Prospective evaluation of surgical palliative care immersion training for general surgery residents

Mustafa Raoof, Lisa O'Neill, Leigh A Neumayer, Mindy J Fain, Robert S Krouse

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. Study design: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework. The training format was modeled after the highly successful University of Arizona Center on Aging's Interprofessional Chief Resident Immersion Training (IP-CRIT) Program to teach palliative care competencies to general surgery residents. Objective and self-assessments were performed at baseline, immediately post training and 5-months after training. For all pre-test, post-test comparisons on Likert scale, Wilcoxon Signed Rank Test was used. For aggregate scores a repeated-measures analysis of variance was used. Results: Forty of the forty-eight residents (83%) completed the learner's needs assessment survey. Thirty-four (71%) of the forty-eight residents in the residency program participated in the SPCIT. Significant improvement was noted in objective assessment of post-test aggregate scores (Mean difference 2.15, 95% CI 0.52-3.77, p = 0.0083). There was a significant increase in proportion of residents who felt confident in discussing palliative care options (96.5% vs. 27.5%, p < 0.0001); end-of-life care (86.2% vs. 52.5%, p < 0.0065); code status (86% vs. 15%, p < 0.0001); prognosis (96% vs. 35%, p < 0.001); or withholding or withdrawing life support (79.2% vs. 45%, p = 0.0059) with patient/families after the SPCIT. Conclusion: The newly developed SPCIT program drastically improves knowledge, attitudes and perceived skills of general surgery residents. Similar training can be implemented in other surgical residency programs.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - May 11 2016

Fingerprint

Immersion
Palliative Care
Internship and Residency
Education
Terminal Care
Needs Assessment
Nonparametric Statistics
Patient Care
Analysis of Variance

Keywords

  • Palliative care
  • Surgery residents
  • Surgical education
  • Surgical training
  • Workshop

ASJC Scopus subject areas

  • Surgery

Cite this

@article{5cd3d4d1dfc442a7b1bc8743c375a8f7,
title = "Prospective evaluation of surgical palliative care immersion training for general surgery residents",
abstract = "Background: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. Study design: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled {"}Surgical Palliative Care: A Resident's Guide{"} as a framework. The training format was modeled after the highly successful University of Arizona Center on Aging's Interprofessional Chief Resident Immersion Training (IP-CRIT) Program to teach palliative care competencies to general surgery residents. Objective and self-assessments were performed at baseline, immediately post training and 5-months after training. For all pre-test, post-test comparisons on Likert scale, Wilcoxon Signed Rank Test was used. For aggregate scores a repeated-measures analysis of variance was used. Results: Forty of the forty-eight residents (83{\%}) completed the learner's needs assessment survey. Thirty-four (71{\%}) of the forty-eight residents in the residency program participated in the SPCIT. Significant improvement was noted in objective assessment of post-test aggregate scores (Mean difference 2.15, 95{\%} CI 0.52-3.77, p = 0.0083). There was a significant increase in proportion of residents who felt confident in discussing palliative care options (96.5{\%} vs. 27.5{\%}, p < 0.0001); end-of-life care (86.2{\%} vs. 52.5{\%}, p < 0.0065); code status (86{\%} vs. 15{\%}, p < 0.0001); prognosis (96{\%} vs. 35{\%}, p < 0.001); or withholding or withdrawing life support (79.2{\%} vs. 45{\%}, p = 0.0059) with patient/families after the SPCIT. Conclusion: The newly developed SPCIT program drastically improves knowledge, attitudes and perceived skills of general surgery residents. Similar training can be implemented in other surgical residency programs.",
keywords = "Palliative care, Surgery residents, Surgical education, Surgical training, Workshop",
author = "Mustafa Raoof and Lisa O'Neill and Neumayer, {Leigh A} and Fain, {Mindy J} and Krouse, {Robert S}",
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doi = "10.1016/j.amjsurg.2016.11.032",
language = "English (US)",
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AU - Fain, Mindy J

AU - Krouse, Robert S

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N2 - Background: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. Study design: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework. The training format was modeled after the highly successful University of Arizona Center on Aging's Interprofessional Chief Resident Immersion Training (IP-CRIT) Program to teach palliative care competencies to general surgery residents. Objective and self-assessments were performed at baseline, immediately post training and 5-months after training. For all pre-test, post-test comparisons on Likert scale, Wilcoxon Signed Rank Test was used. For aggregate scores a repeated-measures analysis of variance was used. Results: Forty of the forty-eight residents (83%) completed the learner's needs assessment survey. Thirty-four (71%) of the forty-eight residents in the residency program participated in the SPCIT. Significant improvement was noted in objective assessment of post-test aggregate scores (Mean difference 2.15, 95% CI 0.52-3.77, p = 0.0083). There was a significant increase in proportion of residents who felt confident in discussing palliative care options (96.5% vs. 27.5%, p < 0.0001); end-of-life care (86.2% vs. 52.5%, p < 0.0065); code status (86% vs. 15%, p < 0.0001); prognosis (96% vs. 35%, p < 0.001); or withholding or withdrawing life support (79.2% vs. 45%, p = 0.0059) with patient/families after the SPCIT. Conclusion: The newly developed SPCIT program drastically improves knowledge, attitudes and perceived skills of general surgery residents. Similar training can be implemented in other surgical residency programs.

AB - Background: Palliative care competencies in surgical training are recognized to improve the care of surgical patients with advanced or life-threatening illnesses. Formal programs to teach these competencies are lacking. The study aims to assess the feasibility and utility of a unique surgical palliative care immersion training program. Study design: A half-day Surgical Palliative Care Immersion Training (SPCIT) was developed using the American College of Surgeon's manual titled "Surgical Palliative Care: A Resident's Guide" as a framework. The training format was modeled after the highly successful University of Arizona Center on Aging's Interprofessional Chief Resident Immersion Training (IP-CRIT) Program to teach palliative care competencies to general surgery residents. Objective and self-assessments were performed at baseline, immediately post training and 5-months after training. For all pre-test, post-test comparisons on Likert scale, Wilcoxon Signed Rank Test was used. For aggregate scores a repeated-measures analysis of variance was used. Results: Forty of the forty-eight residents (83%) completed the learner's needs assessment survey. Thirty-four (71%) of the forty-eight residents in the residency program participated in the SPCIT. Significant improvement was noted in objective assessment of post-test aggregate scores (Mean difference 2.15, 95% CI 0.52-3.77, p = 0.0083). There was a significant increase in proportion of residents who felt confident in discussing palliative care options (96.5% vs. 27.5%, p < 0.0001); end-of-life care (86.2% vs. 52.5%, p < 0.0065); code status (86% vs. 15%, p < 0.0001); prognosis (96% vs. 35%, p < 0.001); or withholding or withdrawing life support (79.2% vs. 45%, p = 0.0059) with patient/families after the SPCIT. Conclusion: The newly developed SPCIT program drastically improves knowledge, attitudes and perceived skills of general surgery residents. Similar training can be implemented in other surgical residency programs.

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