Horlait M, Van Belle S, Leys M
a Department of Health Sciences, Organisation, Policy and Social Inequalities in Health Care (OPIH) , Vrije Universiteit Brussel (VUB) , Brussels , Belgium.
b Department of Medical Oncology , Ghent University Hospital , Ghent , Belgium.
Acta Clin Belg. 2017 Oct;72(5):318-325. doi: 10.1080/17843286.2016.1275377. Epub 2017 Jan 4.
Palliative care is considered an integral part of oncology and communicating this with patients is an unavoidable task for oncologists. This contribution investigated to what extent communication skills for communicating palliative care with patients are trained in the formal academic training program in medical oncology in Flanders, Belgium. The programme is based on the recommendations for a Global Core Curriculum in Medical Oncology, developed by The American Society of Clinical Oncology (ASCO) together with the European Society for Medical Oncology (ESMO).
For this qualitative study, data were collected using document analysis from the ESMO/ASCO recommendations and the documents of the Flanders' medical oncology programme complemented with interviews with Flemish medical oncology trainees.
Few recommendations for training communication skills to communicate about palliative care were found in the ASMO/ASCO recommendations and even less in the Flanders' programme documents. Trainees are mainly exposed to palliative care communication during the clinical practice of their training. Only very few lectures or seminars are devoted to palliative care and even less on communication about palliative care. They reported several barriers to communicate about palliative care.
This study revealed promising developments for the training of Flemish medical oncologists to discuss palliative care. However, there is still a need for more theoretical training on palliative care complemented with communication skills trainings. Communication training in general needs to be fully integrated as a core skill within the medical curriculum at large and should be promoted as lifelong learning and competency development.
姑息治疗被视为肿瘤学的一个组成部分，而与患者沟通这一点对肿瘤学家来说是一项不可避免的任务。本研究调查了在比利时弗拉芒地区医学肿瘤学的正规学术培训项目中，针对与患者沟通姑息治疗的沟通技巧的培训程度。该项目基于美国临床肿瘤学会（ASCO）与欧洲医学肿瘤学会（ESMO）共同制定的《全球医学肿瘤学核心课程建议》。
对于这项定性研究，通过对ESMO/ASCO建议及弗拉芒地区医学肿瘤学项目文件进行文献分析，并辅以对弗拉芒地区医学肿瘤学实习医生的访谈来收集数据。
在ASMO/ASCO建议中，关于培训姑息治疗沟通技巧的建议很少，在弗拉芒地区的项目文件中则更少。实习医生主要是在培训的临床实践中接触到姑息治疗沟通。只有极少数讲座或研讨会专门针对姑息治疗，而关于姑息治疗沟通的则更少。他们报告了在沟通姑息治疗方面存在的几个障碍。
本研究揭示了弗拉芒地区医学肿瘤学家在讨论姑息治疗培训方面的良好进展。然而，仍需要更多关于姑息治疗的理论培训，并辅以沟通技巧培训。总体而言，沟通培训需要作为一项核心技能全面融入整个医学课程，并应作为终身学习和能力发展加以推广。
