Educational interventions for training oncology residents in palliative medicine: a rapid review of the available evidence to inform training standards in cancer care
摘要
Integrating palliative care into routine cancer care improves quality of life, communication, symptom control, and decision-making. Despite strong international recommendations, training in palliative and supportive care for oncology residents remains heterogeneous, and limited evidence informs how required competencies are best developed in clinical practice.
ObjectivesTo synthesise the available evidence on educational interventions aimed at developing palliative and supportive care competencies among oncology residents, in order to inform training approaches relevant to contemporary cancer care, including the development of harmonised recommendations in Europe.
MethodsA rapid review was conducted following PRISMA principles. PubMed was searched (2000–2025) for studies evaluating educational interventions designed to improve palliative care competencies in postgraduate medical trainees involved in oncology care. Eligible studies were synthesised narratively.
ResultsThe search identified 509 unique records, of which 20 studies met inclusion criteria. Educational interventions were grouped into immersive (n = 10), involving supervised clinical practice within specialised palliative care services, and non-immersive (n = 10) approaches (e.g. short courses, workshops, seminars). Both types of interventions were examined in relation to internationally expected palliative care competencies for oncologists. Across studies, immersive clinical rotations—most commonly lasting 4–8 weeks—consistently improved practice-relevant competencies, including communication skills, symptom management, attitudes, knowledge, and self-efficacy. Benefits did not clearly increase with longer rotations. Mandatory immersive experiences produced broader and more consistent gains than elective formats and were more likely to influence clinical behaviours relevant to cancer care. Non-immersive interventions led to more modest but meaningful improvements, primarily in foundational knowledge, perceived preparedness, and structured communication skills. One randomised controlled trial demonstrated significant improvements in observed shared decision-making behaviours.
ConclusionsShort, well-structured immersive rotations (4–8 weeks), particularly when mandatory, consistently yielded broader and more practice-relevant competency gains than elective formats. Non-immersive interventions—including workshops, online modules, and simulation—contributed meaningful improvements in foundational knowledge and structured communication skills and are best understood as complementary to, rather than substitutes for, clinical immersion. Together, these findings suggest that a tiered model combining mandatory immersive and structured non-immersive components may offer a feasible approach to strengthening PC training within oncology programmes. Findings are predominantly North American; transferability to European contexts requires further research.