An assessment of the current state of palliative care education in pediatric hematology/oncology fellowship training

Background. Despite improved survival rates for pediatric oncology patients, childhood cancers continue to be the number one cause of non-accidental death in children. Studies show that many children receiving end-of-life care, and their families, believe that physicians can improve significantly in the delivery of palliative care. This has led to the recommendation that increased palliative care training for physicians taking care of terminally ill pediatric patients is needed. Procedure. We designed a 28-question survey and sent it via electronic mail to all 66 pediatric oncology fellowship program directors in the United States. The questionnaire assessed fellowship training programs' current practice in educating pediatric oncology fellows on palliative care. Results. Thirty-six pediatric oncology program directors responded to the survey for a 55% response rate. Ninety-four percent of all respondents reported that it is very important or extremely important for pediatric oncology fellows to learn about palliative care during their training. Seventy-one percent of fellowship training programs do not currently have a palliative care curriculum, and less than one-third of training programs have any evidence-based journal clubs devoted to palliative care issues. Eighty-eight percent of program directors believe their program will increase palliative care education for their fellows within 5 years. Conclusions. Pediatric oncology fellowship directors believe it is very important for fellows to learn about palliative care during training; however, currently the majority of fellowship programs do not have a palliative care curriculum and lack significant formal education in end-of-life care.