Palliative Care and Palliative Radiotherapy Education in Radiation Oncology: A Survey of US Radiation Oncology Program Directors

Publication date: Available online 1 December 2016
Source:Practical Radiation Oncology
Author(s): Randy L. Wei, Lauren E. Colbert, Joshua Jones, Margarita Racsa, Gabrielle Kane, Steve Lutz, Neha Vapiwala, Kavita Dharmarajan
Purpose/ObjectiveTo assess the state of palliative and supportive care (PSC) and palliative radiotherapy educational curricula in radiation oncology residency programs in the United States.Materials and methodsWe surveyed 87 program directors of radiation oncology residency programs in the United States from September 2015 to November 2015. An electronic survey on PSC and palliative radiotherapy education during residency was sent to all program directors. The survey consisted of questions on (1) perceived relevance of PSC and palliative radiotherapy to radiation oncology training, (2) formal didactic sessions on domains of PSC and palliative radiotherapy, (3) effective teaching formats for PSC and palliative radiotherapy education, (4) and perceived barriers for integrating PSC and palliative radiotherapy into the residency curriculum.ResultsA total of 57 responses (63%) were received. Most program directors agreed or strongly agreed that PSC (93%) and palliative radiotherapy (99%) are important competency for radiation oncology residents and fellows. However, 67% of residency programs had formal educational activities in principles and practice of PSC. Most programs had one or more hours of formal didactics on management of pain (67%), management of neuropathic pain (65%), and management of nausea and vomiting (63%). However, only 35%, 33%, and 30% had dedicated lectures on initial management of fatigue, assessing role of spirituality, and discussing advance care directives, respectively. Lastly, 85% of programs reported having a formal curriculum on palliative radiotherapy. Programs were most likely to have education on palliative radiation to brain, bone, and spine, but less likely on visceral, or skin metastasis.ConclusionResidency program directors believe that PSC and palliative radiotherapy are important competencies for their trainees and support increasing education in these two educational domains. Many residency programs have structured curricula on PSC and palliative radiation education, but room for improvement exists in management of fatigue, assessing role of spirituality and discussion regarding advance care planning.



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