Practicum Highlight: Karen Guo, MPH'23

​​Clinician and Care Team Member Experiences in the Serious Illness Conversation Model of Care Implementation

Serious illness conversations (SIC) are patient/clinician discussions that elicit the values and priorities of seriously ill patients to guide future care and existing literature suggests that SIC improves the quality of care for patients facing advanced cancer. In this qualitative study, Karen Guo explored oncology team members' experiences of an ongoing SIC quality improvement initiative at an outpatient academic cancer center focused on increasing the uptake of serious illness conversations among clinical oncology teams.

"The most profound takeaway from my practicum work was recognizing the compassion, empathy, and resilience of the oncology and palliative care providers at Dartmouth Cancer Center. I am so grateful to have heard the providers' stories and collated them into overarching themes in the context of qualitative research."

The oncology team members who participated in the SIC Model of Care Implementation at the Dartmouth Cancer Center were eligible for enrollment, and interviewees were recruited to participate in a 30–45-minute, semi-structured interview. Among twenty-two eligible participants, twelve participants were enrolled from five oncology teams and five primary disease sites. From a review of the collected data, prominent themes emerged, such as limited time and staff resources curtailing serious illness conversation uptake; oncology team members upholding patient autonomy with regard to the timing of SIC, and oncology team members find the inherent value of SIC to patients and caregivers. 

"I was inspired by the dedication of each of the providers with whom I had the pleasure of interviewing; I hope this research can highlight the resources and needs of oncology and palliative care providers to better serve their patients facing advanced cancer." 

As evidence supports quality, timely serious illness conversations foster goal-concordant care for advanced cancer patients, improving SIC uptake in clinical workflows becomes particularly salient. The analysis of participant experiences informs novel ways to adapt the implementation of ongoing serious illness conversations in the context of post-pandemic challenges. 

"More broadly, I've developed a fondness for qualitative research because it allows the researcher to witness peoples' lived experiences and turn those collective experiences into a vehicle or rationale for impactful systemic change." 

Guo gives acknowledgments and thanks to her PI, Dr. Amelia Cullinan, her practicum advisor in Dartmouth's Online MPH program, Dr. Meghan Longacre, the oncologists/team members, and the SIC leadership team for their incredible effort, guidance, and support in this work. 

On her Dartmouth experience, Guo reflects, "My educational experience at Dartmouth was truly exceptional. The curriculum was challenging and intellectually provocative, but I felt abundantly supported by faculty, staff, and fellow students every step of the way. Each professor was brilliantly passionate about their individual coursework but the courses were threaded together by a common theme — to foster innovative, impactful solutions that promote equitable public health."

Written by: Mia Pennekamp Soucy

POSTED 4/10/2024 AT 02:14 PM IN #practicum