G. Larrieux1, J. T. Miura1, K. J. Brasel1, D. E. Weissman2, A. B. Nattinger3, T. C. Gamblin1, K. T. Turaga1, F. M. Johnston1 1Medical College Of Wisconsin,Surgery,Milwaukee, WI, USA 2Medical College Of Wisconsin,Palliative Care,Milwaukee, WI, USA 3Medical College Of Wisconsin,Medicine,Milwaukee, WI, USA
Introduction: Surgical Oncologists (SO) and Hepatobiliary (HPB) Surgeons frequently care for patients with advanced disease stages who are near the end of life, yet little is known about their training, comfort and readiness in the provision of palliative care. This study sought to assess the quality, adequacy and extent of palliative care training and readiness of SO and HPB Fellows in delivering palliative care.
Methods: A self-administered survey was distributed to all fellows enrolled in Society of Surgical Oncology (SSO) and HPB fellowships during the 2013-2014 academic years. The survey assessed attitudes, training, experience, and readiness of fellows in caring for patients at the end of life. Descriptive analysis was performed and Chi-square, Student’s t-test as well as Mann-Whitney U test were used to compare mean or median values as appropriate.
Results:The response rate was 47.2%. 50.9% of fellows reported exposure to a palliative care specialty service during their fellowship. 75% of our participants observed their faculty discussing the side effects of surgery compared to 54% observation of faculty’s communication regarding end of life goals with patients (p<0.01). 40% of fellows were never observed by faculty discussing symptoms management, goals of care, or hospice referral with patients and 56.7% never received feedback on their palliative skills. Fellows consistently rated their quality of teaching and managment of surgical disease at better compared to palliative and end of life topics (Figure 1).
Conclusion:Fellows rated the quality of palliative care education as poor compared to other aspects of fellowship training, implying the need and lack of palliative care teaching. Surgical oncology and HPB fellows and ultimately patients may benefit from increased clinical and didactic palliative care training.
