title: Palliative care education in gynecologic oncology: a survey of the fellows.
abstract: BACKGROUND
  Gynecologic oncologists regularly care for patients at the end of life, yet little is known about their training or preparedness to deal with issues of palliative care. We sought to examine the training provided to gynecologic oncology fellows as well as their perceived preparedness to provide palliative care.
  
  
  METHODS
  A self-administered survey was distributed to all fellows enrolled in all gynecologic oncology fellowships during the 2009 academic year. The instrument assessed attitudes, training, experience, and preparedness regarding caring for patients at the end of life. Descriptive, bivariate and multivariable analyses were performed.
  
  
  RESULTS
  Sixty-one percent (103/168) of fellows completed the survey. Most (89%) feel that palliative care is integral to their training, but few (11%) have had any palliative care training, including either a rotation or fellowship. Using a scale of 1-10, fellows rated teaching quality on two common training opportunities, specifically managing postoperative complications (7.8) and endometrial cancer patients (8.7), as significantly higher than teaching on managing patients at the end of life (5.5; p<0.001). Fellows rated the quality of end of life teaching as significantly lower than overall teaching (55% vs. 92%; p=0.001). Their self-assessment regarding overall preparedness to deal with end of life issues was associated with higher end of life teaching quality and experience caring for more than 10 dying patients.
  
  
  CONCLUSIONS
  The quantity and quality of training in palliative care are lower compared to other common procedural and oncological issues. Gynecologic oncology fellowship programs need to incorporate a palliative care training curriculum.
authors.affiliation: Mid Atlantic Gynecologic Oncology of Mon General Hospital, Morgantown, WV 26505, USA. LesnockJ@monhealthsys.org
authors.forename: J L
authors.initials: JL
authors.lastname: Lesnock
authors.forename: R M
authors.initials: RM
authors.lastname: Arnold
authors.forename: L A
authors.initials: LA
authors.lastname: Meyn
authors.forename: M K
authors.initials: MK
authors.lastname: Buss
authors.forename: M
authors.initials: M
authors.lastname: Quimper
authors.forename: T C
authors.initials: TC
authors.lastname: Krivak
authors.forename: R P
authors.initials: RP
authors.lastname: Edwards
authors.forename: J C
authors.initials: JC
authors.lastname: Chang
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D005257:Fellowships and Scholarships; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000193:education*; D008875:Middle Aged; D015999:Multivariate Analysis; D010166:Palliative Care; D011795:Surveys and Questionnaires; D013727:Terminal Care
keywords: Gynecologic oncology fellowship; Palliative care; Survey