It is a common misconception that people with cancer are exclusively cared for in specialist oncology settings. They are cared for throughout all large teaching hospitals, so appropriate cancer education and training should be accessible to all staff who work with them, argue Katharine Gale and Deirdre McGuigan

To give employees the skills and knowledge to care for people with cancer, United Bristol Healthcare trust carried out a learning needs analysis survey to identify the cancer education and training needs of its workforce.

The aim of the project was to equip all healthcare workers with an understanding of cancer care appropriate to their role and clinical area.

The main objectives were:

  • to identify which employees need access to cancer education and training;

  • to identify the educational needs in regard to cancer care for all employees;

  • to identify what type of cancer education and training should be delivered in the future.

The results showed that most staff (64 per cent) would be willing to participate in cancer care education and training in the future. The main reasons given for not wanting to participate were: it was not relevant to their post (64 per cent), lack of time (15 per cent), and lack of funding (9 per cent).

The survey required the respondents to indicate their confidence level in various aspects of cancer care. Most reported lacking confidence in explaining what cancer is (57 per cent), engaging in 'difficult conversations' (56 per cent), discussing cancer treatments (74 per cent), cancer interventions (75 per cent) and their side effects.

The main themes that emerged from the qualitative analysis of the survey data were:

  • communication: the respondents indicated a fear of interacting with those affected by cancer and identified a need for communication training to include topics such as how to interact with people affected by cancer, how to break bad news and engage in difficult conversations;

  • health promotion: the respondents wanted increased knowledge of the signs and symptoms of cancer, an understanding of the screening tests available, preventative measures and an overall awareness of cancer;

  • biology of cancer: there was a clear request for training in the basic understanding of cancer;

  • cancer and the family: some of the workforce identified that they had been cancer patients or were dealing with family members affected by cancer. Some employees' desire to undergo training was to enable them to assist friends and families through their cancer journey;

  • management of cancer: the respondents clearly indicated a need for knowledge on cancer diagnostic investigations, treatments and side effects and the clinical care of those affected by cancer;

  • the organisation: the respondents highlighted the various organisational barriers to participating in cancer training and education, especially in regards to being released from clinical practice and the financial cost to the department;

  • supportive care: training on pain control and symptom management was frequently requested, as well as the psychological care of the dying patient.

The local Cancer Nurses and Allied Healthcare Professionals Forum made a number of recommendations based on the survey results.

They included the development of:

  • a cancer fact sheet;

  • cancer services newsletter - keeping up to date with local service provision;

  • access to the Cancer Voluntary Information Centre already in existence;

  • a trust cancer information notice board;

  • a programme to allow staff to shadow members of the cancer team;

  • a pilot cancer learning zone on the ward - e-learning in practice by creating a cancer care website.

The survey has enabled our organisation to listen to the workforce when attending to the needs of patients diagnosed with and treated for cancer. We are now able to explore how these findings can be implemented into a training cycle or action plan.

We are reviewing current in-house training to ensure it is meeting the learning needs of the workforce. These developments and new learning opportunities will have far-reaching benefits when meeting the needs of people affected by cancer for the future in our care.

For more information, e-mail: