The current state of surgical palliative care education: an APDS survey from the Education Committee of the Surgical Palliative Care Society

Formal primary surgical palliative care education in the United States is lacking. We aimed to assess curricula and surgical program directors’ (PDs) attitudes toward instituting formal educational programs. Results will be able to guide future efforts to create and standardize educational materials to meet the needs of surgical training programs.

An anonymized 15-item survey was developed by the SPCS Education Committee and electronically distributed to PDs at 282 general surgery residency programs through the Association of Program Directors in Surgery (APDS) in June 2023.

Forty-three PDs completed the questionnaire (15% response rate). Sixty-seven percent reported providing dedicated instruction time for communication skills with seriously ill patients. Most (76%) reported using didactics format, while 48% utilized simulation-based instruction, 35% dedicated time to clinical instruction in the ICU and 14% of programs utilized routine rounding to offer opportunities to teach communication skills. Use of materials created by educators within the institution was most common (69%), followed by SCORE materials (45%) and other established communication tools (7%). 37 (86%) respondents supported the use of standardized education materials if they were to be provided, including resources regarding end-of-life care (65%), decision-making capacity and the care and role of surrogate decision-makers (56%), code status documentation (49%), and ethics of medicalized death (65%).

Surgical residencies provide variable levels of formal education and utilize different tools and resources to teach primary palliative care and advanced communication skills. While a national standardized formal curriculum does not currently exist, many surgical PDs display positive attitudes toward adopting such materials if made available.