University of Virginia, 1215 Lee St., Charlottesville, VA, 22908, USA.
J Neurooncol. 2018 Nov;140(2):377-383. doi: 10.1007/s11060-018-2963-9. Epub 2018 Aug 2.
Palliative care (PC) for patients with neuro-oncological diseases positively impacts morbidity and mortality. No studies have evaluated whether neuro-oncology fellows receive formal PC education during fellowship. The purpose of this study was to describe the PC education and identify education needs of US neuro-oncology fellowship programs.
Program directors (PDs) of US neuro-oncology fellowships were surveyed. The electronic survey included qualitative and quantitative questions.
Of 26 programs with fellows, 17 completed surveys (65% response rate) of which 3 (18%) offered no formal PC education. The methods most utilized were formal didactics (seminars/conferences) and self-directed reading materials. One-third of programs have developed their own teaching materials. Communication was the domain identified as most important, the domain fellows were most well-trained in, and the domain PDs felt most comfortable providing for their own patients. Addressing spiritual distress and initiating life-prolonging therapies were the domains PDs identified as being least important, fellows were least well trained in, and PDs were least comfortable providing for their own patients. Most programs (83%) were satisfied with the PC education available at their program. Time for teaching and faculty availability were the most common barriers.
Neuro-oncology PDs recognize the need for PC education, which is currently offered in some form by most programs, but the content and methods of delivery are heterogenous. Interdisciplinary educational teams and nationally-available PC educational material may improve implementation of PC education in neuro-oncology.
神经肿瘤学患者的姑息治疗(PC)对发病率和死亡率有积极影响。目前尚无研究评估神经肿瘤学研究员在研究员期间是否接受过正式的 PC 教育。本研究旨在描述美国神经肿瘤学研究员计划中的 PC 教育,并确定教育需求。
对美国神经肿瘤学研究员计划的主任进行了调查。电子调查包括定性和定量问题。
在有研究员的 26 个计划中,有 17 个完成了调查(65%的回复率),其中 3 个(18%)没有提供正式的 PC 教育。最常使用的方法是正式的教学(研讨会/会议)和自我指导的阅读材料。三分之一的计划已经开发了自己的教学材料。沟通被确定为最重要的领域,是研究员训练最好的领域,也是主任认为为自己的患者提供最舒适的领域。解决精神困扰和启动延长生命的治疗方法是主任认为最重要的领域,是研究员训练最差的领域,也是主任认为为自己的患者提供最不舒适的领域。大多数计划(83%)对其计划中提供的 PC 教育感到满意。教学时间和教师可用性是最常见的障碍。
神经肿瘤学主任认识到需要 PC 教育,目前大多数计划都以某种形式提供,但内容和教学方法存在差异。跨学科教育团队和全国范围内可用的 PC 教育材料可能会改善神经肿瘤学中 PC 教育的实施。