title: Palliative care and palliative radiation therapy education in radiation oncology: A survey of US radiation oncology program directors.
abstract: OBJECTIVE
  The purpose of this study was to assess the state of palliative and supportive care (PSC) and palliative radiation therapy (RT) educational curricula in radiation oncology residency programs in the United States.
  
  
  METHODS
  We surveyed 87 program directors of radiation oncology residency programs in the United States between September 2015 and November 2015. An electronic survey on PSC and palliative RT education during residency was sent to all program directors. The survey consisted of questions on (1) perceived relevance of PSC and palliative RT to radiation oncology training, (2) formal didactic sessions on domains of PSC and palliative RT, (3) effective teaching formats for PSC and palliative RT education, and (4) perceived barriers for integrating PSC and palliative RT into the residency curriculum.
  
  
  RESULTS
  A total of 57 responses (63%) was received. Most program directors agreed or strongly agreed that PSC (93%) and palliative radiation therapy (99%) are important competencies for radiation oncology residents and fellows; however, only 67% of residency programs had formal educational activities in principles and practice of PSC. Most programs had 1 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. Last, 85% of programs reported having a formal curriculum on palliative RT. Programs were most likely to have education on palliative radiation to brain, bone, and spine, but less likely on visceral, or skin, metastasis.
  
  
  CONCLUSIONS
  Residency program directors believe that PSC and palliative RT are important competencies for their trainees and support increasing education in these 2 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.
authors.affiliation: Department of Radiation Oncology, University of California Irvine, Orange, California.
authors.forename: Randy L
authors.initials: RL
authors.lastname: Wei
authors.affiliation: Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, Texas.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Colbert
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Joshua
authors.initials: J
authors.lastname: Jones
authors.affiliation: Department of Radiation Oncology, Florida Hospital Cancer Institute, Deland, Florida.
authors.forename: Margarita
authors.initials: M
authors.lastname: Racsa
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle, Washington.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Kane
authors.affiliation: Department of Radiation Oncology, Blanchard Valley Health Systems, Findlay, Ohio.
authors.forename: Steve
authors.initials: S
authors.lastname: Lutz
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Neha
authors.initials: N
authors.lastname: Vapiwala
authors.affiliation: Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York. Electronic address: kavita.dharmarajan@mountsinai.org.
authors.forename: Kavita V
authors.initials: KV
authors.lastname: Dharmarajan
mesh_terms: D004503:Education, Medical, Graduate / Q000592:standards*; D006801:Humans; D010166:Palliative Care / Q000379:methods; D018787:Radiation Oncology / Q000193:education*; D011878:Radiotherapy / Q000379:methods*; D011795:Surveys and Questionnaires; D014481:United States