scholarly journals Palliative Care Education in Radiation Oncology Training Programs Across the United States: A Program Directors’ Survey

2016 ◽  
Vol 96 (2) ◽  
pp. S148
Author(s):  
R.L. Wei ◽  
N. Vapiwala ◽  
M. Racsa ◽  
L.E. Colbert ◽  
J.A. Jones ◽  
...  
Keyword(s):  
United States ◽  
Palliative Care ◽  
Radiation Oncology ◽  
Training Programs ◽  
Program Directors ◽  
The United States ◽  
Care Education ◽  
Palliative Care Education

Palliative care and palliative radiotherapy education in radiation oncology: A survey of US radiation oncology program directors.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 178-178
Author(s):  
Randy Wei ◽  
Lauren Colbert ◽  
Joshua Adam Jones ◽  
Gabrielle Kane ◽  
Margarita Racsa-Alamgir ◽  
...  
Keyword(s):  
Palliative Care ◽  
Radiation Oncology ◽  
Care Service ◽  
Palliative Care Service ◽  
Program Directors ◽  
The United States ◽  
Residency Programs ◽  
Care Education ◽  
Palliative Care Education ◽  
Residency Program Directors

178 Background: To assess the state of palliative care education curricula in radiation oncology residency programs in the United States. Methods: We surveyed 90 program directors of radiation oncology residency programs in the United States from September 2015 to November 2015. An electronic survey on palliative care education during residency was sent to all program directors. The survey consisted of questions on perceived relevance of palliative care in radiation oncology residency, formal didactics on domains of palliative care, effective teaching formats for palliative care education, and perceived barriers for integrating palliative care into the residency curriculum. Results: Sixty-three percent (57/90) residency program directors completed the survey. Most (93%) program directors agree or strongly agree that palliative care is an important competency for radiation oncologists. A vast majority (90%) of programs have dedicated palliative care services; however, only 57% of programs offer residents an opportunity to spend elective time on a palliative care service. Of these programs, only 30% reported residents rotating on a palliative care service in the past two years. Furthermore, 67% of residency programs have formal educational activities in principles and practice of palliative care. The palliative care curriculum included faculty-led lectures (73%), resident-led lectures (42%), and seminars (22%). Most programs have one or more hours of formal didactics on management of pain (66%), management of neuropathic pain (64%), and management of nausea and vomiting (64%). 35%, 46%, and 48% programs had one or more hours of management of non-physical symptoms including fatigue, anorexia, and anxiety, respectively. Conclusions: Residency program directors believe that palliative care is an important competency for their trainees. The survey revealed that many programs have structured curricula on PSC and palliative radiation education, but that there are still areas for improvement.

scholarly journals Impact of Critical Care Medicine Training Programs' Palliative Care Education and Bedside Tools on ICU Use at the End of Life

2014 ◽  
Vol 6 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Howard L. Saft ◽  
Paul S. Richman ◽  
Andrew R. Berman ◽  
Richard A. Mularski ◽  
Paul A. Kvale ◽  
...  
Keyword(s):  
Palliative Care ◽  
Critical Care ◽  
End Of Life ◽  
Training Programs ◽  
Care Program ◽  
Program Directors ◽  
Critical Care Medicine ◽  
Care Education ◽  
Palliative Care Education

Abstract Background Intensive care unit (ICU) use at the end of life is rising. Little research has focused on associations among critical care fellows' training, institutional support, and bedside tools with ICU use at the end of life. Objective We evaluated whether hospital and critical care medicine program interventions were associated with ICU use in the last 6 months of life for patients with chronic illness. Methods Our observational, retrospective study explored associations between results from a survey of critical care program directors and hospital-level Medicare data on ICU use in the last 6 months of life. Program directors evaluated quality of palliative care education in their critical care fellowships and reported on the number of bedside tools and the presence or absence of an inpatient palliative care consultation service. Results For the 89 hospitals and 71 affiliated training programs analyzed, there were statistically significant relationships between 2 of the explanatory variables—the quality of palliative care education and the number of bedside tools—in ICU use. Each level of increased educational quality (1–5 Likert scale) was associated with a 0.57-day decrease in ICU days, whereas, for each additional, evidence-based bedside tool, there was a 0.31-day decrease. The presence of an inpatient palliative care program was not a significant predictor of ICU use. Conclusions We found that the quality of palliative care training in critical care medicine programs and the use of bedside tools were independently associated with reduced ICU use at the end of life.

scholarly journals Integrative Hematology Oncology Fellowship Program: A National Survey Based Analysis of Need

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1887-1887
Author(s):  
Krisstina L. Gowin ◽  
Betsy Wertheim ◽  
Ashley Larsen ◽  
John Camoriano
Keyword(s):  
Palliative Care ◽  
National Survey ◽  
Radiation Oncology ◽  
Formal Education ◽  
Training Programs ◽  
Care Program ◽  
Program Directors ◽  
The United States ◽  
Education Programs ◽  
Fellowship Programs

Abstract Introduction: Integrative hematology oncology (IHO), the combination of complementary medicine in conjunction with conventional cancer treatments, is emerging as an important supportive care modality. Formal education programs, such as IHO fellowship programs, are not currently available. We conducted a national survey to gauge interest and investigate barriers to the development of IHO training programs in the US. Methods: An 18-question survey was sent to hematology/oncology, radiation oncology, and palliative care program directors, physicians, and fellows, and internal medicine residents planning to enter into any of the above fellowship programs. Recruitment was national with use of public email list servs and social media. Program directors and fellowship programs were identified through the Accreditation Council for Graduate Medical Education (ACGME). Participant informed consent was completed online and, Qualtrics survey links were shared weekly via email in two 4-week sessions. Results: Participants (n=208) included physicians from: Hematology/Oncology 65.9% (n=137), Radiation Oncology 8.6%(n=18) and Palliative Care 25.4% (n=53). Hematology oncology respondents included physicians 47.4% (n=65), fellows 33.6% (n=46), and residents planning to enter into a hematology oncology fellowship 3.6% (n=5). Program directors (n=69) from each specialty included: 15.3% (n=21) from hematology/oncology, 61.1% (n=11) from radiation oncology, and 69.8% (n=37) from palliative care. Interestingly, palliative care had the highest response rate in this category. Survey respondents were mostly aged 31-40 y (38.4%), 41-50 y (23.8%), or 51-60 y (21.5%). Participant genders were male (45.7%), female (50.9%), or prefer not to identify (3.5%). There was diverse regional participation across the United States. Overall participant responses revealed significant interest for an IHO training program, despite little (36.0%) to no (49.4%) previous training in integrative medicine (Table 1). Curriculum topics of primary interest were physician/provider wellness, stress reduction techniques, off-label use of medication, exercise/physical activity, nutrition, and lifestyle counseling. The preferred education delivery was didactic lectures and clinical practice exposure. Barriers to implementation included lack of good curriculum and inadequate budget/time/faculty experience to implement the program. Need for IHO training was based on perceived benefit to patients in 39 participants (73.6%), and patient request for services in 37 participants (68.8%). Conclusion: In this national survey of 208 physicians, the majority (64%) expressed interest in IHO education programs. Barriers included lack of curriculum, expertise, budget, and time. Education preference for fellowship track and certificate programs were similar, suggesting interest of both available options. Most participants (87%) felt fellows should participate in IHO research. In conclusion, IHO training is perceived as valuable and desirable. Thus, the development and dissemination of IHO training programs is needed. Figure 1 Figure 1. Disclosures Gowin: Incyte: Speakers Bureau.

A Needs Assessment of Palliative Care Education among the United States Adult Neurology Residency Programs

2018 ◽  
Vol 21 (10) ◽  
pp. 1448-1457 ◽  
Author(s):  
Ambereen K. Mehta ◽  
Salim Najjar ◽  
Natalie May ◽  
Binit Shah ◽  
Leslie Blackhall
Keyword(s):  
United States ◽  
Palliative Care ◽  
Needs Assessment ◽  
The United States ◽  
Residency Programs ◽  
Care Education ◽  
Palliative Care Education

scholarly journals Nephrology Fellows’ and Program Directors’ Perceptions of Hospital Rounds in the United States

