title: Palliative Care Training in Cardiology Fellowship: A National Survey of the Fellows.
abstract: OBJECTIVE
  To address perspectives of cardiology fellows on the current state of palliative education and palliative and hospice resource utilization within their fellowship experiences.
  
  
  METHODS
  We conducted an online national survey of cardiology fellows during the 2015 to 2016 academic year. Survey questions aimed to assess perceived importance of palliative care education, level of palliative care education during fellowship, and the structure of palliative care support at respondent institutions. Responses were collected anonymously. A total of 519 programs, including subspecialty programs, were contacted.
  
  
  RESULTS
  We received 365 responses, a number that represents roughly 14% of all cardiology fellows nationwide during the 2015 to 2016 academic year. Fellows reported discordance in the quality of education between general cardiology and palliative care principles as it relates to care of the patient approaching the end of life. Fellows infrequently received explicit training nor were observed or mentored in delivering end-of-life discussions. Respondents reported an underutilization of palliative care and hospice resources during fellowship training and also a perception that attending faculty were not routinely addressing goals of care.
  
  
  CONCLUSIONS
  Our survey results highlight a need for enhanced palliative care and end-of-life training experiences for cardiology fellows and also suggest underutilization of hospice and palliative care resources for patients with advanced cardiac diseases. These findings create a platform for future work that might: (1) confirm this training deficit, (2) lead to exploration of educational models that could reconcile this deficit, and (3) potentially help improve palliative care support for patients and families facing advanced heart disease.
authors.affiliation: 1 Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.|2 Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Noura M
authors.initials: NM
authors.lastname: Dabbouseh
authors.affiliation: 2 Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Shivtej
authors.initials: S
authors.lastname: Kaushal
authors.affiliation: 2 Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.|3 Palliative Care Center, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Peltier
authors.affiliation: 4 Division of Surgical Oncology, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Fabian M
authors.initials: FM
authors.lastname: Johnston
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D017051:Hospice Care / Q000458:organization & administration*; D006801:Humans; D008495:Medical Oncology / Q000193:education*; D065126:Palliative Medicine / Q000193:education*; D011788:Quality of Life; D013727:Terminal Care / Q000458:organization & administration
keywords: advanced heart failure; cardiology; education; fellowship; heart failure; hospice; palliative care; survey