From Pathophys to Prognosis: Teaching Oncology Concepts to Elevate Interdisciplinary Palliative Care

Key Message: This interdisciplinary oncology curriculum for specialty palliative care professionals addresses critical knowledge gaps through evidence-informed design and active learning. By enhancing oncologic fluency across disciplines, the curriculum promotes meaningful collaboration with oncology teams and offers a replicable model for advancing integrated, team-based care in complex cancer populations.

Abstract:

Background: Integrating specialty palliative care (SPC) with oncology improves outcomes for patients with advanced cancer.(1) Yet, oncologists express concerns that SPC professionals may lack familiarity with evolving oncologic therapies and their impact on prognosis and decision making.(2) While one workshop at the AAHPM Annual Assembly addresses this gap, no formal curricula currently exist.(3)

Objective: To design, implement, and evaluate an interdisciplinary oncology curriculum for SPC health science professionals (HSPs) at a single institution to enhance knowledge and collaboration in caring for patients with advanced solid-tumor malignancies.

Methods: A targeted needs assessment was conducted with oncologists and palliative care physicians to inform curriculum content. The curriculum comprised of five synchronous, virtual sessions delivered over five months, with electronic flashcards for session preparation/review. Sessions incorporated active learning strategies and were grounded in the principles of Andragogy and Self-Determination Theory, emphasizing learner autonomy, relevance, and intrinsic motivation.(4,5) Medical oncologists reviewed the curriculum and participated in the sessions. A paired pre/post survey assessed knowledge (via multiple-choice) and attitudes (via 5-point Likert scale); only physicians, APPs, and pharmacists received knowledge questions.

Results: Four medical oncologists and 4 SPC physicians participated in the needs assessment that identified key topics including terminology, therapeutics and disease trajectories for common advanced solid-tumor cancers. Of 79 invited SPC HSPs across nine sites, 51 participated in the curriculum: 17 APPs, 26 physicians, 1 pharmacist, 7 social workers, and 1 chaplain. Of those asked knowledge questions, mean scores improved from 53.9% (SD 13.6) to 67.8% (SD 13.1), p < 0.001. Confidence increased from 2.7 (0.8) to 3.5 (0.5), p < 0.001. Perceived importance of this education remained high (pre 4.2 [0.6], post 4.1 [0.8], p = 0.609).

Conclusion: This interdisciplinary oncology curriculum improved knowledge and confidence among SPC HSPs and may serve as a scalable model to strengthen SPC-Oncology collaboration.

References: 1.    Zimmermann C, Swami N, Krzyzanowska M, et al. Early palliative care for patients with advanced cancer: a cluster-randomised controlled trial. Lancet. 2014;383(9930):1721-1730. doi:10.1016/S0140-6736(13)62416-2
2.    Kruser TJ, Kruser JM, Gross JP, et al. Medical oncologist perspectives on palliative care reveal physician-centered barriers to early integration. Ann Palliat Med. 2020;9(5):2800-2808. doi:10.21037/apm-20-270
3.    Newport K, Sivendran S, Leblanc TW, Jones JA. Oncologist in my pocket: what the palliative clinician needs to know about hematology, oncology and radiation oncology. J Pain Symptom Manage. 2024;67(5):e509. doi:10.1016/j.jpainsymman.2024.02.267
4.    Lemov D. Teach Like a Champion 3.0: 63 Techniques That Put Students on the Path to College. 3rd ed. Jossey-Bass; 2021:560.
5.    Orsini C, Evans P, Jerez O. How to encourage intrinsic motivation in the clinical teaching environment?: a systematic review from the self-determination theory. J Educ Eval Health Prof. 2015;12:8. doi:10.3352/jeehp.2015.12.8