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Teo YH, Peh TY, Abdurrahman ABHM, Lee ASI, Chiam M, Fong W, Wijaya L, Krishna LKR. A modified Delphi approach to nurturing professionalism in postgraduate medical education in Singapore. Singapore Med J 2024; 65:313-325. [PMID: 34823327 PMCID: PMC11232710 DOI: 10.11622/smedj.2021224] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Nurturing professional identities instils behavioural standards of physicians, and this in turn facilitates consistent professional attitudes, practice and patient care. Identities are socioculturally constructed efforts; therefore, we must account for the social, cultural and local healthcare factors that shape physicians' roles, responsibilities and expectations. This study aimed to forward a programme to nurture professionalism among physicians in Singapore. METHODS A three-phase, evidenced-based approach was used. First, a systematic scoping review (SSR) was conducted to identify professionalism elements. Second, a questionnaire was created based on the findings of the SSR. Third, a modified Delphi approach, which involved local experts to identify socioculturally appropriate elements to nurture professionalism, was used. RESULTS A total of 124 articles were identified from the SSR; these articles revealed definitions, knowledge, skills and approaches to nurturing professionalism. Through the modified Delphi approach, we identified professional traits, virtues, communication, ethical, self-care, teaching and assessment methods, and support mechanisms. CONCLUSION The results of this study formed the basis for a holistic and longitudinal programme focused on instilling professional traits and competencies over time through personalised and holistic support of physicians. The findings will be of interest to medical communities in the region and beyond.
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Affiliation(s)
- Yao Hao Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Tan Ying Peh
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- Assisi Hospice, Singapore
- The Palliative Care Centre for Excellence in Research and Education, Singapore
| | - Ahmad Bin Hanifah Marican Abdurrahman
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
| | - Warren Fong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
- Duke-NUS Medical School, Singapore
| | - Limin Wijaya
- Duke-NUS Medical School, Singapore
- Department of Infectious Diseases, Singapore General Hospital, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
- The Palliative Care Centre for Excellence in Research and Education, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore
- Duke-NUS Medical School, Singapore
- Palliative Care Institute Liverpool, Academic Palliative and End of Life Care Centre, University of Liverpool, United Kingdom
- Centre of Biomedical Ethics, National University of Singapore, Singapore
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Zhu Y, Bai Y, Wang A, Liu Y, Gao Q, Zeng Z. Effects of a death education based on narrative pedagogy in a palliative care course among Chinese nursing students. Front Public Health 2023; 11:1194460. [PMID: 38026299 PMCID: PMC10665499 DOI: 10.3389/fpubh.2023.1194460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Death education has been confirmed to be an effective method to enhance nursing students' attitudes and coping abilities toward death. However, integrated Narrative Pedagogy into the death education to explore educational effectiveness is still limited. The study aimed to evaluate the effects of a death education based on Narrative Pedagogy in a palliative care course on the attitude toward death, coping with death, and attitude toward caring for the dying among undergraduate nursing students in China. Methods The study was designed as a pre-post intervention study with a quasi-experimental design. All the participants received 6 class hours of death education which was designed in a palliative care course. The death education includes preparation, presentation, discussion, reflection, and practice of the narrative materials. Death Attitude Profile-Revised (DAP-R), Coping with Death Scale (CDS), and Frommelt Attitude Toward Care of the Dying-Form B (FATCOD-Form B) were used to measure outcomes. Results Sixty undergraduate nursing students who consented. There were statistically significant increases in the mean score of neutral acceptance and approach acceptance in the DAP-R, CDS, and FATCOD-Form B before and after the intervention. Conclusion This death education integrated Narrative Pedagogy which indicated to improve attitude toward death, competence to cope with death, and attitude toward the care of dying patients. The findings assist teachers in understanding the importance and urgency of death education, as well as providing a favorable approach to death education. However, the long-term effectiveness still needs to study in further.
