ReCAP: Attitudes, Beliefs, and Awareness of Graduate Medical Education Trainees Regarding Palliative Care at a Comprehensive Cancer Center

Abstract

QUESTION ASKED: What are graduate medical education trainees' attitudes and beliefs regarding palliative care, what is their awareness of the availability and role of palliative care services, and does previous exposure to a palliative care rotation facilitate a better awareness of palliative care?SUMMARY ANSWER: A vast majority of oncology trainees perceived palliative care services to be beneficial for patient care (92%) and were supportive of mandatory palliative care training (74%). Surgical oncology trainees and trainees with no previous palliative care exposure were significantly less likely to consult palliative care and had significantly less awareness of palliative care. METHODS:We conducted an institutional review board-approved online survey to determine awareness of palliative care among graduate medical trainees at MD Anderson. One hundred seventy oncology trainees who completed at least 9 months of training in medical, surgical, gynecologic, and radiation oncology fellowship and residency program during the 2013 academic year completed an online questionnaire. Descriptive, univariate, and multivariate analyses were performed. BIAS, CONFOUNDING FACTOR(S), DRAWBACKS:Although there was a substantial response rate (78%), the results may not be generalizable as the survey was conducted at a single institution. Also, the frequency of palliative care referrals is self-reported. REAL-LIFE IMPLICATIONS:Our findings suggest that exposure to palliative care training may lead to increased awareness of palliative care among oncologists, and thus, increased overall and early referrals to palliative care. Surgical oncology trainees may benefit from increased exposure to palliative care rotations. More research is needed to characterize the impact of training on referral patterns to palliative care. In the meantime, efforts should be made to include formal palliative care rotations in oncology training. Participants and MethodsWe conducted a survey to determine awareness of PC among graduate medical trainees at a comprehensive cancer center with an established PC program. One hundred seventy oncology trainees who completed $ 9 months of training in medical, surgical, gynecologic, and radiation oncology fellowships and residency programs during the 2013 academic year completed an online questionnaire. Descriptive, univariable, and multivariable analyses were performed. ResultsThe response rate was 78% (132 of 170 trainees); 10 trainees without hands-on patient care were excluded.

Pattern and Predictors of Outpatient Palliative Care Referral Among Thoracic Medical Oncologists

“…We hypothesize that younger oncologists were (a) more familiar with the concept of early palliative care compared with their more senior colleagues, (b) more prepared to adopt new advances based on the literature, and (c) more willing to adhere to clinical practice guidelines. A recent survey found that medical oncology fellows at our institution who all had a 1‐month palliative care rotation had a higher level of awareness of the role of palliative care than fellows who did not have a rotation . This rotation offers an enriched opportunity for oncology trainees to gain a better understanding of the role of palliative care and to build a professional relationship with the palliative care team.…”

Ensuring Quality in Online Palliative Care Resources

“…This requires that cancer professionals are familiar with the role of palliative care and comfortable in discussing palliative care considerations with their patients. However, attitudes to, and use of, palliative care services and approaches vary among oncology professionals and cancer services [28,29,30,31]. This is turn may affect the care received by patients and their quality of life in the end stage of the disease.…”

Integration of oncology and palliative care: a Lancet Oncology Commission

“…In a recent study exploring attitudes and beliefs among oncology trainees regarding palliative care, 67% believed that a mandatory palliative care rotation was important; those who had completed palliative care rotations were more aware of the role of palliative care services than those who had not done so (96% versus 74%). 541 Further, a survey of Canadian oncologists found that oncologists were more likely to refer to TPC services when they had completed a rotation in palliative care. 167 Thus, being part of a larger, multidisciplinary team alongside palliative care colleagues allows oncologists to share the burden of complex care delivery, potentially also preventing burnout and compassion fatigue.…”