Cardio-oncology Training in the COVID-19 Era

Abstract

Opinion Statement Cardio-oncology is a field dedicated to the prevention, diagnosis, and management of cardiovascular disease in cancer patients before, during, and after cancer therapy. It is an emerging field with limited opportunities for structured education and training. In the year 2021, we cannot define the requirements of cardio-oncology training without acknowledging the impact of the global coronavirus disease 19 (COVID-19) pandemic. While this pandemic poses significant health risks to patients with cancer and cardiovascular disease as well as the providers who care for them, it also allows novel opportunities for the nascent field of cardio-oncology to readily adapt. In this article, we detail how the COVID-19 pandemic has impacted all aspects of cardio-oncology training, how programs and trainees can adapt to these challenges, and how lessons learned from the COVID-19 era can continue to positively impact cardio-oncology training for the foreseeable future.

Cardio-oncology and COVID 19: Lessons learned, past reflections and future deliberations

“…Share qualitative data and quantitative data about how you have been able to build and incorporate virtual health into your hybrid cardio-oncology practice, recognizing that some of your patients will also be coming in who currently, previously, or in the future would have COVID-19 [4] . To protect our patients, we must minimize in-person visits, making most visits virtual and safe, to protect the patient from COVID-19, and to protect each other, as well as our trainees [5] . Thus, as trainees learn, they are learning in virtual didactics and conferences, from social media “Tweetorials”, learning by experiencing telemedicine and remote monitoring, and by individualizing cardiotoxicity surveillance, whether in the inpatient or outpatient setting [5] (Brown et al, Heart Failure Clinics, Invited, In Press).…”

“…To protect our patients, we must minimize in-person visits, making most visits virtual and safe, to protect the patient from COVID-19, and to protect each other, as well as our trainees [5] . Thus, as trainees learn, they are learning in virtual didactics and conferences, from social media “Tweetorials”, learning by experiencing telemedicine and remote monitoring, and by individualizing cardiotoxicity surveillance, whether in the inpatient or outpatient setting [5] (Brown et al, Heart Failure Clinics, Invited, In Press). Therefore, virtual care for our patients, telemedicine and remote monitoring, partnering with virtual communication, can expand the capacity of each other and our trainees to collaborate across each institution, across institutions, and across the world [4] .…”

The Pandemic and Beyond: Innovation in Cardiovascular Training to Improve Quality of Education and Trainees’ Well-being

“…Gathering available data such as heart rates, blood pressures, and weights and utilizing remote monitoring such as event monitors or CardioMEMs is an important aspect of virtual patient care. 10 The final medical decision making regarding next steps is a complex interplay of the patient’s clinical status and indicated further workup and management, the patient’s personal risk of contracting the virus, and management of limited resources. Even in non-pandemic times, triaging patients based on information available over the phone is an invaluable skill.…”

“…Even in non-pandemic times, triaging patients based on information available over the phone is an invaluable skill. 10 Three-way call capabilities to include the fellow, attending physician, and patient as well as allowing adequate time for feedback on tele-visits is essential to ensure patient safety and fellows’ education. 5 …”

Cardio-Oncologic Knowledge of Nurses in the Oncology Service: A Multi-Center Survey in China

“…1 , 2 However, most chemotherapy drugs are cardiotoxic and cause certain heart conditions, such as arrhythmia and heart failure, which are collectively referred to as cardio-oncology. 3 With rapid advances in the treatment options for tumors, most patients with tumors achieve a complete cure. However, mortality does occur, not due to the tumor, and rather because of cardiotoxicity.…”