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Affiliation(s)
- Yuanyuan Zhu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Aihong Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Yuexian Liu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Qinyi Gao
- Nursing Department, Nanjing Jiangning Hospital, Nanjing, Jiangsu, China
| | - Zhi Zeng
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Benedetti DJ, Marron JM, Thomas SM, Brown AEC, Pyke-Grimm KA, Johnson LM, Unguru Y, Kodish E. The role of ethicists in pediatric hematology/oncology: Current status and future needs. Pediatr Blood Cancer 2023; 70:e30132. [PMID: 36495529 DOI: 10.1002/pbc.30132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 12/14/2022]
Abstract
As pediatric hematology/oncology (PHO) becomes more complex and sub-subspecialized, dedicated PHO ethicists have emerged as sub-subspecialists focused on addressing ethical issues encountered in clinical and research practices. PHO physicians and other clinicians with advanced training in bioethics contribute to the field through ethics research, education, and ethics consultation services. Furthermore, there exists a newer generation of PHO trainees interested in bioethics. This review details the experiences of current PHO ethicists, providing a blueprint for future educational, research and service activities to strengthen the trajectory of the burgeoning sub-subspecialty of PHO ethics. Creating an American Society of Pediatric Hematology/Oncology (ASPHO) ethics Special Interest Group, enhancing clinical ethics education for pediatric hematologists/oncologists (PHOs), developing multi-institutional research collaborations, and increasing attention to ethical issues germane to nonmalignant hematology will serve the interests of the entire field of PHO, enhancing the care of PHO patients and careers of PHOs.
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Affiliation(s)
- Daniel J Benedetti
- Division of Pediatric Hematology/Oncology, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan M Marron
- Division of Pediatric Hematology/Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, and Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stefanie M Thomas
- Department of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Amy E Caruso Brown
- Division of Pediatric Hematology/Oncology, and Center for Bioethics and Humanities, SUNY Upstate Medical University, Syracuse, New York, USA
| | - Kimberly A Pyke-Grimm
- Department of Nursing Research and Evidence-Based Practice, Stanford Children's Health and Division of Pediatric Hematology/Oncology, Stanford University School of Medicine, Stanford, California, USA
| | - Liza-Marie Johnson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Yoram Unguru
- Division of Pediatric Hematology/Oncology, The Herman and Walter Samuelson Children's Hospital at Sinai, Baltimore, Maryland, USA.,Johns Hopkins University Berman Institute of Bioethics, Baltimore, Maryland, USA
| | - Eric Kodish
- Departments of Pediatrics, Oncology, and Bioethics, Cleveland Clinic Children's and Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, Ohio, USA
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4
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Doukas DJ, Ozar DT, Darragh M, de Groot JM, Carter BS, Stout N. Virtue and care ethics & humanism in medical education: a scoping review. BMC MEDICAL EDUCATION 2022; 22:131. [PMID: 35219311 PMCID: PMC8881825 DOI: 10.1186/s12909-021-03051-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE This scoping review explores how virtue and care ethics are incorporated into health professions education and how these factors may relate to the development of humanistic patient care. METHOD Our team identified citations in the literature emphasizing virtue ethics and care ethics (in PubMed, NLM Catalog, WorldCat, EthicsShare, EthxWeb, Globethics.net , Philosopher's Index, and ProQuest Central) lending themselves to constructs of humanism curricula. Our exclusion criteria consisted of non-English articles, those not addressing virtue and care ethics and humanism in medical pedagogy, and those not addressing aspects of character in health ethics. We examined in a stepwise fashion whether citations: 1) Contained definitions of virtue and care ethics; 2) Implemented virtue and care ethics in health care curricula; and 3) Evidenced patient-directed caregiver humanism. RESULTS Eight hundred eleven citations were identified, 88 intensively reviewed, and the final 25 analyzed in-depth. We identified multiple key themes with relevant metaphors associated with virtue/care ethics, curricula, and humanism education. CONCLUSIONS This research sought to better understand how virtue and care ethics can potentially promote humanism and identified themes that facilitate and impede this mission.
