Synthesis of Existent Oncology Curricula for Primary Care Providers: A Scoping Review With a Global Equity Lens

Abstract

PURPOSE Global increases in cancer, coupled with a shortage of cancer specialists, has led to an increasing role for primary care providers (PCP) in cancer care. This review aimed to examine all extant cancer curricula for PCPs and to analyze the motivations for curriculum development. METHODS A comprehensive literature search was conducted from inception to October 13, 2021, with no language restrictions. The initial search yielded 11,162 articles and 10,902 articles underwent title and abstract review. After full-text review, 139 articles were included. Numeric and thematic analyses were conducted and education programs were evaluated using Bloom's taxonomy. RESULTS Most curricula were developed in high-income countries (HICs), with 58% in the United States. Cancer-specific curricula focused on HIC priority cancers, such as skin/melanoma, and did not represent the global cancer burden. Most (80%) curricula were developed for staff physicians and 73% focused on cancer screening. More than half (57%) of programs were delivered in person, with a shift toward online delivery over time. Less than half (46%) of programs were codeveloped with PCPs and 34% did not involve PCPs in the program design and development. Curricula were primarily developed to improve cancer knowledge, and 72 studies assessed multiple outcome measures. No studies included the top two levels of Bloom's taxonomy of learning (evaluating; creating). CONCLUSION To our knowledge, this is the first review to assess the current state of cancer curricula for PCPs with a global focus. This review shows that extant curricula are primarily developed in HICs, do not represent the global cancer burden, and focus on cancer screening. This review lays a foundation to advance the cocreation of curricula that are aligned to the global cancer burden.

Effectiveness of an ultrasound basic cancer training program through on-site training and virtual case discussions in rural Tanzania: a proof-of-concept study

“…Currently, a major barrier to the use of ultrasound in the clinical practices of developing countries is the lack of training in general and the absence of specific oncology curricula for primary care [ 20 , 21 , 23 , 26 ]. Therefore, ultrasound training concepts based on local patterns of disease are imperative [ 19 , 33 ].…”

“…Nonetheless, elsewhere as in Tanzania, a lack of training is a barrier to the broader use of sonography [ 20 – 23 ]. Moreover, curricula developed in the Global North do not account for the healthcare system and provision challenges in Tanzania and other Sub-Saharan African countries [ 19 , 24 – 26 ]. Unfortunately, efforts to build capacity in context-specific training are often left unevaluated, or else the evaluation is not shared publicly [ 12 , 19 ].…”