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Standards of Oncology Education: Patient/Significant
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Other and Public (4th Edition)
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Carol S. Blecher, MS, RN, AOCN®, APNC, CBCN
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Anne M. Ireland, MSN, RN, AOCN® CENP
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Joni L. Watson, MBA, MSN, RN, OCN®
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Introduction
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In 2013 the Oncology Nursing Society published a Statement on the Scope and Standards of
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Oncology Nursing Practice – Generalist and Advanced Practice. Like the previous versions, it
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defines the roles of oncology nurses and reflects ONS’s mission statement (Brandt, and
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Wickham). The scope of oncology nursing care includes assessment, diagnosis, outcome
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identification, planning, implementation and evaluation (Brandt, and Wickham). This mirrors the
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ANA Standards of Professional Nursing Practice 2nd edition (2010). In Standard 5
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(Implementation) of both the ANA and ONS documents it indicates that the registered nurse
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provides education to promote health.
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ONS believes that oncology nurses have the responsibility of developing, assessing,
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implementing and evaluating educational programs for patients, their significant others, and the
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public. The nurse should provide teaching and anticipatory guidance regarding cancer and its
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treatment, including symptoms and side effects (APHON, 2009). Joint Commission (1992-2000)
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in the section on Education Standards identifies the facts that the patient’s learning needs,
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abilities, preferences and readiness to learn must be identified. They also emphasize the fact that
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patient education is interactive, meaning that we must include the patient, significant other, and
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the public and assure their interest in the programs. An important method of achieving this is by
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incorporating “teach back” techniques into the educational process. In short the educator role is a
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nursing responsibility (APHON, 2009; ANA, 2010; ONS, 2013; Home Health Nursing
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Standards, 2007; Joint Commission 1992-2000) and a necessity for patients, their significant
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others, and the public.
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The Outcome Standards for Cancer Patient Education was first published by ONS in 1982,
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followed by the Outcome Standards for Public Cancer Education in 1983. In 1989, the standards
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were revised and consolidated into one document. These were again updated and revised in 1995
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and 2004.
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The purpose of this document is to provide comprehensive guidelines for nurses to:
 Develop, implement, and evaluate formal and informal patient/significant other education
programs.
 Develop, implement, and evaluate formal and informal public education programs.
The intended outcomes of the Standards of Oncology Education: Patient/Significant Other
and Public are to:
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 Enhance the quality of patient teaching.
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 Exemplify the scope of teaching in all phases of cancer care, including prevention, early
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detection, rehabilitation, survivorship, and supportive care.
 Improve health promotion and care for the public.
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The standards in this document are descriptive statements designed to guide the achievement of
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quality education for the patient, their significant others, and the public. The format is consistent
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with the American Nurses Association (ANA) Standards for Nursing Professional Development
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and includes the following categories:
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I. Oncology Nurse
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II. Resources
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III. Curriculum
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IV. Teaching-Learning Process
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V. Learner: The Patient/Significant Others and the Public
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The following assumptions were made in the development of the Standards of Oncology
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Education:
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1. All people are at risk for cancer.
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2. All people have the right to information related to cancer and oncology care presented at
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the individual’s level of learning/comprehension.
3. Education is a component of the comprehensive nursing care of the patient/significant
others experiencing cancer as well as the public.
4. Inappropriate responses to the potential or actual threat of cancer may be modified by
enhancing knowledge, skills, and attitudes of the patient/significant others and the public.
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5. Application of principles of adult education theory enhances learning.
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6. Professional oncology nurses are role models in cancer education.
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7. All educational activities reflect sensitivity to and respect for diverse cultural
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backgrounds and health belief systems of the patient and significant others experiencing cancer.
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8. Professional oncology nurses provide care in a variety of settings, including hospitals,
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ambulatory settings, private practices, homes, and hospices.
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This edition of Standards of Oncology Education: Patient/Significant Other and Public is
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designed to affirm nursing’s role as educator (ANA, 2015) and be reflective of current practice
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trends and evidence-based practice. Updated references are provided for practitioners to use in
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their role of educator for patients, significant others, and the public.
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Changing Methods and Technology in Education
Lecture, verbal instruction, discussion, written materials both in hardcopy or digital format
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through short message system (SMS) text messaging and email, demonstration, teach-back,
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audio and visual (AV) aids – either hardcopy through discs or digitally through online audio and
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video files, “edutainment through gamification” (e.g. the use of games), and role-playing either
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in-person or virtually through programs such as Second Life – all of these are methods of current
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patient and public education. As technology has rapidly changed and continues to morph, so do
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the tools in which we use to fulfill the static principles of learning, utilizing the foundational
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nursing process. The Internet now provides instant evidence, resources, and tools, often well
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ahead of traditionally printed versions. In addition, mobile and televideo education methods are
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commonplace in today’s teaching environment with far-reaching effects (O’Connor & Andrews,
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2015; Raman, 2015).
