Brief Overview: With improved treatment for pediatric cancers, there are increasing numbers of survivors living well into adulthood. In 2005, there were more than 325,000 pediatric cancer survivors in the United States. As this population ages, their care is eventually transitioned from their oncology to local primary care providers. Health care providers are often not familiar with identifying and managing the long-term effects associated with the treatment of pediatric cancers because their training did not provide clinical experience with this population, and until very recently, there were no established practice guidelines for the long-term management of these survivors. A pediatric oncology/hematolgy specialty hospital in the southern United States has a specialty clinic (After Completion of Therapy [ACT]) that follows pediatric cancer survivors from five years after date of diagnosis and two years off therapy until they are either eighteen years old or ten years from their date of diagnosis. The ACT Clinic uses the Children’s Oncology Group (COG) Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent and Young Adult Cancers (COG Survivorship Guidelines) as their clinical practice guidelines to direct risl-based care. This project tested the effectiveness of an interactive educational intervention that teaches graduate medical trainees about the COG Survivorship Guidelines. The PI of this scholarly project used both the evidence-based practice model known as the Stetler Model and the evidence-based practice change plan known as the Interaction Model of Client Health Behavior to create this change within the ACT clinic. The program was offered to graduate medical trainees visiting the ACT clinic during their rotation. The objective of this program was to improve clinician’s knowledge and comfort level in caring for pediatric cancer survivors. Intervention effectiveness was assessed by the adequacy of a trainee-developed survivorship care plan in response to a fictional patient scenario. Intervention: This project tested the effectiveness of an interactive educational intervention that taught graduate medical trainees about the COG Survivorship Guidelines. The intervention involved a 45-minute didactic session with a nurse practitioner (PI), followed by observation of an actual patient encounter with the nurse practitioner. Intervention effectiveness was assessed by the adequacy of a trainee-developed survivorhsip care plan in response to a fictional patient scenario. Data Management: The PI collected the trainee-developed survivorship care plans in a large envelope. This information was reviewed for appropriateness of the care plan relative to the long-term effects associated with the treatment of pediatric cancers. Conclusion: Successful implementation of Educational Intervention of the COG guidelines was achieved. The rotating clinicians that participated in the intervention verbalized an increased comfort and knowledge level in the use of the guidelines in practice. Subsequently the guidelines have been incorporated as a core requirement for successful completion of the rotation through the ACT clinic.
