Palliative Care Education in Gynecologic Oncology: a Survey of Gynecologic Oncologists and Gynecologic Oncology Fellows in Thailand

Background: The main purpose of this study was to survey the education and training of certified gynecologiconcologists and fellows in Thailand. A secondary objective was to study the problems in fellowship trainingregarding palliative care for gynecologic cancer patients. Materials and
Methods: A descriptive study wasconducted by sending a questionnaire regarding palliative care education to all certified gynecologic oncologistsand gynecologic oncology fellows in Thailand. The contents of the survey included fellowship training experience,caring for the dying, patient preparation, attitudes and respondent characteristics. Statistics were analyzed bypercentage, mean and standard deviation and chi-square.
Results: One hundred seventy completed questionnaireswere returned; the response rate was 66%. Most certified gynecologic oncologists and fellows in gynecologiconcology have a positive attitude towards palliative care education, and agree that “psychological distress canresult in severe physical suffering”. It was found that the curriculum of gynecologic oncology fellowship trainingequally emphasizes three aspects, namely managing post-operative complications, managing a patient at the endof life and managing a patient with gynecologic oncology. As for experiential training during the fellowship ofgynecologic oncology, education regarding breaking bad news, discussion about goals of care and proceduresfor symptoms control were mostly on-the-job training without explicit teaching. In addition, only 42.9 % ofrespondents were explicitly taught the coping skill for managing their own stress when caring for palliativepatients during fellowship training. Most of respondents rated their clinical competency for palliative care inthe “moderately well prepared” level, and the lowest score of the competency was the issue of spiritual care.
Conclusions: Almost all certified gynecologic oncologists and fellows in gynecologic oncology have a positiveattitude towards learning and teaching in palliative care. In this study, some issues were identified for improvingpalliative care education such as proper training under the supervision of a mentor, teaching how to deal withwork stress, competency in spiritual care and attitudes on responsibility for bereavement care.