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Palliative care training in surgical oncology and hepatobiliary fellowships: a national survey of the fellows. Ann Surg Oncol 2015;22(6):1761-7

Date

11/09/2014

Pubmed ID

25380685

DOI

10.1245/s10434-014-4226-0

Scopus ID

2-s2.0-84939964878   30 Citations

Abstract

BACKGROUND: Surgical oncologists (SO) and hepatobiliary (HPB) surgeons frequently care for patients with advanced diseases near the end of life, yet little is known about their training, comfort, and readiness in the provision of palliative care. This study sought to assess the quality, adequacy, and extent of palliative care training and the readiness of SO and HPB fellows in delivering palliative care.

METHODS: A self-administered survey was distributed to all fellows enrolled in Society of Surgical Oncology (SSO) and HPB fellowships during the 2013-2014 academic year. The survey assessed attitudes, training, experience, and readiness of fellows in caring for patients at the end of life. Descriptive analysis was performed, and Chi square, Student's t test, and the Mann-Whitney U test were used to compare mean or median values as appropriate.

RESULTS: The response rate was 47.2 %, and 50.9 % of the fellows reported exposure to a palliative care specialty service during their fellowship. Of the study participants, 75 % observed their faculty discussing the side effects of surgery compared with 54 % who observed faculty communication with patients regarding end-of-life goals (p < 0.01). On the other hand, 40 % of the fellows were never observed by faculty discussing symptoms management, goals of care, or hospice referral with patients, and 56.7 % never received feedback on their palliative skills.

CONCLUSION: The fellows rated the quality of their palliative care education as poor compared with other aspects of their fellowship training, implying the lack and need of palliative care teaching. Surgical oncology and HPB fellows and ultimately patients may benefit from increased clinical and didactic palliative care training.

Author List

Amini A, Miura JT, Larrieux G, Tsai S, Turaga KK, Christians KK, Brasel KJ, Clark Gamblin T, Weissman DE, Nattinger AB, Johnston FM

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Ann B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Susan Tsai MD Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Attitude of Health Personnel
Biliary Tract Diseases
Clinical Competence
Communication
Education, Medical, Graduate
Fellowships and Scholarships
Female
Health Services Needs and Demand
Humans
Liver Diseases
Male
Medical Oncology
Palliative Care
Surveys and Questionnaires