Cancer Rehabilitation Education During Physical Medicine and Rehabilitation Residency

Abstract

Although cancer rehabilitation is considered an important area of education, quality and quantity of experiences may be improved. Several opportunities may exist to improve such exposure in anticipation of serving the functional needs for a growing population of cancer survivors.

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

“…It is clear that cancer rehabilitation and palliative care play independent and important roles in the treatment of the complex cancer patient, but better collaboration between these two specialties is needed. However, barriers may include, but are not limited to, rehabilitation professionals' real or perceived lack of experience with medically complex cancer patients who may have a high symptom burden that may include end of life situations [45,46]. On the other hand, oncology professionals, including those in palliative care, may not understand the many different ways rehabilitation medicine can help these patients and/or they may not have experience in screening these patients for their rehabilitation needs [30].…”

“…For example, physicians and medical students have expressed deficiencies in palliative care training and communication skills and concerns also exist regarding the variable approach to training across medical schools [83]. Although cancer rehabilitation is considered an important part of physical medicine and rehabilitation (PM&R) residency education, research has demonstrated that the quality and quantity of experiences may be improved [45]. Furthermore, variability exists regarding perceived appropriateness of rehabilitation for individuals with advanced cancer by both medical oncologists and physiatrists [84].…”

“…The IOM is currently recommending that clinicians across almost all specialties be trained in person-centered communication skills-a key foundation of palliative care-as well as Binterprofessional collaboration, and symptom management^ [66]. Perhaps equally concerning is that patients and families too lack understanding of palliative care services [45], and a concerted effort must be made to educate them about available resources and give them the words to use to get the care they need. Patients and survivors experience reduced health-related QOL as a result of impairments, and rehabilitation can improve physical, psychological, and cognitive impairments throughout the trajectory of cancer care [1].…”

Toward a National Initiative in Cancer Rehabilitation: Recommendations From a Subject Matter Expert Group

“…The genesis of ad hoc program development may be a result of the current curricula deficits and the dearth of medical residencies dedicated to this field. 113 Rehabilitation integration is also challenged by the lack of screening and triage procedures to identify patients at the highest risk for functional decline or those with early functional impairment. Baseline measures of function are not routinely captured in current oncology practice, 39 and critical thresholds for risk stratification and meaningful clinical change are ill defined, resulting in a wide variation of rehabilitation referral patterns.…”

“…Efforts are underway to improve cancer rehabilitation education and to elevate the knowledge and skills requisite of a specialty workforce. 113,122 Screening and triage procedures must be developed to enhance care delivery to the patients most at risk for functional decline and most in need of rehabilitative services. 4,39 Finally, active patient engagement in the treatment planning process that emphasizes shared decision-making and fosters survivors' self-determination and autonomy is needed.…”