2020 ◽  
Vol 15 (4) ◽  
pp. 474-483
Author(s):  
Suzanne M. Boyle ◽  
Keshab Subedi ◽  
Kurtis A. Pivert ◽  
Meera Nair Harhay ◽  
Jaime Baynes-Fields ◽  
...  
Keyword(s):  
United States ◽  
Patient Care ◽  
Training Programs ◽  
Clinical Skills ◽  
Care Delivery ◽  
Clinical Skill ◽  
Program Directors ◽  
The United States ◽  
Early Morning ◽  
Attending Rounds

Background and objectivesHospital rounds are a traditional vehicle for patient-care delivery and experiential learning for trainees. We aimed to characterize practices and perceptions of rounds in United States nephrology training programs.Design, setting, participants, & measurementsWe conducted a national survey of United States nephrology fellows and program directors. Fellows received the survey after completing the 2019 National Board of Medical Examiners Nephrology In-Training Exam. Program directors received the survey at the American Society of Nephrology’s 2019 Nephrology Training Program Directors’ Retreat. Surveys assessed the structure and perceptions of rounds, focusing on workload, workflow, value for patient care, and fellows’ clinical skill-building. Directors were queried about their expectations for fellow prerounds and efficiency of rounds. Responses were quantified by proportions.ResultsFellow and program director response rates were 73% (n=621) and 70% (n=55). Most fellows (74%) report a patient census of >15, arrive at the hospital before 7:00 am (59%), and complete progress notes after 5:00 pm (46%). Among several rounding activities, fellows most valued bedside discussions for building their clinical skills (34%), but only 30% examine all patients with the attending at the bedside. Most directors (71%) expect fellows to both examine patients and collect data before attending-rounds. A majority (78%) of directors commonly complete their documentation after 5:00 pm, and for 36%, after 8:00 pm. Like fellows, directors most value bedside discussion for development of fellows’ clinical skills (44%). Lack of preparedness for the rigors of nephrology fellowship was the most-cited barrier to efficient rounds (31%).ConclusionsHospital rounds in United States nephrology training programs are characterized by high patient volumes, early-morning starts, and late-evening clinical documentation. Fellows use a variety of prerounding styles and examine patients at the beside with their attendings at different frequencies.PodcastThis article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_03_17_CJN.10190819.mp3

Long-term collaboration for building sustainable palliative care in Belarus.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 142-142
Author(s):  
Sarah Slater ◽  
Kathleen Doyle
Keyword(s):  
Palliative Care ◽  
Needs Assessment ◽  
Legal Status ◽  
The United States ◽  
Difficulty Level ◽  
Major Barrier ◽  
Care Education ◽  
Palliative Care Education ◽  
The Government ◽  
Healthcare Administrators

142 Background: The WHO and the Worldwide Palliative Care Alliance have published findings that only 10% of the 20.4 million people who need palliative care currently receive it. A major barrier to meeting that need is insufficient education of healthcare workers in palliative care. Over the last decade, palliative care has attracted significant interest from the government of Belarus, with the first adult hospice founded in 2005 and introduced palliative care into the National Healthcare Law in 2013. However, the country faces a shortage of healthcare providers trained in palliative care. We report on the experience of developing and implementing a palliative care curriculum in Belarus. Methods: We first conducted a needs assessment that examined physician knowledge of and attitudes toward palliative care, the legal status of palliative care, drug availability, and other topics. We utilized past in-country experience, a literature review, a questionnaire, and interviews with Belarusian colleagues. Based on the needs assessment, we developed, modified, and translated a 25-lecture curriculum that was comprehensive, at an adequate difficulty level, and culturally appropriate. A team of four clinicians taught the curriculum in Belarus over to an audience of physicians, and healthcare administrators. Results: The course was well-received—participants were satisfied, reported a better understanding of palliative care, and improved their skills and confidence in managing symptoms and discussing prognosis. Conclusions: We have continued our collaboration with our Belarusian colleagues. New government policies and have passed which promote palliative care. We subsequently held a web-based teleconference with members of the Ministry of Health as well has medical education administrators in Belarus to discuss the structure of palliative care programs in the United States and our model of palliative care education. A second in-person palliative care education workshop for both physicians and nurses is being planned for the fall of 2015. We hope that our experience provides encouragement and resources for the continued promotion of palliative care education and development worldwide.

