Dataset Information

Palliative Care Training during Fellowship: A National Survey of U.S. Hematology and Oncology Fellows.

ABSTRACT:

Background

Despite requirements for palliative care training during fellowship, there is a paucity of recent data regarding the attitudes, knowledge, and skills of hematology/ oncology fellows in palliative care.

Objective

Our aim was to assess fellows' attitudes toward and quality of training in palliative care during fellowship and perceived preparedness to care for patients at the end of life (EOL).

Methods

In May 2013 a cross-sectional survey of hematology/oncology fellows was conducted.

Results

Fellows from 93 of 138 fellowship programs responded (67.4%). Of the 347 fellows e-mailed, 176 participated. Nearly all fellows (99%) indicated that physicians have a responsibility to help patients at EOL. Fellows felt their overall training in fellowship was superior to training in EOL care (4.24±0.78 versus 3.53±0.99 on a 5-5 scale where 1=poor and 5=excellent, p<0.0001). Fellows who had a rotation in palliative care during fellowship (44.9%) reported better teaching on managing a patient at EOL than those who did not (3.91±1.0 versus 3.21±0.87, p<0.0001). Fellows reporting better teaching in EOL care felt better prepared to care for patients at EOL (r=0.52, p<0.0001). More than 25% reported not being explicitly taught how to assess prognosis, when to refer a patient to hospice, or how to conduct a family meeting to discuss treatment options.

Conclusion

Many recent oncology fellows are still inadequately prepared to provide palliative care to their patients. There is significant room for improvement with regards to the quality of palliative care training in U.S. hematology/oncology fellowship programs.

SUBMITTER: Thomas RA

PROVIDER: S-EPMC4696424 | biostudies-literature | 2015 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Palliative Care Training during Fellowship: A National Survey of U.S. Hematology and Oncology Fellows.

Thomas Roby A RA Curley Brendan B Wen Sijin S Zhang Jianjun J Abraham Jame J Moss Alvin H AH

Journal of palliative medicine 20150622 9

<h4>Background</h4>Despite requirements for palliative care training during fellowship, there is a paucity of recent data regarding the attitudes, knowledge, and skills of hematology/ oncology fellows in palliative care.<h4>Objective</h4>Our aim was to assess fellows' attitudes toward and quality of training in palliative care during fellowship and perceived preparedness to care for patients at the end of life (EOL).<h4>Methods</h4>In May 2013 a cross-sectional survey of hematology/oncology fell ...[more]

PMID: 26098204

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Project description:Despite the likely benefits of palliative care (PC) for patients with cirrhosis, physician experiences and perspectives about best practices are variable. We aimed to assess PC experience and gaps in training among transplant hepatology fellows. We conducted a national survey of all transplant hepatology fellows enrolled in accredited fellowship programs during the 2020-2021 academic year. We assessed the frequency of PC provision and comfort with physical and psychological symptom management, psychosocial care, communication skills, advance care planning, and end-of-life care. A total of 45 of 56 (79%) of transplant hepatology fellows responded to the survey; 50% (n = 22) were female. Most trained at centers performing over 100 transplants per year (67%, n = 29) distributed evenly across geographic regions. Most fellows (69%, n = 31) had a PC or hospice care rotation during residency, and 42% (n = 19) of fellows received education in PC during transplant hepatology fellowship. Fellows reported feeling moderately to very comfortable with communication skills such as breaking bad news (93%, n = 41) and leading family meetings (75%, n = 33), but nearly one-third (30%, n = 13) reported feeling not very or not at all comfortable assessing and managing anxiety and depression (30%, n = 13) and spiritual distress (34%, n = 15). Nearly one-quarter (22%, n = 10) had never discussed or documented advance care plans during fellowship. Fellows wished to receive future instruction on the assessment and management of physical symptoms (68%, n = 30) and anxiety and depression (64%, n = 28). Conclusion: Our survey highlights gaps in PC experience and education during transplant hepatology fellowship, lack of comfort in managing psychological distress and advance care planning, and desire to improve skills, particularly in symptom management. Future studies should investigate how to enhance transplant hepatology competencies in these PC domains and whether this impacts clinical care, advance care planning, or patient experience.

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Dataset Information

Palliative Care Training during Fellowship: A National Survey of U.S. Hematology and Oncology Fellows.

Background

Objective

Methods

Results

Conclusion

Publications

Palliative Care Training during Fellowship: A National Survey of U.S. Hematology and Oncology Fellows.

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