Journal of Cancer Education

, Volume 32, Issue 2, pp 301–307 | Cite as

Oncologist Experience Implementing Goals of Care Discussions in Everyday Ambulatory Oncology Practice: Implications for Education

  • Carole A. Robinson
  • Gillian Fyles
  • Michael McKenzie
Article
First Online:

Abstract

Despite evidence that Goals of Care (GOC) discussions should occur early in the disease trajectory, the majority occur close to end of life. In a pilot, oncologists routinely initiated GOC discussions with all patients in their everyday ambulatory practice. Following the pilot, 9 of 12 eligible oncologists participated in semi-structured interviews about their experiences. Analysis resulted in the identification of seven principles of good GOC discussions embedded in the oncologists’ interviews, four barriers to engaging in GOC discussions and foundational education needs. Participants believed that the appropriate trigger for a GOC discussion is a diagnosis of advanced cancer, not simply a diagnosis of cancer, and supported the importance of selective and strategic targeting of GOC discussions. The findings have informed the development of an education-based model for culture change within a province-wide cancer care system.

Keywords

Advance care planning Goals of care Ambulatory oncology Oncology Palliative care 
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Copyright information

© American Association for Cancer Education 2015

Authors and Affiliations

  • Carole A. Robinson
    • 1
  • Gillian Fyles
    • 2
  • Michael McKenzie
    • 3
  1. 1.School of NursingUniversity of British ColumbiaKelownaCanada
  2. 2.Medical Lead, Pain and Symptom Management Palliative Care ProgramBC Cancer Agency Sindi Ahluwalia Hawkins Centre for the Southern InteriorKelownaCanada
  3. 3.Radiation Therapy ProgramBC Cancer Agency Vancouver Cancer CentreVancouverCanada

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