Addressing the training gap in oncology on sexual health: Development and pilot test of a virtual, group-based course for hematology-oncology fellows.
TL;DR
In this pilot, SHIFT was endorsed as highly valuable and demonstrated significant, scalable impact up to 6 weeks post-course, which could align current fellowship training with guideline-informed best practice, with major potential benefits for patient care and health outcomes.
Abstract
455 Background: Oncology treatments cause distressing sexual side effects for patients. Although clinical guidelines recommend that oncologists address patients’ sexual health concerns, most hesitate to do so due to lack of training. We developed SHIFT (Sexual Health Integrative Fellowship Training), a virtual group-based course providing hematology-oncology (HO) fellows education and skills training for communicating effectively about cancer-related sexual health based on formative research and feedback from key stakeholders (faculty, fellows, patients). We pilot tested SHIFT for acceptability and impact on fellows’ knowledge, beliefs, and communication. Methods: Fellows from three U.S. HO programs were invited by program directors and self-selected to enroll. The half-day SHIFT course [live lectures, small group role plays with simulated patients, and support materials] was held in April 2025 and January 2026, with minor course refinements made before the second course to enhance clarity and relevance. Fellows completed pre-course, post-course, and 6-week follow-up surveys assessing knowledge [range (0-28)], beliefs [self-efficacy, outcome expectancies; range (0-10)], and clinical communication outcomes (comfort, communication) regarding cancer-related sexual health [range (0-10)]. Program evaluations assessed course acceptability at post-course [pre-set benchmark defined as 75% of learners endorsing >75% of acceptability items (e.g., satisfaction, informativeness) favorably (“Quite a bit”/“Very”)]. Paired t-tests analyzed change in outcomes from pre-course to post-course/follow-up. Results: Twenty-five fellows attended and all completed study surveys; most (88%) endorsed nearly all acceptability items, exceeding the acceptability benchmark, with 96% reporting high satisfaction, informativeness, and likelihood of changing practice. In the full cohort, improvements were seen in mean scores on all outcome measures from pre-course to post-course: [knowledge (16.0 to 18.8, p <.001, 8 of 13 knowledge items increased); self-efficacy (4.1 to 8.0, p <.001) and outcome expectancies for discussing sexual health (7.3 to 8.7, p <.001); and comfort with discussing sexual health (4.6 to 7.4, p <.001)] and to 6-week follow-up [communication (1.8 to 2.7, p <.001)]. Increases in all other outcomes remained significant at follow-up ( p <.001). Conclusions: SHIFT is the first course in the U.S. to target HO fellows’ clinical communication about sexual health. In this pilot, SHIFT was endorsed as highly valuable and demonstrated significant, scalable impact up to 6 weeks post-course. Integrating SHIFT into HO fellowship programs nationwide could align current fellowship training with guideline-informed best practice, with major potential benefits for patient care and health outcomes.