title: Assessment of palliative care training in gynecologic oncology: a gynecologic oncology fellow research network study.
abstract: OBJECTIVE
  Palliative care is recognized as an important component of oncologic care. We sought to assess the quality/quantity of palliative care education in gynecologic oncology fellowship.
  
  
  METHODS
  A self-administered on-line questionnaire was distributed to current gynecologic oncology fellow and candidate members during the 2013 academic year. Descriptive statistics, bivariate and multivariate analyses were performed.
  
  
  RESULTS
  Of 201 fellow and candidate members, 74.1% (n=149) responded. Respondents were primarily women (75%) and white (76%). Only 11% of respondents participated in a palliative care rotation. Respondents rated the overall quality of teaching received on management of ovarian cancer significantly higher than management of patients at end of life (EOL), independent of level of training (8.25 vs. 6.23; p<0.0005). Forty-six percent reported never being observed discussing transition of care from curative to palliative with a patient, and 56% never received feedback about technique regarding discussions on EOL care. When asked to recall their most recent patient who had died, 83% reported enrollment in hospice within 4 weeks of death. Fellows reporting higher quality EOL education were significantly more likely to feel prepared to care for patients at EOL (p<0.0005). Mean ranking of preparedness increased with the number of times a fellow reported discussing changing goals from curative to palliative and the number of times he/she received feedback from an attending (p<0.0005).
  
  
  CONCLUSIONS
  Gynecologic oncology fellow/candidate members reported insufficient palliative care education. Those respondents reporting higher quality EOL training felt more prepared to care for dying patients and to address complications commonly encountered in this setting.
authors.affiliation: University of California Irvine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Orange, CA, United States. Electronic address: Eskander@uci.edu.
authors.forename: Ramez N
authors.initials: RN
authors.lastname: Eskander
authors.affiliation: University of California Irvine, Department of Medicine, Irvine, CA, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.affiliation: University of Minnesota, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Minneapolis, MN, United States.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Dickson
authors.affiliation: Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
authors.forename: Laura L
authors.initials: LL
authors.lastname: Holman
authors.affiliation: The Massachusetts General Hospital, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Boston, MA, United States.
authors.forename: J Alejandro
authors.initials: JA
authors.lastname: Rauh-Hain
authors.affiliation: Albert Einstein College of Medicine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Bronx, NY, United States.
authors.forename: Lori
authors.initials: L
authors.lastname: Spoozak
authors.affiliation: University of Southern California Medical Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Los Angeles, CA, United States.
authors.forename: Eijean
authors.initials: E
authors.lastname: Wu
authors.affiliation: University of California Irvine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Orange, CA, United States.
authors.forename: Lauren
authors.initials: L
authors.lastname: Krill
authors.affiliation: The Johns Hopkins Medical Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Baltimore, MD, United States.
authors.forename: Amanda Nickles
authors.initials: AN
authors.lastname: Fader
authors.affiliation: University of California Irvine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Orange, CA, United States.
authors.forename: Krishnansu S
authors.initials: KS
authors.lastname: Tewari
mesh_terms: D000328:Adult; D035843:Biomedical Research; D005257:Fellowships and Scholarships; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000193:education*; D010166:Palliative Care; D011795:Surveys and Questionnaires
keywords: Education; End of life care; Fellowship training; Gynecologic cancer; Hospice; Palliative care