Improving resident education in ambulatory oncology: A targeted needs assessment.

Abstract

e21034 Background: In order to address disparities in cancer detection and outcomes, internal medicine physicians require strong foundations in evidence-based cancer screening, diagnosis, treatment and survivorship. Evidence suggests that residents are disproportionately more dissatisfied with oncology education compared to other IM subspecialties, which may be related to lack of dedicated learning and subspecialty exposure. This study will focus on assessing gaps in institutional ambulatory oncology education and seek to fill the growing need in oncology medical education at the resident level by developing a novel curriculum for IM residents. Methods: This is a single institution educational survey of internal medicine residents at Johns Hopkins Bayview Medical Center. Following Kern’s curriculum development model, a targeted needs assessment survey was iteratively developed and disseminated to all internal medicine residents. The medical oncology tenets of the ABIM Blueprint were used to develop this mixed-methods survey. The survey assessed confidence in aspects of ambulatory care of oncology patients as well as satisfaction in current curricula, clinical experiences, and preferred educational delivery methods. Results: 56% (n=27) of residents across all 3 three years of training completed the survey. 63% have not completed an oncology-focused rotation. 82% rate their level of satisfaction with the current oncology curricula as either “extremely” or “somewhat dissatisfied.” 82% responded “not confident” in caring for oncology patients in the ambulatory setting. 64% responded “not confident” in caring for the needs of cancer survivors. Common barriers to education include lack of formal education, access to specialists and dedicated time for learning. Topics selected to include in a pilot curriculum were cancer staging and performance status evaluations, basic principles of treatment, and diagnostic work up of cancers of unknown primary. Preferred formats of delivery included in-person conferences, asynchronous videos and online modules. Conclusions: There is a deficiency in the education of internal medicine residents surrounding ambulatory care of patients with cancer as evidenced by perceived lack of confidence in related skills. These skills are crucial to burgeoning internists who will care for and interface with these patients in their future practice. The results of this survey will be used to develop a novel outpatient curriculum to address these gaps. Resident confidence in oncology-focused ambulatory care. Ambulatory care of cancer patients (%) Caring for the needs of cancer survivors (%) Ambulatory goals of care discussions in patients with malignancy (%) Not confident 82 64 23 Slightly confident 14 27 37 Somewhat confident 5 9 32 Fairly confident 0 0 14 Very confident 0 0 5