Characterizing Palliative Radiotherapy Education in Hospice and Palliative Medicine Fellowship: A Survey of Fellowship Program Directors

87 Background: Educational deficiencies among hospice and palliative medicine (HPM) physicians are thought to contribute to sub-optimal utilization of palliative radiotherapy (PRT) for patients with advanced cancer. We conducted a national survey of HPM fellowship program directors and fellows to assess the need for increased PRT education in HPM fellowship. Methods: A 17-item, anonymous, electronic survey was distributed via email in May 2018 to the directors of all US Accreditation Council for Graduate Medical Education-accredited HPM fellowship programs with at least one enrolled fellow. A similar 19-item survey was emailed to the coordinators of these programs for distribution to enrolled fellows. Three reminder emails were sent over a one-month period. Results: Eighty-one (68%) of 120 eligible program directors and 114 (34%) of 338 eligible fellows completed the surveys. Nearly all respondents (98% of program directors and 99% of fellows) agreed that HPM physicians should be familiar with the principles of PRT and 95% of both groups agreed that this topic should be taught in HPM fellowship. Thirty percent of programs, however, lacked any PRT curriculum and 57% of programs provided only 1 or 2 hours of didactic PRT education. The minority of fellows felt confident in their ability to identify radiation oncology emergencies (43%) or to manage symptoms associated with radiotherapy toxicities (42%) and only 56% felt confident in their ability to assess which patients should be referred to radiation oncology for possible PRT. Notably, the majority of fellows reported that if they were more knowledgeable about PRT they would be more likely to consider referral to radiation oncology (78%), to collaborate with the radiation oncologists involved in their patients’ care (76%), and to advocate for shorter fractionation schedules or possible omission of radiation therapy altogether based on a patient’s prognosis or goals of care (78%). Conclusions: HPM fellowship program directors and fellows agree that that there is a need for increased education in PRT in HPM fellowship. Curricular interventions that address this need may result in more appropriate utilization of PRT.

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Development of a Clinical Fellowship Program in Palliative Medicine

Journal of Pain and Symptom Management ◽

10.1016/s0885-3924(00)00210-4 ◽

2000 ◽

Vol 20 (5) ◽

pp. 345-352 ◽

Cited By ~ 8

Author(s):

Susan B LeGrand ◽

Declan Walsh ◽

Kristine Nelson ◽

Donna S Zhukovsky

Keyword(s):

Palliative Medicine ◽

Fellowship Program

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Molecular and Cytogenetic Education in Hematopathology Fellowship

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz048 ◽

2019 ◽

Vol 152 (4) ◽

pp. 438-445 ◽

Cited By ~ 1

Author(s):

Lorinda A Soma ◽

Alexandra E Kovach ◽

Alexa J Siddon ◽

Rose Beck ◽

Sarah E Gibson ◽

...

Keyword(s):

Program Directors ◽

Fellowship Training ◽

Fellowship Program ◽

Basic Principles ◽

Raw Data ◽

Education Committee ◽

Cytogenetic Testing

Abstract Objectives Given the increased complexity of molecular and cytogenetic testing (MOL-CG), the Society for Hematopathology Education Committee (SH-EC) was interested in determining what the current expectations are for MOL-CG education in hematopathology (HP) fellowship training. Methods The SH-EC sent a questionnaire to HP fellowship program directors (HP-PDs) covering MOL-CG training curricula, test menus, faculty background, teaching, and sign-out roles. These findings were explored via a panel-based discussion at the 2018 SH-EC meeting for HP-PDs. Results HP fellows are expected to understand basic principles, nomenclature, and indications for and limitations of testing. Interpretation of common assays is within that scope, but not necessarily proficiency in technical troubleshooting of testing or analysis of complex raw data. Conclusions The consensus was that HP fellows should understand the components of MOL-CG testing necessary to incorporate those results into an accurate, clinically relevant, and integrated HP report.

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The Struggling Infectious Diseases Fellow: Remediation Challenges and Opportunities

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa058 ◽

2020 ◽

Vol 7 (3) ◽

Author(s):

Michael T Melia ◽

Armando Paez ◽

Gail Reid ◽

Lisa M Chirch ◽

Vera P Luther ◽

...

Keyword(s):

Infectious Diseases ◽

Performance Management ◽

Time Management ◽

Well Being ◽

Program Directors ◽

Fellowship Program ◽

Struggling Learners ◽

Challenges And Opportunities ◽

Competency Based ◽

Knowledge Deficits

Abstract Remediation of struggling learners is a challenge faced by all educators. In recognition of this reality, and in light of contemporary challenges facing infectious diseases (ID) fellowship program directors, the Infectious Diseases Society of America Training Program Directors’ Committee focused the 2018 National Fellowship Program Directors’ Meeting at IDWeek on “Remediation of the Struggling Fellow.” Small group discussions addressed 7 core topics, including feedback and evaluations, performance management and remediation, knowledge deficits, fellow well-being, efficiency and time management, teaching skills, and career development. This manuscript synthesizes those discussions around a competency-based framework to provide program directors and other educators with a roadmap for addressing common contemporary remediation challenges.

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