The present paper is a longitudinal study which aims to develop and deliver cancer nursing education conferences in Honduras using volunteer nurse educators. This program intends to (1) perform site assessments of work environments and resources for cancer care in Honduras, (2) develop cancer nursing education programs, (3) survey conference participants continuing education needs, (4) deliver cancer nursing education conferences, and (5) share data with local and global partners for future cancer programs. The study draws on a longitudinal program development with site assessments, data collection, and educational conferences at two time points. Assessments and surveys were used for conference development and delivery by volunteer nurse educators. Site assessments and conferences were delivered twice. Data were collected regarding assessments and surveys to inform program development. Survey data revealed that <4 % had formal training in cancer care and >65 % had internet access. Participants desired more information about handling of chemotherapy, symptom management, and palliative care. Volunteer nurse educators perform site assessments and develop educational programming for cancer nurses. Local and global partners should explore internet-based programs between site visits to create sustainable education programs.
According to the GLOBOCAN 2012 data released by the International Agency for Research on Cancer, an estimated 14.1 million new cancer cases and 8.2 million cancer deaths occurred worldwide in 2012. This is an immense increase compared with 2008 statistics, which reported 12.7 and 7.6 million new cases and deaths, respectively. 1 Low-and low-middle-income countries accounted for more than half of the new cancer cases and nearly two thirds of all cancerrelated deaths. The social and economic disparities in cancer prevention and treatment present a disproportionate burden in these low-resource settings. Honduras is a low-middle-income country with a total population of 8.3 million. Cancer accounts for 13% of deaths each year. The most common cancers reported are prostate, gastric, cervix, liver, and breast. The mortality rates from cervix and gastric cancers are among the highest globally, at 18.5 and 8.8%, respectively. 2,3 There are 24 surgical, eight gynecologic, 13 medical, and four radiation oncologists in Honduras. Hospital General San Felipe (HGSF) is the only public cancer hospital in Honduras that treats underserved patients. Currently, there is only one surgical oncology training program in Honduras. During the 4-year curriculum, residents are taught to provide surgical care for men and women with a wide spectrum of malignancies.Efforts to improve the education and training of residents in surgery and oncology in countries with limited specialists have been growing in the last decade. Medical volunteerism in such countries has become an area of interest for medical students, residents, fellows, and attending physicians from outside of the affected countries, and there are a number of models for providing this assistance. Barriers to successful exchanges between volunteers and in-country physicians include time constraints of the volunteers and infrastructure deficits in low-resource settings that prohibit optimal learning environments. Increasingly, a combination of short-term, hands-on teaching sessions coupled with ongoing Internet-based instruction by volunteers at a distance has emerged as a successful model for supporting incountry physicians to provide increasingly sophisticated medical and surgical care within the limits of available resources. For example, a successful program of surgical training to perform radical hysterectomies in patients with cervical cancer has been implemented in Kenya through collaboration with the Society of Gynaecologic Oncology of Canada. 4 The 2-week intensive program, which is staffed by one expert Canadian surgeon, included seven video didactics, a pre-and post-test, and seven live surgical sessions with oral and written feedback after each patient case. Short-term follow-up revealed four successful radical hysterectomies by the Kenyan surgeons after the Canadian trainer had left. Similarly, the Central America Gynecologic Oncology Education Program, an initiative that is focused on the education and training of obstetrics and gynecology residents in the prevention an...
PURPOSE Delivering high-quality cancer care to patients through a multidisciplinary team (MDT) care approach remains a challenge, particularly in low- and middle-income countries characterized by fragmented health systems and limited human resources for cancer care. City Cancer Challenge (C/Can) is supporting cities in low- and middle-income countries as they work to improve access to equitable quality cancer care. C/Can has developed an innovative methodology to address the MDT gap, piloted in four cities—Asunciòn, Cali, Kumasi, and Yangon. METHODS Collaborating with a network of partners, C/Can and ASCO have developed a package of technical cooperation support focusing on two priority areas that have emerged as core needs: first developing consensus-based, city-wide patient management guidelines for the most common cancers and second, building capacity for the implementation of MDTs in institutions providing cancer care in the city. RESULTS The real-time application of C/Can's MDT approach in Cali and Asuncion underlined the importance of engaging the right stakeholders early on and embedding MDT guidelines in local and national regulatory frameworks to achieve their sustainable uptake. The results in Cali and Asuncion were essential for informing the process in Yangon, asserting the clear benefits of city-to-city knowledge exchange. Finally, the global COVID-19 pandemic prompted a rapid adaptation of the methodology from an in-person to virtual format; the unexpected success of the virtual program in Kumasi has led to its application in subsequent C/Can cities. CONCLUSION The application of C/Can's methodology in this first set of cities has reinforced not only the importance of both resource appropriate guidelines and a highly trained health workforce but also the need for commitment to work across institutions and disciplines.
Cervical cancer is the leading cause of death among women in Nepal. The American Society of Clinical Oncology (ASCO) and The University of Texas MD Anderson Cancer Center collaborated with international and local experts to hold a cervical cancer prevention course in Nepal in November 2019. The course included didactic lectures and a hands-on workshop. The didactic lectures included the epidemiology of cervical cancer globally and locally, cervical cancer screening guidelines, human papillomavirus vaccination, colposcopy and visual inspection with acetic acid (VIA), cervical dysplasia, and cervical cancer treatment. The hands-on workshop consisted of four stations: (1) VIA; (2) colposcopy, cervical biopsy, and endocervical curettage; (3) thermal ablation; and (4) loop electrosurgical excision procedure (LEEP). A train-the-trainer model short course was held by the international faculty to assist six local faculty to become familiar with the instruments, procedures, and models used in the hands-on training stations. Forty-two people (84% gynecologist, 8% radiation oncologist, and 8% other) attended the course. Following the course, the international faculty visited the regional hospitals for additional educational activities. Increased knowledge in cervical cancer screening guidelines and ability in performing VIA, colposcopy and cervical biopsy, thermal ablation, and LEEP were reported by 89%, 84%, 84%, 87%, and 84% of participants, respectively, from the postcourse on-site evaluations. From the 6-month follow-up survey, all respondents reported that they had made practice changes based on what they learned in the course and had implemented or tried to implement the cervical cancer screening guidelines presented at the course. In conclusion, the course evaluations suggested an improvement in participants' ability to perform cervical cancer screening and diagnostic procedures and reported the changes in practices after training.
PURPOSE Palliative care in Sarawak is mainly provided by health care professionals with limited formal training in palliative care. Therefore, in 2020, collaborative work between Sarawak General Hospital, University Malaysia Sarawak, and ASCO began. This study reports on the outcome of this collaboration. METHODS The collaboration was initiated with the first ASCO Palliative Care e-course, Train the Trainer program, International Development and Education Award—Palliative Care and translation of ASCO Palliative Care Interdisciplinary Curriculum resources. RESULTS This collaboration has resulted in the change of practice of palliative care among the oncology team of Sarawak General Hospital. CONCLUSION It encourages more timely palliative care referrals to ensure that patients with complex physical, psychosocial, and spiritual needs have the necessary input and support from the palliative care team throughout the course of patients’ illnesses.
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