Aims
It is critical that cancer care clinicians have a strong knowledgebase regarding cancer, including evidence-based assessment and interventions. The COVID-19 pandemic necessitated a more generalised skill set, resulting in the dilution of specialist skills. The aim of this project was to evaluate the implementation of education and supervision strategies to improve clinical competency and patient care in occupational therapy.
Methods
Occupational therapists participated in evidence-based “Oncology Fundamentals” package, developed by senior clinicians with over ten years’ experience. This consisted of dual supervision models and 6x intensive one-hour face-to-face education modules targeting priority practice areas. This included cancer treatments, oncological emergencies, and symptom management. Data was collected pre-post training including clinical record audits and participant program evaluation surveys to measure change in adherence to best practice guidelines, clinician competence and self-efficacy. Staff rated confidence post-intervention was self-rated from 1=not confident at all to 5 extremely confident.
Results
Clinicians (n=6, 3x Grade 1 and 3x Grade 2) had worked in cancer care for an average of 2.2 years. Education session attendance was 86%. Audit findings included improved frequency in documentation of fatigue (60.8% to 77.8%), cognition (71.74% to 75%), pressure care (67.39% to 75.00%). Confidence increased in all key areas including cancer treatments (30%) oncological emergencies (33%), metastatic spinal cord compression (27%), dyspnoea (23%) and pressure care (13%). Documentation of pain and positioning decreased (41.30% to 25%). Areas to further target education based on the audit included documentation of clinical reasoning.
Conclusion
Implementing a dual supervision and intensive education model can improve clinician confidence and competence in delivering cancer care, in particular cancer symptom management, and enhancing service capacity to provide specialist cancer interventions to address patient needs. Further investigation is required on the sustainability of this model and translation across other clinical disciplines.