Jacob Regina A, Hyatt Vanneta
Assistant Professor, Section of General Internal Medicine, Lewis Katz School of Medicine at Temple University.
MedEdPORTAL. 2018 Jan 25;14:10673. doi: 10.15766/mep_2374-8265.10673.
The growing number of cancer survivors has expanded the need for physicians familiar with survivorship care outside the subspecialty of oncology. However, primary care providers have historically not been comfortable managing the growing number of cancer survivors and their long-term sequela. To date, there is no current ambulatory curriculum designed as a workshop to discuss general concepts of cancer survivorship with internal medicine resident physicians.
This was a 3-day workshop series given over 5 weeks. Residents were given a simulated case following a geriatric breast cancer survivor. Session 1 consisted of creating a survivorship care plan and discussing secondary cancer screening. Session 2 included a discussion on primary tumor recurrence and short-term side effects of cancer treatments. Finally, Session 3 incorporated mental health adjustment and long-term side effects of various cancer treatments. Knowledge and attitude assessments were administered during Sessions 1 and 3.
Eighty-seven residents participated, with 59 completing the survey on Session 1, and 36 completing the same survey on Session 3. Prior to the curriculum, two residents reported comfort in creating a survivorship care plan compared to 23 after the curriculum. Similarly, comfort in screening for excess mortality increased from three residents to 19. General knowledge of common side effects from cancer treatment modalities was well known prior to the curriculum.
Survivorship care heavily incorporates the basics of primary care. This curriculum successfully raised awareness among resident physicians regarding survivorship terminology, which, in turn, improved their comfort in the long-term management of the cancer survivor.
癌症幸存者数量的不断增加,使得对熟悉肿瘤学亚专业以外的生存护理的医生的需求也在扩大。然而,初级保健提供者历来对管理日益增多的癌症幸存者及其长期后遗症感到不自在。迄今为止,尚无针对内科住院医师设计的作为研讨会形式来讨论癌症生存护理一般概念的门诊课程。
这是一个为期5周、分3天进行的研讨会系列。住院医师们收到了一个老年乳腺癌幸存者的模拟病例。第1节包括制定生存护理计划并讨论二次癌症筛查。第2节讨论原发性肿瘤复发和癌症治疗的短期副作用。最后,第3节纳入了心理健康调整以及各种癌症治疗的长期副作用。在第1节和第3节期间进行了知识和态度评估。
87名住院医师参与,59人完成了第1节的调查,36人完成了第3节的相同调查。在课程之前,只有两名住院医师表示在制定生存护理计划方面感到自在,而课程之后这一数字增加到了23人。同样,对超额死亡率筛查的自在程度从三名住院医师增加到了19人。在课程之前,住院医师们就对癌症治疗方式常见副作用的一般知识有所了解。
生存护理大量融入了初级保健的基础知识。该课程成功提高了住院医师对生存护理术语的认识,进而提高了他们对癌症幸存者长期管理的自在程度。