• Ramez N Eskander, Kathryn Osann, Elizabeth Dickson, Laura L Holman, Rauh-Hain J Alejandro JA The Massachusetts General Hospital, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Boston, MA, United States., Lori Spoozak, Eijean Wu, Lauren Krill, Amanda Nickles Fader, and Krishnansu S Tewari.
• University of California Irvine, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Orange, CA, United States. Electronic address: Eskander@uci.edu.
• Gynecol. Oncol. 2014 Aug 1; 134 (2): 379-84.

ObjectivePalliative care is recognized as an important component of oncologic care. We sought to assess the quality/quantity of palliative care education in gynecologic oncology fellowship.MethodsA self-administered on-line questionnaire was distributed to current gynecologic oncology fellow and candidate members during the 2013 academic year. Descriptive statistics, bivariate and multivariate analyses were performed.ResultsOf 201 fellow and candidate members, 74.1% (n=149) responded. Respondents were primarily women (75%) and white (76%). Only 11% of respondents participated in a palliative care rotation. Respondents rated the overall quality of teaching received on management of ovarian cancer significantly higher than management of patients at end of life (EOL), independent of level of training (8.25 vs. 6.23; p<0.0005). Forty-six percent reported never being observed discussing transition of care from curative to palliative with a patient, and 56% never received feedback about technique regarding discussions on EOL care. When asked to recall their most recent patient who had died, 83% reported enrollment in hospice within 4 weeks of death. Fellows reporting higher quality EOL education were significantly more likely to feel prepared to care for patients at EOL (p<0.0005). Mean ranking of preparedness increased with the number of times a fellow reported discussing changing goals from curative to palliative and the number of times he/she received feedback from an attending (p<0.0005).ConclusionsGynecologic oncology fellow/candidate members reported insufficient palliative care education. Those respondents reporting higher quality EOL training felt more prepared to care for dying patients and to address complications commonly encountered in this setting.Copyright © 2014 Elsevier Inc. All rights reserved.

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