The Impact of a Physician Awareness Group and the First Year of Training on Hematology-Oncology Fellows

• Published in: Journal of clinical oncology Vol. 21; no. 19; pp. 3676 - 3682
• Main Authors: SEKERES, Mikkael A, CHERNOFF, Miriam, LYNCH, Thomas J, KASENDORF, Eydie I, LASSER, Daniel H, GREENBERG, Donna B
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01.10.2003; Lippincott Williams & Wilkins
• Subjects: Adult; Attitude of Health Personnel; Biological and medical sciences; Family Health; Fellowships and Scholarships; Female; Hematology - education; Humans; Internship and Residency; Interprofessional Relations; Job Satisfaction; Male; Medical Oncology - education; Medical sciences; Physician-Patient Relations; Public health. Hygiene; Public health. Hygiene-occupational medicine; Stress, Psychological; Teaching. Deontology. Ethics. Legislation; United States; North America; America; Attitude; Awareness; Physician; Perception; Formation; Medical specialty; Public health
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2003.12.014

To assess the impact of a Balint-like physician awareness group on hematology-oncology fellows' attitudes and measure changes in attitudes during the first fellowship year. We used a modified crossover design in which one half of a fellowship class at a time was exposed to the group intervention over a 2-year period (2000 to 2002). Two 14-fellow classes were followed for 1 year each and were given three "attitudes" questionnaires, at the beginning, middle, and end of the academic year. Forty Balint group sessions were held during the 2-year study period; 82 questionnaires of the 84 administered (98%) were recovered. Instrument content and criterion validity were demonstrated, as was topic domain reliability. Overall, mean attitude scores increased following the group intervention, from 3.6 (95% CI, 3.5 to 3.7) to 3.7 (95% CI, 3.6 to 3.8; P =.09). Within domains, scores increased in a "fellow's views of him/herself as a physician," from 3.8 (95% CI, 3.6 to 3.9) to 4.1 (95% CI, 3.9 to 4.2; P =.008) and "comfort dealing with emotional patient/clinical situations," from 3.5 (95% CI, 3.3 to 3.7) to 3.7 (95% CI, 3.6 to 3.9; P =.11). Changes in responses to individual questions included: an increase in fellows' comfort with the technical aspects of being an oncologist (P <.03); an increase in fellows' comfort with discussing the stress of home at work (P <.023); and an increase among fellows in feeling pressed for time to discuss psychosocial issues with patients (P =.035). A physician awareness group was feasible and enhanced fellows' development as physicians. Further research is needed to determine how to incorporate such groups into oncology fellowships.