Developing global curricula for cancer control

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Published: 26 Nov 2018
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Prof Meredith Giuliani - Princess Margaret Cancer Centre, Toronto, Canada

Prof Meredith Giuliani speaks to ecancer at the CCLMIC meeting at the Royal Society of Medicine in London, UK.

She discusses the development of global curricula for cancer control in order to match the global increase in cancer, and cancer workforce.

Prof Giuliani describes the best way to implement this process, and how the representation of different voices in this process is very important.

I’m speaking about the development of global curricula for cancer control. This is a very important topic because to meet the needs of cancer care in the next twenty years we’re looking at a doubling of the oncology workforce, so not just physicians but all of the different professionals that work with cancer patients. That’s obviously a huge undertaking to have to double the amount of healthcare workforce that you have to treat patients

There are a few different things that are driving that. There’s obviously increasing number of cancer cases, especially driven by low and middle income countries; as people live longer the prevalence of cancer goes up. There’s virus related cancers that are becoming endemic in different places in the world and as the population ages we’re seeing more cases of cancer and care is becoming more complex and you need a larger team and more professionals to deliver care for patients. So if you need to have a doubling of the workforce you obviously need to train all these individuals.

There was a few years ago a commission by The Lancet looking at healthcare professionals for the 21st century, basically describing the mismatch between outdated curricula and what healthcare professionals need to serve the needs of patients, their family members and the system now and going forward. So we’re very interested in looking at what is happening in oncology in terms of global curriculum development and how might those global curricula be adapted or modified to be able to suit local needs because you’re trying to balance the universal requirements of curriculum with local implementation.

How can it be achieved?

That’s a great question, there’s no easy answer to that. There’s no perfect model for curriculum development, it’s a very iterative process, it involves a lot of people getting together. Most of the curricula that are out there have been generated by consensus, occasionally through a Delphi process but usually committees or taskforces of sometimes up to a hundred members getting together and sitting down and working on these curricula. Then even once they’re created they often go around for multiple rounds of review and input from stakeholders all over the world and from different professional groups. So it’s a very iterative process, it involves a lot of people getting together and the more we can promote representation of different voices and different perspectives because medical education and the training of, in my case, physicians or other healthcare providers can be very different in different places in the world. So getting those different voices and perspectives on the table is very important.

Where is this work happening?

A lot of the work that is out there right now has been led by either Europe or North America with representatives from other areas. But future efforts are going to see more and more regions of the world coming together and presenting their work and their thoughts about what is core curricula and what really needs to happen to mobilise this huge workforce that’s needed to deliver cancer care.

What would your take home message be?

The key points are that there’s not going to be one size fits all and that we really need to look at while there are some universal principles how we need to look at that balance of local context and local implementation. Some groups have already started to articulate ways to do that but we need more conversations and more best practices around how we can have common universal statements and then ways to implement that or modify them locally to make them very relevant.