S.M. Smith is instructor, Division of Hematology/Oncology, Department of Pediatrics, Stanford University School of Medicine, Stanford, California; ORCID: https://orcid.org/0000-0002-3369-7516 .
P. Williams was, at the time of this work, a research professional, Stanford Cancer Institute, Stanford, California.
Acad Med. 2021 Aug 1;96(8):1164-1167. doi: 10.1097/ACM.0000000000003935. Epub 2021 Jan 25.
The transition from oncology care back to primary care after cancer therapy is challenging for cancer survivors who seek services that address the effect of their cancer history on their present health. Lack of knowledge about the health needs of cancer survivors is a barrier to incorporating survivorship care into primary care practice. Formal training in cancer survivorship is rarely included in medical education and presents an opportunity for intervention.
The authors developed (January 2019-March 2020) an online continuing medical education (CME) course for primary care physicians (PCPs) that launched in April 2020. Course design and content were informed by critically reviewing cancer survivorship CME courses and understanding cancer survivors' clinical experiences in a primary care setting. The course aims to pique learners' interest through a concise, practical educational experience using peer-to-peer primary care-focused instruction in a case-based, multimedia-enriched format. In the course, 4 patient cases illustrate the physical and psychological effects of cancer treatment, and a primary care narrator demonstrates ways to approach these concerns during a clinic visit, providing tips for empathic communication with cancer survivors. The course development team-including a PCP, medical and pediatric oncologists, and medical educators with expertise in instructional design-used an iterative process to review and revise the content. PCPs and specialists reviewed the script and provided constructive feedback that was incorporated into revisions.
The authors will evaluate course effectiveness based upon user experience and perceived effect on clinical practice and professional growth. A follow-up survey will assess barriers to course completion and durability of effect.
Future directions include dissemination of the course to a broader audience including medical trainees, evaluation of higher-level learning outcomes (e.g., effect on PCPs' clinical practice), and adaptation of the course for patients with a focus on self-management.
癌症治疗后重返肿瘤学护理的过渡期对癌症幸存者来说是具有挑战性的，他们寻求能够解决其癌症病史对当前健康影响的服务。缺乏对癌症幸存者健康需求的了解是将生存护理纳入初级保健实践的障碍。癌症生存教育在医学教育中很少被纳入，这为干预提供了机会。
作者于 2019 年 1 月至 2020 年 3 月为初级保健医生（PCP）开发了一个在线继续医学教育（CME）课程，该课程于 2020 年 4 月推出。课程设计和内容是通过批判性地审查癌症生存 CME 课程并了解癌症幸存者在初级保健环境中的临床经验而得到的。该课程旨在通过使用基于同行的、以案例为基础的多媒体丰富格式的专注于初级保健的点对点教学，提供简洁、实用的教育体验，从而激发学习者的兴趣。在课程中，4 个患者案例说明了癌症治疗的身体和心理影响，初级保健叙述者展示了在诊所就诊期间如何处理这些问题的方法，并提供了与癌症幸存者进行共情沟通的技巧。课程开发团队——包括一名 PCP、医学和儿科肿瘤学家以及具有教学设计专业知识的医学教育工作者——使用迭代过程来审查和修改内容。PCP 和专家审查了脚本并提供了建设性的反馈，这些反馈被纳入了修订中。
作者将根据用户体验以及对临床实践和专业成长的感知效果来评估课程的有效性。后续调查将评估完成课程的障碍和效果的持久性。
未来的方向包括将课程推广到更广泛的受众，包括医学受训者，评估更高层次的学习成果（例如，对 PCP 临床实践的影响），以及为关注自我管理的患者改编课程。