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Affiliation(s)
- David J Doukas
- Department of Family and Community Medicine, James A. Knight Chair of Humanities and Ethics in Medicine, Program in Medical Ethics and Human Values, Tulane University School of Medicine, 1430 Tulane Ave, #8033, New Orleans, LA, USA.
| | | | | | | | | | - Nathan Stout
- Department of Family and Community Medicine, James A. Knight Chair of Humanities and Ethics in Medicine, Program in Medical Ethics and Human Values, Tulane University School of Medicine, 1430 Tulane Ave, #8033, New Orleans, LA, USA
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Gergelis KR, Anand US, Rian JS, Roberts KW, Quinones PJ, Olivier KR, Corbin KS, Stonnington CM. Integrating a Grassroots Well-Being Curriculum into a Radiation Oncology Residency Program. Adv Radiat Oncol 2021; 7:100837. [PMID: 34934867 PMCID: PMC8654639 DOI: 10.1016/j.adro.2021.100837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/30/2021] [Accepted: 10/07/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose The burnout rate among US radiation oncology residents was 33% in 2016. To our knowledge there are no published interventions addressing burnout among radiation oncology residents. We describe the implementation of a well-being curriculum, cocreated by a psychologist, a medical humanities professional, and radiation oncology attending and resident physicians. Methods and Materials Radiation oncology residents at our institution were surveyed to determine themes that induced burnout. A curriculum was developed, with monthly small group sessions focused on 1 identified topic. Sessions alternated between psychological tool-focused approaches and humanities exercises. These were led by a psychologist or medical humanities professional. Residents were given protected time to attend sessions during business hours. Participation was optional. Participants were assigned a random identifier, and the Stanford Professional Fulfillment Index (PFI) was assessed at baseline and 3-month intervals. PFI trends were analyzed after 1 year. At the end of the year, a focus group was held to evaluate work satisfaction and self-reported interactions with patients and coworkers. This information was used to improve the curriculum. Results All 12 residents in the radiation oncology program participated in the curriculum. There was an equal number of residents of postgraduate years 2 through 5. Six of the participants were female. Of the participants, 11 completed the PFI. At baseline, 80% of residents met criteria for burnout. This decreased to 67%, 50%, and 33% at 3, 6, and 9 months, respectively. The proportion of residents meeting criteria for very good professional fulfillment was 30%, 56%, 38%, and 22% at baseline and 3, 6, and 9 months, respectively. On average, 9 of 12 residents attended each session. Conclusions Our experience demonstrates the feasibility of collaborating with residents in the development of a well-being curriculum to cater programming to their needs, which we believe led to excellent engagement and attendance at each session.
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Affiliation(s)
| | - Uma S Anand
- Department of Student Services, Mayo Clinic, Rochester, Minnesota.,Academic and Staff Assistance Program, University of California Davis Health, Sacramento, California
| | - Johanna S Rian
- Dolores Jean Lavins Center for Humanities in Medicine, Mayo Clinic, Rochester, Minnesota
| | - Kristofer W Roberts
- Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.,Radiation Oncology Associates, Concord, New Hampshire
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Hessissen L, Patte C, Martelli H, Coze C, Howard SC, Kili A, Gagnepain-Lacheteau A, Harif M. African School of Pediatric Oncology Initiative: Implementation of a Pediatric Oncology Diploma Program to Address Critical Workforce Shortages in French-Speaking Africa. J Glob Oncol 2019; 5:1-12. [PMID: 31657980 PMCID: PMC6825251 DOI: 10.1200/jgo.19.00161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE In 2012, the French African Pediatric Oncology Group established the African School of Pediatric Oncology (EAOP), a training program supported by the Sanofi Espoir Foundation’s My Child Matters program. As part of the EAOP, the pediatric oncology training diploma is a 1-year intensive training program. We present this training and certification program as a model for subspecialty training for low- and middle-income countries. METHODS A 14-member committee of multidisciplinary experts finalized a curriculum patterned on the French model Diplôme Inter-Universitaire d’Oncologie Pédiatrique. The program trained per year 15 to 25 physician participants committed to returning to their home country to work at their parent institutions. Training included didactic lectures, both in person and online; an onsite practicum; and a research project. Evaluation included participant evaluation and feedback on the effectiveness and quality of training. RESULTS The first cohort began in October 2014, and by January 2019, 72 participants from three cohorts had been trained. Of the first 72 trainees from 19 French-speaking African countries, 55 (76%) graduated and returned to their countries of origin. Four new pediatric oncology units have been established in Niger, Benin, Central African Republic, and Gabon by the graduates. Sixty-six participants registered on the e-learning platform and continue their education through the EAOP Web site. CONCLUSION This training model rapidly increased the pool of qualified pediatric oncology professionals in French-speaking countries of Africa. It is feasible and scalable but requires sustained funding and ongoing mentoring of graduates to maximize its impact.
