Assessing palliative care education and attitudes among radiation oncology residents

Palliative care (PC) plays a vital role in radiation oncology (RO), but the breadth, quality, and effectiveness of formal PC education and radiation-specific palliative care (RSPC) during residency vary widely. A better understanding of how RO residents view their current training and where they see room for improvement can help guide future educational efforts. The study aims to evaluate RO residents' experiences with and attitudes toward PC and RSPC education, identify perceived gaps in training, gather suggestions for important topics, and determine preferred ways to optimally incorporate PC teaching into the existing resident schedule framework.

From January through May 2025, a national cross-sectional survey was sent to 552 PGY-3 to PGY-5 U.S. RO residents using a REDCap-based online platform. The anonymous survey collected demographic information and inquired about the adequacy of current PC education, areas of additional instruction, and preferred learning formats and scheduling. Quantitative data were summarized descriptively, and mapped to the corresponding structured categories where relevant.

A total of 110 responses were received (response rate 19.9%). Most respondents identified as White (60.9%) and male (65.4%) from programs with 5-9 (40.7%) or 10-14 (35.2%) residents. While 89.0% reported access to a dedicated PC specialist, only 27.5% reported access to an RSPC specialist. Nearly all respondents supported the need for formal training in RSPC (96.0%) and general PC (84.2%). Although 45.5% reported faculty-led instruction in PC or RSPC, 15.8% indicated receiving no formal training in either area. Topics of greatest interest included symptom management, hospice care, ethical issues for PC, spinal stereotactic body radiation therapy (SBRT), and on-call management for RSPC. Residents preferred case-based, quarterly modules lasting 30-60 minutes as the most feasible educational format.

RO residents widely recognize the importance of structured PC and RSPC training but report significant variability in current educational offerings. Programs may enhance preparedness and patient care by integrating concise, case-based, and specialty-relevant PC content into existing curricula. These findings highlight the need for standardized national efforts to strengthen PC education within RO training.