Palliative Care Education for Surgical Residents: Current Practices and Constraints
Benjamin G. Allar, MD1; Judy Weinstock, MD2; Mary K. Buss, MD2; and Tara S. Kent, MD1
1Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA 2 Section of Palliative Care, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA
Background: Awareness and implementation of surgical palliative care (PC) principles continue to grow, yet resident training in PC remains limited. This study identifies current practices and barriers in surgical residency PC education.
Methods: An IRB-approved REDCap survey, adapted from a validated PC education survey, was distributed to general surgery Program Directors (PD) via the American Program Directors in Surgery list-serve. PDs were asked about current and ideal-scenario curricula for surgical PC education.
Results: 22 PDs completed the survey. Educational time averaged 3 hours per week (range, 1-9). PC curriculum was on average two hours per year (range, 0-8). PDs noted a potential to spend up to 4 hours per year on palliative care (median, range 1-10). 21 of 22 PDs noted that PC training is important and 17 of 22 PDs (77%) supported more time for palliative care teaching. PC was taught through dedicated lectures (n=17), rotation-specific learning (n=5), online modules (n=4), and simulation (n=3). Reported barriers to further PC education were inadaptability of structured resident educational time (n=8), lack of inclusion in SCORE® curriculum (n=7) or lack of teaching expertise (n=7). Conclusions: Among this small sample, PDs noted potential to increase PC education, which they deemed important to surgical training. Limited educational time, few experts, and a lack of dedicated curriculum are barriers to improving PC education and competency in surgical training. Developing a focused, several-hour surgical PC curriculum and associated teacher training to supplement the current SCORE® PC module could help to address these hurdles.
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