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Affiliation(s)
| | - Catherine Patte
- Institut Gustave Roussy, Villejuif, France.,Paris-Sud University, Orsay, France
| | - Helene Martelli
- Institut Gustave Roussy, Villejuif, France.,Paris-Sud University, Orsay, France
| | - Carole Coze
- Hôpital d'Enfants de La Timone, Marseille, France
| | - Scott C Howard
- University of Tennessee Health Science Center, Memphis, TN
| | | | | | - Mhamed Harif
- Ibn Rochd University Hospital, Casablanca, Morocco
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Butani L, Bogetz A, Plant J. Illuminating exemplary professionalism using appreciative inquiry dialogues between students and mentors. MEDICAL TEACHER 2019; 41:325-331. [PMID: 29801424 DOI: 10.1080/0142159x.2018.1472371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE To explore the types of exemplary professional behaviors and the facilitators and barriers to professional behavior discussed by student-mentor dyads during appreciative inquiry (AI) dialogs. MATERIALS AND METHODS We conducted a qualitative analysis of AI narratives discussing exemplary professional practice written by third-year medical students following a dialog with mentors. Narratives were thematically analyzed using directed content analysis to explore the types of exemplary professional behaviors discussed and the facilitators and barriers to professional practice. Narratives were coded independently by two investigators; codes were finalized, themes were derived, and a model on how exemplary professional behaviors are nurtured and reinforced was developed. RESULTS Themes addressed humanism toward others and excellence, with altruism being an underlying implicit guiding principle behind professional behavior. Humanism toward self was infrequently discussed as an aspect of professionalism, but when discussed, was perceived to foster resilience. Principle-based attitudes and emotional intelligence facilitated professional behaviors. Programmatic scaffolds facilitated professional behavior and included curricula on reflective practice, mentorship, promoting learner autonomy and connectedness, and a safe environment. CONCLUSIONS AI is an effective strategy that can be used to stimulate learner reflection on professionalism, humanism, and wellness and promote learner acknowledgement of positive aspects of the learning environment.
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Affiliation(s)
- Lavjay Butani
- a Department of Pediatrics , University of California Davis , Sacramento , CA , USA
| | - Alyssa Bogetz
- b Department of Pediatrics , Stanford University School of Medicine , Stanford , CA , USA
| | - Jennifer Plant
- a Department of Pediatrics , University of California Davis , Sacramento , CA , USA
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Whitford B, Nadel AL, Fish JD. Burnout in pediatric hematology/oncology-time to address the elephant by name. Pediatr Blood Cancer 2018; 65:e27244. [PMID: 29797652 DOI: 10.1002/pbc.27244] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 04/13/2018] [Accepted: 04/23/2018] [Indexed: 11/10/2022]
Abstract
The last decade has brought increasing recognition that the wellness of health care providers has an impact on the quality of care, patient satisfaction, and health care economics. This review will describe models of burnout, discuss the impact of burnout on medicine with a focus on pediatric hematologists/oncologists, and present interventions that may help ameliorate physician burnout.
