairing this shortened IRI-based measure with additional validated or complementary empathy measures to better characterize the effect of short-duration educational interventions such as the CCE.

Career awareness, interest, and mentorship structure

While many medical students enter medical school with an intended career path in mind, most students will deviate from their initial plan and ultimately match into a different specialty [ 17 ]. However, certain factors can make it more likely that a student will maintain a particular specialty interest. One of those factors is early exposure to a specialty-related educational curriculum [ 18 , 19 ], such as the one implemented through the CCE. While the results did not demonstrate an increase in the student interest in oncology as a result of CCE participation, the proportion of students ranking oncology in their top three career choices did remain stable, which suggests that the program may have been successful in at least retaining interest. Qualitative responses of CCE participants suggested a greater understanding and appreciation for the role of an oncologist, as well as an increased appreciation for the value of longitudinal relationships with patients. These outcomes indicate the fulfillment of an important secondary objective; increasing awareness and literacy in cancer care is important among all future physicians, regardless of specialty.

Recent 2025 CCE survey results further reinforced the course’s impact, with over half of respondents in the survey (50.7%) indicating they intend to pursue a career in oncology. Although only one-third of eligible students responded, the number of respondents suggesting the course influenced their career decision suggests a strong level of engagement with the material and course. Notably, immediate pre–post changes in specialty ranking were minimal, whereas retrospective follow-up respondents frequently described the course as influential in how they thought about oncology careers. These measures capture different constructs and should not be interpreted interchangeably. Additionally, prior literature suggests that a student’s specialty exploration and choice may be related to their subjective self-efficacy [ 20 ]. Although this study design precludes causal inferences regarding specialty selection, participants did report higher confidence in several cancer care domains after course participation. To further increase interest in pursuing oncology, a continued emphasis will be placed on targeted mentorship, increased scope for structured research in oncology-related fields, and increased opportunity for follow-up engagement in subsequent years.

Limitations

This study was conducted at a single academic medical center, limiting generalizability. Enrollment in the course was on a first-come, first-served basis, which also may have introduced some self-selection bias towards students already interested in oncology or the humanistic aspects of cancer care. Outcomes were self-reported, which may have inflated perceived gains. Additionally, some measured outcomes were specifically oncology-focused, but others measured broader clinical competencies that were simply assessed within an oncology context, which limits claims that observed changes were uniquely oncology-specific. Furthermore, empathy-related attitudes were assessed using an abbreviated IRI item set rather than the full validated 28-item IRI; accordingly, these findings should be interpreted cautiously and not as a formal validation-based measure equivalent to the full IRI. Variations in longitudinal care and experiences also occurred for a cohort of participants that participated in CCE at the height of the COVID-19 pandemic. Finally, the 2025 follow-up survey was retrospective and had a 32.8% response rate, creating substantial potential for nonresponse bias, and participants with more favorable impressions of the course may have been more likely to respond.

Conclusions and future direction

Participation in this longitudinal oncology elective was associated with higher self-reported confidence across multiple oncology and non-oncology clinical domains and with favorable student perceptions of oncology exposure, multidisciplinary care, and patient-centered learning. Empathy-related responses were generally stable on an abbreviated IRI-derived measure. Because this was a single-group educational evaluation with self-reported outcomes, the findings should be interpreted cautiously. Even so, the program offers a feasible model for integrating longitudinal oncology exposure into the pre-clinical curriculum.

Future directions for the CCE course include expansion of the content to address health systems and the psychosocial dimensions of cancer care such as insurance navigation, financial toxicity, cancer disparities, and survivorship support. Additionally, the incorporation of specialties such as physical therapy, occupational therapy, and nutrition will broaden the scope of the course and increase student interest. Continued resident-led module development and curriculum design will further enhance the clinician-educator skillset of trainees participating in CCE. In addition, the implementation of further longitudinal outcome measures, and possible expansion to a multi-year curriculum, will strengthen the evidence of CCE’s educational impact. Ultimately, multi-institutional collaboration will be valuable for assessing reproducibility and scalability of the CCE model.

Supplementary Information

Supplementary Material 1.

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Anagh Kulkarni and Zachary Creech contributed equally to this manuscript as co-first authors.

Acknowledgements

We thank all survey participants for their responses and faculty for their contribution to CCE. We also thank the Duke Department of Medicine Faculty Development Academy. The Duke Faculty Development Academy is an initiative designed to support faculty professional growth across the career lifespan. Through monthly cohort meetings and guided project work, the Academy provided a structured forum for collaboration with Duke faculty, which informed the successful integration of CCE into the medical school curriculum. The authors are grateful for the Duke Faculty Academy’s contributions to the development and implementation of CCE.

Authors’ contributions

Anagh Kulkarni, BS, and Zachary Creech, MD, are co-first authors and contributed equally to this manuscript. A.K. and Z.C. contributed to survey development, data collection, data analysis, interpretation of results, figure and table creation, and manuscript drafting. K.T.S. contributed to the study design and development of the study methods and critically revised the manuscript. M.N. contributed to the study design and revision of the manuscript. S.P.O. contributed to the conception and design of the study, curriculum development, interpretation of the data, and critically revised the manuscript. M.L. contributed to the conception and design of the study, provided oversight of the project, participated in manuscript drafting, critically revised the final manuscript, and served as the corresponding author.

Funding

Not applicable.

Data availability

All data generated or analyzed during this study are included in this published article [and its supplementary information files].

Declarations

Ethics approval and consent to participate

This study was submitted to and approved by the Duke University Health System Institutional Review Board (DUHS IRB) and was determined to be exempt from IRB review (protocol #00101881). All methods and human ethics were carried out in accordance with the Declaration of Helsinki. Electronic informed consent to participate was obtained from all participants at the beginning of each survey. Participants were informed that completion and submission of the questionnaire indicated consent to participate, and therefore, consent was obtained before the collection of any data.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Abbreviations

Cancer Care Experience

Duke University School of Medicine

Interpersonal Reactivity Index

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