title: Mandatory palliative care education for surgical residents: initial focus on teaching pain management.
abstract: BACKGROUND
  Knowledge concerning palliative care and the associated skills, including effective pain control, is essential for surgeons who treat cancer patients in daily practice. This study focuses on a palliative care training course that has been mandatorily conducted for all surgical residents of our hospital since 2009.
  
  
  METHODS
  We evaluated the effectiveness of our mandatory palliative care training course by conducting a retrospective study of the patients' medical records and participants' questionnaire results and discussed the importance of palliative care education for surgical residents.
  
  
  RESULTS
  All 12 surgical residents who participated in the course in 2009 had graduated 4-9 years back. They were assigned to look after a total of 92 cases (average, 7.66 cases per resident) during the course. The purpose of care in most cases (92.3%) was to mitigate pain. Introducing analgesic adjuvants such as gabapentin or amitriptyline accounted for the largest part of initial interventions (23.9%) aimed at controlling cancer pain, followed by changes in route of administration or doses of prior opioid analgesics (21.7%). Interventions with opioid analgesics were conducted most frequently (47.7%). The overall pain improvement rate was 89.1%. We used a questionnaire after the course to evaluate its effectiveness.
  
  
  CONCLUSIONS
  The surgical residents stated that it was a meaningful course through which they gained practical knowledge on palliative care and that the experience would change their approach to home care.
authors.affiliation: Surgery Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. u4946008@yahoo.co.jp
authors.forename: Hisaharu
authors.initials: H
authors.lastname: Oya
authors.forename: Motohiro
authors.initials: M
authors.lastname: Matoba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Murakami
authors.forename: Taihei
authors.initials: T
authors.lastname: Ohshiro
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Kishino
authors.forename: Yuya
authors.initials: Y
authors.lastname: Satoh
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tsukahara
authors.forename: Syutarou
authors.initials: S
authors.lastname: Hori
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maeda
authors.forename: Takashi
authors.initials: T
authors.lastname: Makino
authors.forename: Takashi
authors.initials: T
authors.lastname: Maeda
mesh_terms: D000328:Adult; D000588:Amines / Q000008:administration & dosage; D000639:Amitriptyline / Q000008:administration & dosage; D000700:Analgesics / Q000008:administration & dosage*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D003479:Curriculum / Q000592:standards / Q000639:trends; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration*; D007564:Japan; D008297:Male; D009294:Narcotics / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy*; D059408:Pain Management / Q000379:methods / Q000639:trends; D010166:Palliative Care; D012189:Retrospective Studies; D013043:Specialties, Surgical / Q000193:education*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods / Q000639:trends; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage
chemical_list: D000588:Amines; D000700:Analgesics; D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D003509:Cyclohexanecarboxylic Acids; D009294:Narcotics; D000639:Amitriptyline; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin