Palliative Care Training During Surgical Critical Care Fellowship: A Preliminary Needs Assessment at a Major Academic Center

Am Surg. 2024 Jun;90(6):1791-1793. doi: 10.1177/00031348241241619. Epub 2024 Mar 20.

Abstract

Surgical palliative care (PC) facilitates communication between surgeons and patients/family about prognosis, symptom control, and therapeutic goals. Surgical critical care (SCC) fellows are at the forefront of the intensive care team; thus, we aim to assess previous and ongoing experiences in delivering PC by surveying fellows at a large academic center. Seventeen surveys were completed in which 59% of fellows reported no previous PC education. Six fellows (35%) reported participating in goals of care/end-of-life (GOC/EOL) discussions "a few times a year" during residency, while 41% responded the same for transitioning patients to comfort-focused care (CFC). When asked if respondents felt comfortable facilitating GOC/EOL discussions prior to fellowship, 7 (41%) answered "disagree" or "strongly disagree." Most fellows reported that more training in navigating GOC/EOL discussions (88%) and transitioning patients to CFC (76%) is needed. This assessment demonstrates variability in fellows' prior PC exposure and a strong desire for more structured training.

Keywords: communication; fellowship; goals of care; surgical critical care; surgical palliative care.

MeSH terms

  • Academic Medical Centers*
  • Acute Care Surgery
  • Critical Care*
  • Education, Medical, Graduate / methods
  • Fellowships and Scholarships*
  • Female
  • General Surgery / education
  • Humans
  • Internship and Residency
  • Male
  • Needs Assessment*
  • Palliative Care*
  • Surveys and Questionnaires