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Are trainees working in obstetrics and gynecology confident and competent in the care of frail gynecological oncology patients?
- Source :
- Audit and Research in Gynaecological Oncology (ARGO) Collaborative 2020, ' Are trainees working in obstetrics and gynecology confident and competent in the care of frail gynecological oncology patients? ', International journal of gynecological cancer : official journal of the International Gynecological Cancer Society, vol. 30, no. 12, pp. 1959-1965 . https://doi.org/10.1136/ijgc-2020-001834
- Publication Year :
- 2020
-
Abstract
- IntroductionOlder patients undergoing cancer surgery are at increased risk of post-operative complications, prolonged hospital stay, and mortality. Identification of frailty can help predict patients at high risk of peri-operative complications and allow a collaborative, multidisciplinary team approach to their care. A survey was conducted to assess the confidence and knowledge of trainees in obstetrics and gynecology regarding identification and management of peri-operative issues encountered in frail gynecological oncology patients.MethodsA web-based survey was distributed via the Audit and Research in Gynaecological Oncology (ARGO) collaborative and UK Audit and Research Collaborative in Obstetrics and Gynaecology (UKARCOG) . The survey on the management of frail peri-operative patients was disseminated to doctors-in-training (trainees) working in obstetrics and gynecology in the United Kingdom (UK) and Ireland. Specialty (ST1–7), subspecialty, and general practice trainees, non-training grade doctors, and foundation year doctors currently working in obstetrics and gynecology were eligible. Consultants were excluded. Study data were collected using REDCAP software hosted at the University of Manchester. Responses were collected over a 6-week period between January and February 2020.ResultsOf the 666 trainees who participated, 67% (425/666) reported inadequate training in peri-operative management of frail patients. Validated frailty assessment tools were used by only 9% (59/638) of trainees and less than 1% (4/613) were able to correctly identify all the diagnostic features of frailty. Common misconceptions included the use of chronological age and gender in frailty assessments. The majority of trainees (76.5%, 448/586) correctly answered a series of questions relating to mental capacity; however, only 6% (36/606) were able to correctly identify all three diagnostic features of delirium. A total of 87% (495/571) of trainees supported closer collaboration with geriatricians and a multidisciplinary approach.ConclusionsObstetrics and gynecology trainees reported inadequate training in the peri-operative care of frail gynecological oncology patients, and overwhelmingly favored input from geriatricians. Routine use of validated frailty assessment tools may aid diagnosis of frailty in the peri-operative setting. There is an unmet need for formal education in the management of frail surgical patients within the UK and Irish obstetrics and gynecology curriculum.
- Subjects :
- medicine.medical_specialty
Students, Medical
Genital Neoplasms, Female
Frail Elderly
Specialty
Audit
Subspecialty
Medical Oncology
03 medical and health sciences
surgical oncology
0302 clinical medicine
Obstetrics and gynaecology
Multidisciplinary approach
Surveys and Questionnaires
Medicine
Humans
030212 general & internal medicine
Curriculum
Aged
Aged, 80 and over
Gynecological oncology
Internet
Manchester Cancer Research Centre
business.industry
ResearchInstitutes_Networks_Beacons/mcrc
gynecology
Obstetrics and Gynecology
postoperative care
Self Concept
United Kingdom
Obstetrics
Oncology
Education, Medical, Graduate
Geriatrics
Gynecology
030220 oncology & carcinogenesis
Family medicine
Delirium
Female
Clinical Competence
medicine.symptom
business
Ireland
Subjects
Details
- ISSN :
- 15251438
- Volume :
- 30
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
- Accession number :
- edsair.doi.dedup.....894b06f54215356cec7a9fe7bfb40c7d