Palliative care education in surgery

Abstract: Though incorporating palliative care principles with standard medical and surgical care has been associated with multiple benefits, surgical training devotes far less time to developing skills within the palliative care domains. In this review, we sought to explore the existing literature concerning palliative care education within the context of surgical training. Current studies may be categorized under two major areas: (I) measurement of trainee exposure through needs assessments and (II) implementation of novel palliative care-based training curricula. Within the former group, a number of studies found surgical trainees having substantial exposure to seriously-ill and dying patients, yet the application of palliative care approaches was informed by informal, on-the-job experiences. Further, a number of studies found that a minority of trainees had previously been involved in some type of formalized palliative care training, and among those who did, the majority reported the quality of this training to be inferior relative to the quality of training of clinical or technical skills. Among the latter group of studies examining palliative care training curricula, multiple studies demonstrated that trainees improved significantly post-intervention with respect to palliative care skills, knowledge, attitudes, and comfort. In addition, trainees regarded palliative care skills as important for surgeons, and supported adoption of palliative care curricula within surgical training. Finally, though multiple palliative care resources currently exist for practicing surgeons and surgical trainees, most of these opportunities are optional and must be sought out by the individual surgeon. Consequently, in an effort to standardize palliative care in conjunction with surgical care, widespread adoption of palliative care curricula during residency training may prove to be most beneficial.