Beyond the Incision: A Palliative Care Curriculum for General Surgery Residents

Surgical palliative care (PC) is an essential component of comprehensive, high quality surgical care. Formalized surgical PC education is absent despite a call to action by the American College of Surgeons. We aimed to assess the PC educational needs of general surgery residents and to implement a resident-led surgical palliative care curriculum.

A needs and knowledge assessment was performed with general surgery residents from a single program at an academic tertiary care health center. In response to this evaluation, a resident-led curriculum was then created and implemented in collaboration with the PC department. The 6-month curriculum included monthly sessions comprised of lectures and interactive small group sessions on PC topics.

A total n = 97 resident surveys were included in this study. Of the total 77 residents in the program, a 74% (n = 57) response rate was obtained for the initial needs and knowledge-based assessment. A 52% (n = 40) response rate was obtained for the postcurriculum assessment. Most respondents (54%) lacked previous formal PC training. Most respondents (77%) had participated in PC conferences with patients or family members with many respondents (46%) acting as the primary surgical liaison. Most respondents (84%) were interested in a formal PC curriculum. After completion of our educational palliative care curriculum, there were statistically significantly increased rates of interest in ongoing palliative care education as well as more substantial resident participation in goals of care meetings (p < 0.05). Residents' comfort level with palliative care skills also improved after completion of the palliative care curriculum (p < 0.05).

With the help of interprofessional collaborators from the palliative care department, we developed and implemented a novel curriculum to address the self-reported resident lack of comfort with and formal training in palliative care. We demonstrated that a resident-led surgical PC curriculum helps general surgery residents participate more confidently in providing PC and improves communication, compassion, and engagement with patients and families. With careful planning and implementation, formal surgical PC training can and should be successfully integrated into general surgery residency education.