Lifrieri Andrea, Schmidt Lee, Kline Taylor, Agathis Alexandra Z, Wu Jeanne, Zhong Allen, Javier Noelle Marie, Divino Celia
Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of General Surgery, Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Surg Educ. 2025 Sep;82(9):103581. doi: 10.1016/j.jsurg.2025.103581. Epub 2025 Jun 25.
Surgical palliative care (PC) is an essential component of comprehensive, high quality surgical care. Formalized surgical PC education is absent despite a call to action by the American College of Surgeons. We aimed to assess the PC educational needs of general surgery residents and to implement a resident-led surgical palliative care curriculum.
DESIGN/SETTING/PARTICIPANTS: A needs and knowledge assessment was performed with general surgery residents from a single program at an academic tertiary care health center. In response to this evaluation, a resident-led curriculum was then created and implemented in collaboration with the PC department. The 6-month curriculum included monthly sessions comprised of lectures and interactive small group sessions on PC topics.
A total n = 97 resident surveys were included in this study. Of the total 77 residents in the program, a 74% (n = 57) response rate was obtained for the initial needs and knowledge-based assessment. A 52% (n = 40) response rate was obtained for the postcurriculum assessment. Most respondents (54%) lacked previous formal PC training. Most respondents (77%) had participated in PC conferences with patients or family members with many respondents (46%) acting as the primary surgical liaison. Most respondents (84%) were interested in a formal PC curriculum. After completion of our educational palliative care curriculum, there were statistically significantly increased rates of interest in ongoing palliative care education as well as more substantial resident participation in goals of care meetings (p < 0.05). Residents' comfort level with palliative care skills also improved after completion of the palliative care curriculum (p < 0.05).
With the help of interprofessional collaborators from the palliative care department, we developed and implemented a novel curriculum to address the self-reported resident lack of comfort with and formal training in palliative care. We demonstrated that a resident-led surgical PC curriculum helps general surgery residents participate more confidently in providing PC and improves communication, compassion, and engagement with patients and families. With careful planning and implementation, formal surgical PC training can and should be successfully integrated into general surgery residency education.
外科姑息治疗（PC）是全面、高质量外科护理的重要组成部分。尽管美国外科医师学会呼吁采取行动，但尚未有正式的外科PC教育。我们旨在评估普通外科住院医师的PC教育需求，并实施以住院医师为主导的外科姑息治疗课程。
设计/地点/参与者：对一所学术性三级医疗健康中心单一项目的普通外科住院医师进行了需求和知识评估。针对这一评估结果，随后与PC部门合作创建并实施了以住院医师为主导的课程。为期6个月的课程包括每月一次的课程，内容涵盖PC主题的讲座和互动式小组讨论。
本研究共纳入97份住院医师调查问卷。该项目共有77名住院医师，初始需求和知识评估的回复率为74%（n = 57）。课程后评估的回复率为52%（n = 40）。大多数受访者（54%）此前缺乏正式的PC培训。大多数受访者（77%）曾参与过与患者或家属的PC会议，许多受访者（46%）担任主要外科联络人。大多数受访者（84%）对正式的PC课程感兴趣。完成我们的姑息治疗教育课程后，对持续姑息治疗教育的兴趣率有统计学显著提高，住院医师对护理目标会议的参与也更为积极（p < 0.05）。完成姑息治疗课程后，住院医师对姑息治疗技能的舒适度也有所提高（p < 0.05）。
在姑息治疗部门跨专业合作者的帮助下，我们开发并实施了一门新颖的课程，以解决住院医师自我报告的对姑息治疗缺乏舒适度和正规培训的问题。我们证明，以住院医师为主导的外科PC课程有助于普通外科住院医师更自信地参与提供PC，并改善与患者及家属的沟通、同情心和互动。通过精心规划和实施，正式的外科PC培训能够且应该成功融入普通外科住院医师教育。