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Affiliation(s)
- Brittney Whitford
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Cohen Children's Medical Center, New Hyde Park, New York
| | - Amy L Nadel
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Cohen Children's Medical Center, New Hyde Park, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
| | - Jonathan D Fish
- Division of Pediatric Hematology/Oncology and Stem Cell Transplantation, Cohen Children's Medical Center, New Hyde Park, New York.,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York
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Kesselheim JC, Agrawal AK, Bhatia N, Cronin A, Jubran R, Kent P, Kersun L, Rao AN, Rose M, Savelli S, Sharma M, Shereck E, Twist CJ, Wang M. Measuring pediatric hematology-oncology fellows' skills in humanism and professionalism: A novel assessment instrument. Pediatr Blood Cancer 2017; 64. [PMID: 27808467 DOI: 10.1002/pbc.26316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 09/19/2016] [Accepted: 09/21/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Educators in pediatric hematology-oncology lack rigorously developed instruments to assess fellows' skills in humanism and professionalism. PROCEDURE We developed a novel 15-item self-assessment instrument to address this gap in fellowship training. Fellows (N = 122) were asked to assess their skills in five domains: balancing competing demands of fellowship, caring for the dying patient, confronting depression and burnout, responding to challenging relationships with patients, and practicing humanistic medicine. An expert focus group predefined threshold scores on the instrument that could be used as a cutoff to identify fellows who need support. Reliability and feasibility were assessed and concurrent validity was measured using three established instruments: Maslach Burnout Inventory (MBI), Flourishing Scale (FS), and Jefferson Scale of Physician Empathy (JSPE). RESULTS For 90 participating fellows (74%), the self-assessment proved feasible to administer and had high internal consistency reliability (Cronbach's α = 0.81). It was moderately correlated with the FS and MBI (Pearson's r = 0.41 and 0.4, respectively) and weakly correlated with the JSPE (Pearson's r = 0.15). Twenty-eight fellows (31%) were identified as needing support. The self-assessment had a sensitivity of 50% (95% confidence interval [CI]: 31-69) and a specificity of 77% (95% CI: 65-87) for identifying fellows who scored poorly on at least one of the three established scales. CONCLUSIONS We developed a novel assessment instrument for use in pediatric fellowship training. The new scale proved feasible and demonstrated internal consistency reliability. Its moderate correlation with other established instruments shows that the novel assessment instrument provides unique, nonredundant information as compared to existing scales.
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Affiliation(s)
- Jennifer C Kesselheim
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts
| | - Anurag K Agrawal
- Children's Hospital and Research Center Oakland, Oakland, California
| | - Nita Bhatia
- Department of Psychological and Brain Sciences, University of Iowa.,Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Angel Cronin
- Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Rima Jubran
- Children's Hospital of Los Angeles, Los Angeles, California
| | - Paul Kent
- Rush University Medical Center, Chicago, Illinois
| | - Leslie Kersun
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | | | - Mukta Sharma
- Children's Mercy Hospital, Kansas City, Missouri
| | - Evan Shereck
- Doernbecker Children's Hospital, Oregon Health Sciences University, Portland, Oregon
| | - Clare J Twist
- Lucile Packard Children's Hospital at Stanford University, Palo Alto, California
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Feraco AM, Brand SR, Mack JW, Kesselheim JC, Block SD, Wolfe J. Communication Skills Training in Pediatric Oncology: Moving Beyond Role Modeling. Pediatr Blood Cancer 2016; 63:966-72. [PMID: 26822066 PMCID: PMC5861499 DOI: 10.1002/pbc.25918] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 12/21/2015] [Accepted: 01/03/2016] [Indexed: 11/09/2022]
Abstract
Communication is central to pediatric oncology care. Pediatric oncologists disclose life-threatening diagnoses, explain complicated treatment options, and endeavor to give honest prognoses, to maintain hope, to describe treatment complications, and to support families in difficult circumstances ranging from loss of function and fertility to treatment-related or disease-related death. However, parents, patients, and providers report substantial communication deficits. Poor communication outcomes may stem, in part, from insufficient communication skills training, overreliance on role modeling, and failure to utilize best practices. This review summarizes evidence for existing methods to enhance communication skills and calls for revitalizing communication skills training within pediatric oncology.
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Affiliation(s)
- Angela M. Feraco
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Department of Medicine, Boston Children’s Hospital, Boston, MA,Ariadne Labs, Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston MA
| | - Sarah R. Brand
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
| | - Jennifer W. Mack
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Department of Medicine, Boston Children’s Hospital, Boston, MA,Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Jennifer C. Kesselheim
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA,Department of Medicine, Boston Children’s Hospital, Boston, MA,Center for Population Sciences, Dana-Farber Cancer Institute, Boston, MA
| | - Susan D. Block
- Ariadne Labs, Brigham and Women’s Hospital and Harvard T.H. Chan School of Public Health, Boston MA,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA,Departments of Psychiatry and Medicine, Brigham and Women’s Hospital,Harvard Medical School Center for Palliative Care
| | - Joanne Wolfe
- Department of Medicine, Boston Children’s Hospital, Boston, MA,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA
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