Survey of the University of Florida hematology/oncology fellows on perceived skills of independent management of oncologic pain, chemotherapy-related nausea and vomiting, and end-of-life discussions.

Abstract

7 Background: Prior literature in oncology suggests that oncologists receive less training during fellowship in the areas of pain management, chemotherapy-related nausea/vomiting (CRNV), and end-of-life (EOL) discussions than is desired for later practice. As such, confidence in management could be improved by focused interventions. This survey sought to determine whether fellows in the department of Hematology/Oncology at the University of Florida (UF) felt they would benefit from additional education in these areas. Methods: An anonymous voluntary survey was administered by an impartial third party to assess the fourteen fellows’ comfort levels. Questions numbered 1-7 focused on oncologic pain, numbers 8-17 on CRNV, and numbers 18-28 on EOL care. Answers were converted to a numeric scale in the range of 1-4, with 4 points as the highest endorsement of confidence and 1 point as the lowest comfort level. 95% confidence intervals were used to analyze results of each question. Results: 79% (95% CI:57%-100%) of fellows felt additional training in pain management and CRNV would be beneficial. Half of fellows surveyed (50%, 95% CI:24%-76%) considered need for additional training in EOL discussions worthwhile. The scores were not significantly different when stratified by year of training (p value = 0.10, 0.48, 0.20). Conclusions: We conclude that the majority of UF Hematology/Oncology fellows feel that additional training in oncologic pain and CRNV is desired. This is significant as it parallels national trends. Limitations of the study include relatively small sample size, thus the absence of any statistically significant differences in responses by year of training may have been a result of the sample size. Several methods exist to satisfy this perceived need, including targeted lectures or standardized online teaching modules from the American Society of Clinical Oncology. A future prospective study using these modules is underway to further validate our findings. [Table: see text]