Oncology fellows’ knowledge and current practice regarding outpatient oncology and palliative care.

Abstract

10527 Background: Patients with advanced cancers often suffer from a number of symptoms and need guidance when discussing treatment goals as their diseases’ progress. Palliative care competencies include the assessment and management of both physical and psychological symptoms, as well as, the conduct of goals of care conversations and advanced care planning. Palliative medicine is subspecialty that specially addresses these needs in patients with advanced cancers, but is not universally available. Oncology fellowship training must include these competencies and there is little evidence regarding the palliative care educational experiences of oncology fellows. This study examines fellows’ experiences with palliative care education and fellows’ attitudes about concurrent palliative care in the outpatient setting. Methods: An electronic nationwide survey of medical oncology fellows was conducted in the second half of the academic year in 2018. Results: 43 of 191, 22.5%, of oncology fellows contacted at 17 institutions responded. 96% of fellows indicated they would strongly agree or agree with having a Palliative Care team in their future outpatient clinics. 93% of fellows agree or strongly agree with being comfortable managing cancer related pain, but only half agree or strongly agree with being comfortable managing depression and anxiety. 91% agree or strongly agree they are comfortable with discussions about transitions to best supportive care, while only 31% of fellows always or often assist patients in completing advance care documents. 70% of fellows are always, often, or sometimes receiving feedback on their communication and symptom management skills. Conclusions: Oncology fellows fell comfortable with some aspects of palliative care more than others. Fellows in this survey report feeling comfortable with goals of care conversations and pain management, but are not as comfortable managing other symptoms like depression and anxiety. Respondents are not universally assisting patients in advanced care documentation and only two-thirds of responding fellows are receiving frequent feedback on their communication and symptom skills. There is a consensus among responding fellows about a desire to have palliative care embedded in their future clinics.