San Diego, CA—With an estimated 15.5 million cancer survivors living in the United States, there is an increased recognition of the need for continuing education of healthcare providers focused on this growing population.
“Survivors are at greater risk for a variety of issues caused by cancer and its treatment, including long-term and late effects. In recent years, there has been an increased focus on ensuring coordinated care for survivors, but education of health professionals is critical to tackling these issues,” said Allison Harvey, MPH, CHES, Senior Manager, Health Care Professional Education, George Washington University Cancer Center, Washington, DC.
According to data presented at the 2017 Cancer Survivorship Symposium, eLearning technology may help address gaps in provider education. Preliminary outcomes among primary care and oncology providers who participated in the Cancer Survivorship E-Learning Series for Primary Care Providers demonstrated significant improvements in knowledge.
Launched in 2013, the E-Learning Series is part of the National Cancer Survivorship Resource Center, a collaboration between the American Cancer Society, the George Washington University Cancer Center, and the Centers for Disease Control and Prevention. Although originally developed for primary care providers, a number of different healthcare professionals have participated in the online educational program, said Ms Harvey, who noted that free continuing education credits are available.
The series consists of 10 modules, with each module lasting approximately 1 hour. The first 6 modules cover broad topics, including the current state of survivorship care, the role of primary care providers, psychosocial health, rehabilitation, prevention, and care coordination. The latter 4 modules are disease-specific, addressing the needs of survivors for prostate, colorectal, breast, and head and neck cancers.
“Within each module, we offer presentations from national experts. There are also audio interviews with survivors so that providers can connect with patients and get their perspective. Finally, we include a pre- and postassessment,” said Ms Harvey.
Of the 730 professionals who participated in the program, 593 were oncology care providers and 137 were primary care providers. The overwhelming majority (79%) of oncology providers were advanced practice nurses, whereas primary care providers were more evenly split between physicians and nurses (36% vs 45%, respectively).
Positive learning gains were seen among primary care and oncology care providers, and for most learning objectives, primary care and oncology care providers had equivalent gains from pre- to postassessment.
However, as Ms Harvey reported, primary care providers had “higher gains in confidence in being able to describe common, late effects after treatment compared with oncology providers” (P <.001). Oncology care providers, on the other hand, had a significant increase in confidence in being able to describe the roles of primary care providers involved in survivorship care.
“Results indicate that the E-Learning Series is effective in improving providers’ self-efficacy around meeting the needs of survivors and engaging in recommended care practices. There is a need for continued dissemination among providers, particularly those in primary care,” said Ms Harvey.
Are eTools Enough?
In discussing this abstract, Tara O. Henderson, MD, MPH, Associate Professor of Pediatrics, and Director, Childhood Cancer Survivor Center, University of Chicago, IL, highlighted recent research that suggests primary care physicians and oncologists have “very different perceptions about their knowledge of survivorship care,” with primary care physicians feeling less confident than oncologists.
Moreover, when Dr Henderson and colleagues tested this knowledge via a survey, only 5% of general internists and 2% of family physicians were concordant with long-term follow-up guidelines for survivors of childhood cancer. Whereas pediatric oncologists performed better, only one-third were concordant with the guidelines.
“This shows there are still significant gaps in providers’ knowledge of taking care of these patients. Even oncology providers have a lot of work left to understand some of these long-term effect issues,” said Dr Henderson.
Although the early data suggest that the eTools for oncology and primary care providers can be successful, more approaches are needed.
“Medical student, graduate medical education, and CME curriculum really need to be in place across the board in North America. This learning is critical for taking care of the growing population of cancer survivors,” added Dr Henderson.
Communication among providers also needs to improve, she added. In 1 survey, general internists reported receiving a treatment summary or letter from oncologists <15% of the time.
“Finally, we need to think about dissemination strategies. We might be able to show that these tools are effective in research, but unless we can disseminate them, they’re not useful for all our patients,” said Dr Henderson.
To help promote dissemination, Ms Harvey recommended that the audience go to the following websites for more information: