Abstract
Introduction/Background: In recent years, the treatment paradigm for management of advanced pancreatic cancer has changed dramatically. Because oncology nurses are on the front line of care for patients with pancreatic cancer, we sought to evaluate their knowledge and competence in the care of patients with advanced disease and the impact of case-based education on narrowing gaps in clinical practice. Materials and Methods: An online educational program designed as a video roundtable discussion between nurses and tailored to a nursing audience was posted on Medscape Oncology January 13, 2016, and ran until March 8, 2016 (http://www.medscape.org/viewarticle/855566). Educational efficacy was determined by using each learner as their own control and comparing each participant’s responses to a series of 4 questions posed before exposure to educational content (pre-assessment) with his/her responses the identical questions posed after exposure to the educational content (post-assessment). Responses of participants who answered all pre- and post-assessment questions during the study period were included in the analysis. McNemar’s chi-square test was used to assess differences from pre- to post-assessment responses for all questions combined. Cramer’s V was used to estimate the strength of the association between pre- and post-assessment test scores. P values are shown as a measure of significance with P<.05 indicated statistical significance. Results: Nearly 13,000 nurses participated in the activity, of which 1896 qualified for inclusion in this study. Participation in this educational program resulted in a medium effect size (Cramer’s V = 0.189; P < .05). Significant improvements included (Figure 1; all P < .05):
- A relative 81% improvement in knowledge related to the management of pancreatic insufficiency in patients (P < .05)
- A relative 46% improvement in comprehension of the role palliative care has in the management of patients with advanced pancreatic cancer (P < .05), although nearly 30% still selected incorrect responses after the activity
- A relative 31% improvement in recognition that one of the most common treatment-related adverse effects of nanoliposomal irinotecan is neutropenia (P < .05)
- A relative 36% improvement in distinguishing differences in the adverse effect profiles of nab-paclitaxel with gemcitabine versus gemcitabine monotherapy (P < .05)
Conclusions: This study identified ongoing educational gaps that suggest development of additional education is needed to improve oncology nurse knowledge and competence in the management of pancreatic cancer, especially in recognition of the value of supportive and palliative care as well as recognition of distinguishing characteristics of the adverse effect profiles of evidence-based regimens.
