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Needs assessment of current palliative care education in U.S. hematology/oncology fellowship programs

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Abstract

Background

Palliative care (PC) education for fellows in hematology/oncology (H/O) training programs is widely accepted, but no studies to date have assessed PC education practices and values among program leadership.

Methods

Program Directors and Associate Program Directors of active H/O fellowship programs in the U.S.A. were surveyed.

Results

Of 149 programs contacted, 84 completed the survey (56% response rate), of which 100% offered some form of PC education. The most frequently utilized methods of PC education were didactic lectures/conferences (93%), required PC rotations (68%), and simulation/role-playing (42%). Required PC rotations were ranked highest, and formal didactic seminars/conferences were ranked fifth in terms of perceived effectiveness. The majority felt either somewhat (60%) or extremely satisfied (30%) with the PC education at their program. Among specific PC domains, communication ranked highest, addressing spiritual distress ranked lowest, and care for the imminently dying ranked second lowest in importance and competency. Solid tumor oncologists reported more personal comfort with pain management (p = 0.042), non-pain symptom management (p = 0.014), ethical/legal issues (p = 0.029), reported their fellows were less competent in pain assessment/management (p = 0.006), and communication (p = 0.011), and were more satisfied with their program’s PC education (p = 0.035) as compared with hematologists.

Conclusions

Significant disparities exist between those modalities rated most effective for PC education and those currently in use. Clinical orientation of program leadership can affect both personal comfort with PC skills and estimations of PC curriculum effectiveness and fellows’ competency. H/O fellowship programs would benefit from greater standardization and prioritization of active PC education modalities and content.

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Data availability

Deidentified data for this study are available online via Open Science Framework at the following link: https://osf.io/eq5u2/?view_only=d1e6dd41f0dc4c98ac48f5936959650f

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Authors and Affiliations

  1. Division of Hematology & Oncology, Department of Medicine, University of California, Los Angeles, Box 951678 Factor Building, Los Angeles, CA, 90095-1678, USA

    Jafar H. Al-Mondhiry

  2. Department of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA

    Aaron D. Burkenroad

  3. David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA

    Eric Zhang

  4. Palliative Care Program, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA

    Christopher J. Pietras & Ambereen K. Mehta

  5. Division of General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, 21224, USA

    Ambereen K. Mehta

Authors
  1. Jafar H. Al-Mondhiry
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  2. Aaron D. Burkenroad
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  3. Eric Zhang
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  4. Christopher J. Pietras
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  5. Ambereen K. Mehta
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Correspondence to Jafar H. Al-Mondhiry.

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The authors declare that they have no conflict of interest.

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The University of California, Los Angeles Institutional Review Board committee reviewed this study and declared it exempt from further review.

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Informed consent was obtained from all individual participants in this study.

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Participants consented to publication of submitted responses in aggregate. No individual identifying information of participants is included in this study.

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Al-Mondhiry, J.H., Burkenroad, A.D., Zhang, E. et al. Needs assessment of current palliative care education in U.S. hematology/oncology fellowship programs. Support Care Cancer 29, 4285–4293 (2021). https://doi.org/10.1007/s00520-020-05919-7

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  • DOI: https://doi.org/10.1007/s00520-020-05919-7

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