Advertisement

Journal of Cancer Education

, Volume 33, Issue 6, pp 1255–1262 | Cite as

Identifying Primary Care Physicians Continuing Education Needs by Examining Clinical Practices, Attitudes, and Barriers to Screening Across Multiple Cancers

  • Brenna Lynn
  • Alexandra Hatry
  • Chloe Burnett
  • Lisa Kan
  • Tunde Olatunbosun
  • Bob Bluman
Article

Abstract

Population-based cancer screening for cervical, breast, and colorectal cancers improves patient outcomes, yet screening rates remain low for some cancers. Despite studies investigating physician perceptions and practices for screening, many have focused on individual cancers and lack primary care physicians’ (PCPs) realities around screening for multiple cancers. We surveyed 887 PCPs in British Columbia (BC) to examine practices, beliefs, barriers, and learning needs towards cancer screening across breast, cervical, colorectal, prostate, as well as hereditary predisposition to cancer. Survey results identified differences in PCPs belief in the benefit of screening for recommended and non-recommended routine cancer screening, PCPs adherence to screening guidelines for some cancers and physician comfort and patient testing requests related to physician gender for gender sensitive tests. Further, across cancers, screening barriers included patients with multiple health concerns (41%), limited time to discuss screening (36%), and lack of physician financial compensation to discuss screening (23%). The study highlighted the need for more physician education on screening programs, referral criteria, follow-up processes, and screening guidelines. Conferences (73%), self-directed (46%), small group workshops (42%), hospital rounds (41%), and online CME/CPD (39%) were highly preferred (4+5) for learning about cancer screening. The results suggest a need to improve awareness and adherence to screening guidelines and recommended practices, as well as to provide educational opportunities which address knowledge and practice gaps for physicians.

Keywords

Cancer Screening Primary care physicians Needs assessment CME effectiveness 

References

  1. 1.
    Canadian Cancer Statistics (2016) Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Canadian Cancer Society, Toronto, 2016 October. Report No: ISSN0835-2976Google Scholar
  2. 2.
    Sasieni P, Castanon A, Cuzick J (2009) Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ (Clin Res ed) 339:b2968CrossRefGoogle Scholar
  3. 3.
    Strumpf Erin C, Chai Z, Kadiyala S (2010) Adherence to cancer screening guidelines across Canadian provinces: an observational study. BMC Cancer 10:304CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Feeley TH, Cooper J, Foels T, Mahoney MC (2009) Efficacy expectations for colorectal cancer screening in primary care: identifying barriers and facilitators for patients and clinicians. Health Commun 24:304–315CrossRefPubMedGoogle Scholar
  5. 5.
    Cardarelli R, Kurian AK, Pandya V (2010) Having a personal healthcare provider and receipt of adequate cervical and breast cancer screening. J Am Board Fam Med : JABFM 23:75–81CrossRefPubMedGoogle Scholar
  6. 6.
    Wender RC (1993) Cancer screening and prevention in primary care. Obstacles for physicians. Cancer 72:1093–1099CrossRefPubMedGoogle Scholar
  7. 7.
    Davis D, Davis ME, Jadad A, Perrier L, Rath D, Ryan D, Sibbald G, Straus S, Rappolt S, Wowk M, Zwarenstein M (2003) The case for knowledge translation: shortening the journey from evidence to effect. BMJ. doi: 10.1136/bmj.327.7405.33
  8. 8.
    Davis D, O'Brien MAT, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A (1999) Impact of formal continuing medical education do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 282:867–874CrossRefPubMedGoogle Scholar
  9. 9.
    Davis D, Galbraith R (2009) Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest 135:42S–48SCrossRefPubMedGoogle Scholar
  10. 10.
    Grant J (2002) Learning needs assessment: assessing the need. BMJ. doi: 10.1136/bmj.324.7330.156
  11. 11.
    Curran V, Solberg S, Mathews M, Church J, Buehler S, Wells J, Lopez T (2005) Prostate cancer screening attitudes and continuing education needs of primary care physicians. J Cancer Educ: Off J Am Assoc Cancer Educ 20:162–166CrossRefGoogle Scholar
  12. 12.
    McGregor SE, Hilsden RJ, Yang H (2010) Physician barriers to population-based, fecal occult blood test-based colorectal cancer screening programs for average-risk patients. Can J Gastroenterol = Journal canadien de gastroenterologie 24:359–364CrossRefPubMedGoogle Scholar
  13. 13.
    Levy S, Dowling P, Boult L, Monroe A, McQuade W (1992) The effect of physician and patient gender on preventive medicine practices in patients older than fifty. Fam Med 24:58–61PubMedGoogle Scholar
  14. 14.
    Yarnall KSH, Pollak KI, Østbye T, Krause KM, Lloyd Michener J (2003) Primary care: is there enough time for prevention? Am J Public Health 93:635–641CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Grol R, Grimshaw J (2003) From best evidence to best practice: effective implementation of change in patients’ care. Lancet 362(9391):1225–1230CrossRefPubMedGoogle Scholar
  16. 16.
    Hoag NA, Alan IS (2012) The confusion surrounding prostate cancer screening faced by family physicians. Can Urol Assoc J 6(3):194–195CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Williamson PM (1975) The adoption of new drugs by doctors practising in group and solo practice. Soc Sci Med 9(4–5):233–236CrossRefPubMedGoogle Scholar
  18. 18.
    Dochy F, Segers M, Van den Bossche P, Gijbels D (2003) Effects of problem-based learning: a meta-analysis. Learn Instr 13:533–568CrossRefGoogle Scholar
  19. 19.
    Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, Miller RG, Thomas PA, Prokopowicz GP, Qayyum R, Bass EB (2007) Effectiveness of continuing medical education. Evid Report/Technol Assess 149:1–69Google Scholar
  20. 20.
    Pathman DE, Konrad TR, Freed GL, Freeman VA, Koch GG (1996) The awareness-to-adherence model of the steps to clinical guideline compliance. The case of pediatric vaccine recommendations. Med Care 34(9):873–889CrossRefPubMedGoogle Scholar

Copyright information

© American Association for Cancer Education 2017

Authors and Affiliations

  1. 1.Division of Continuing Professional Development, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  2. 2.Continuing Medical Education and Professional Development, Faculty of MedicineUniversity of CalgaryCalgaryCanada
  3. 3.Screening Program, BC Cancer AgencyVancouverCanada

Personalised recommendations