Strengthening the Pediatric Radiation Oncology Workforce Through Digital Learning: A Capacity-Building Pilot from Pakistan.

Pediatric cancer is a significant global health challenge, especially in low- and middle-income countries where there is a critical shortage of trained pediatric radiation oncologists. To address this gap, we piloted a digital learning program to improve radiation therapy planning skills for pediatric sarcomas within Pakistan and the surrounding region. The activity included a two-day virtual workshop, held in July 2024, which featured didactic lectures and a week-long practical component where participants used the Eclipse Treatment Planning System for hands-on contouring exercises. We also administered pre- and post-workshop surveys to evaluate engagement and skill acquisition. Sixty-two participants, mainly radiation oncology trainees and consultants from South Asia and the Middle East, registered. Twenty-six were shortlisted for the hands-on activity, but only 19% completed the assignment. Technical issues like poor internet connectivity and platform glitches were identified as the main barriers. Despite these challenges, feedback was overwhelmingly positive. The hands-on contouring activity was considered the most valuable component by 63.6% of respondents, and 91% reported greater confidence in applying pediatric radiation oncology principles in their practice. This pilot demonstrates that a digital learning approach is a feasible and effective way to build capacity and address training disparities in resource-constrained settings.