Representation trends in radiation oncology training programs in the United States.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11043-11043
Author(s):  
Emilie Garcia ◽  
Jacob Lang ◽  
Oluchi Ukaegbu Oke ◽  
Krishna Reddy ◽  
Obi Ekwenna
Keyword(s):  
United States ◽  
Native American ◽  
Ethnic Diversity ◽  
Radiation Oncology ◽  
Medical Oncology ◽  
Training Programs ◽  
Surgical Oncology ◽  
The United States ◽  
Chi Square ◽  
Data Resource

11043 Background: The ASCO and American Society of Radiation Oncologists (ASTRO) have recently committed to initiatives on increasing URM representation in the radiation oncology workforce. This study aims to assess representation trends in radiation oncology training programs across five academic years in order to understand representation trends and better guide initiatives moving forward. Methods: Data on racial and ethnic representation from the ACGME Data Resource Books over a span of five academic years (2015-2020) was included. URM was defined as those who identified as Hispanic, Black, or Native American/Alaskan in concordance with AAMC definition. Chi square testing was used to compare the proportion of residency positions occupied by URM residents by self-identified race and ethnicity in radiation oncology to that of hematology and medical oncology, complex general surgical oncology, and all other specialties. Results: A total of 3,315 radiation oncology positions were identified over the study period, 2015 and 2020. 1,938 (58.5%) of radiation oncology residency positions were filled by residents who identified as White, 967 (29.2%) as Asian/ Pacific Islander, 126 (3.8%) as Hispanic, 120 (3.6%) as Black, 7 (0.2%) as Native American/ Alaskan, and 157 (4.7%) as Other. URM representation was 7.6% in total and was relatively stagnant, remaining between 7.3% and 8.0% across study years. Results of chi square comparative analysis demonstrated lower rates of representation in radiation oncology in comparison to hematology and medical oncology as well as all other specialties (Table). Conclusions: There is lack of racial and ethnic diversity in radiation-oncology residency training positions in the United States. Over the five-year study period, only 7.6% of trainees identified as URM. URMs have significantly lower rates of representation in radiation-oncology compared to hematology and medical oncology, and other specialties. Efforts to mitigate disparities require a multifaceted approach.[Table: see text]

Practice Patterns of Sleep Otolaryngologists at Training Institutions in the United States

2016 ◽  
Vol 156 (6) ◽  
pp. 1025-1031 ◽  
Author(s):  
Austin S. Lam ◽  
Sarah K. Wise ◽  
Raj C. Dedhia
Keyword(s):  
United States ◽  
Residency Training ◽  
Online Survey ◽  
Practice Patterns ◽  
Training Programs ◽  
Program Directors ◽  
The United States ◽  
Sleep Medicine ◽  
Board Certification ◽  
Obstructive Sleep

Objective To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. Study Design Cross-sectional online survey. Setting Otolaryngology residency training programs. Subjects and Methods Program directors from 106 otolaryngology training programs in the United States were contacted. Program directors were instructed to forward a survey to otolaryngologists within the institution who provided Accreditation Council for Graduate Medical Education (ACGME) Otolaryngology Milestone Project feedback in “sleep-disordered breathing.” The survey assessed demographics, nonsurgical practices, and surgical/procedural practices of adult sleep otolaryngologists. Data were collected and analyzed. Results Forty-six surveys met inclusion criteria, representing 40 of 106 (38%) programs. Ninety-three percent of respondents reported that residents gained a significant portion of their sleep medicine training from themselves (ie, the respondents), yet only 36% of respondents spent ≥50% of their time on sleep medicine/surgery. Forty-one percent reported being board certified in sleep, with 18% having completed an ACGME fellowship in sleep medicine. Respondents with board certification were more likely to spend greater portions of their practice on sleep medicine/surgery, χ2(3, n = 44) = 23.161 ( P < .001), treat non–obstructive sleep apnea sleep disorders (13 of 18 vs 1 of 26, P < .001), interpret polysomnograms (13 of 17 vs 1 of 15, P < .001), and perform drug-induced sleep endoscopy, χ2(1, n = 43) = 5.43, ( P = .02). A similar pattern was seen with stratification by ACGME sleep medicine fellowship. Conclusion This study highlights the variance in practice patterns among sleep otolaryngologists who instruct residents. Board certification and fellowship training in sleep medicine significantly influence breadth of trainee exposure to this field. The highly disparate trainee experiences to sleep otolaryngology across US programs require attention.

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