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Teaching methods and “strategies [are only as] effective as their audience’s access to the
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necessary tools to use them” (Friedman, Cosby, Boyko, Hatton-Bauer, & Turnbull, 2011, p. 18).
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Demonstration and the teach-back method are most effective followed by written materials and
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AV tools, with verbal teaching and discussions least effective. While multiple education methods
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exist, there is no “one size fits all” to educate patients, families, or the public. A combination of
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education methods is preferred and proven to be more successful in producing enhanced patient
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outcomes (Friedman, et al., 2011).
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The rise of the digital age has changed the way we teach and learn. Digital natives – those
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born after 1980 – are generally well-versed and comfortable with learning via digital methods; it
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is a natural language for Generation Y’ers and Generation Z’ers, a population currently totaling
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approximately 94 million people who will grow to surpass all prior generations combined
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(Schroer, n.d.; Prensky, 2001). Conversely, digital immigrants – those born prior to 1980 – are
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often the educators, researchers, and the lions-share of the workforce teaching patients and the
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public, so a disparity in electronic/digital “first-language” teaching and learning styles may exist
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(Prensky, 2001; HRSA 2013)
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The increase of e-patients, those who use electronic sources of health information to become
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empowered and engaged healthcare consumers has increased dramatically with widespread,
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public adoption of technology and social media (Nelson, Joos, & Wolf, 2013). There is now
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more horizontal information-sharing and crowdsourcing information using peoples’ “collective
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wisdom” as opposed to vertical information-sharing from face-to-face interactions with
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traditionally-thought experts (Nelson, Joos, & Wolf, 2013; Keller, Labrique, Jain, Pekosz, &
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Levine, 2014).
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Eighty-one percent of adults use the Internet and email at least occasionally, and fifty-two
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percent of online adults use two or more social media (SM) sites. Contrary to popular belief, SM
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is not only for the young nor is it used solely for entertainment. Thirty-one percent of all seniors
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aged 65 and above have and use Facebook, and between one-third to one-half of adults using the
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Internet express utilizing SM for myriad healthcare information reasons (Duggan, Ellison,
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Lampe, Lenhart, & Madden, 2015; PricewaterhouseCoopers, 2012).
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Social media such as blogs, Facebook, YouTube, Twitter, Instagram, LinkedIn, Pinterest, etc.
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garners the “collective wisdom” of its users, relationally connecting content. SM has been and
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continues to be used for various health reasons including broad engagement around clinical
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trials, increasing both targeted and wide-spread awareness of public health efforts, and
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connecting micro-populations for ongoing support (Thackery, Burton, Giraud-Carrier, Rollins, &
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Draper, 2013). Social media’s effectiveness in educating clinicians as well as the public is just
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now beginning to be studied more fully and certainly needs more exploration.
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This shift of information sharing and use clearly shows the movement from “Web 1.0” in
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which Internet content was static and passive to “Web 2.0” that includes engagement of large
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communities via SM applications and now our entry into “Web 3.0/Web 4.0” in which multiple
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networks and systems meld together and technology becomes a longitudinal, ubiquitous part of
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the human and health care experience (Nelson, Joos, & Wolf, 2013; Thompson, Younes, &
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Miller, 2012; Strickland, 2007).
Web 1.0
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Web 2.0
Web 3.0/4.0
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•Content-focused
•Passive reading of static content
•Single point of connectivity
•Information exclusivity
•Examples: government or organizational web pages
•Community-focused
•Mobile connectivity
•Group interaction around the content or generating the content
•Examples: Social media including patient/provider blogs, Twitter chats, Facebook or web-based
diagnosis-specific support groups, mobile health applications
•Comprehensive-focused
•Personalization
•Patient interactivity with multiple networks
•Moving data to useful, meaningful information
•Ubiquitous connectivity
•Intelligent search (e.g. technology that learns)
•Examples: synced home, business, health, and mobile networks; IBM's Watson
As technology continues to shift and shape health, the U.S. government passed the Health
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Information Technology for Economic and Clinical Health (HITECH) Act of 2009, setting
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Meaningful Use (MU) criteria to effectively provide safe, quality population health management
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through integrated electronic systems (U.S. Department of Health & Human Services [HHS],
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n.d.). Again, the shift to Web 4.0 is evident as multiple networks of information focus on
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singular patients as well as large populations. MU stage 2 criteria includes sharing secure
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electronic communications through the use of certified EHR technology, or CEHRT, which is
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more commonly referred to as patient portal communication. As the number of organizations
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compliant with MU criteria continues to increase, the number of patients who express feeling
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more informed through EHRs and patient portal communications also continues to climb (Jones,
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Weiner, Shaw, & Stewart, 2015; Kruse, Argueta, Lopez, & Nair, 2015; Palma, et al., 2012).
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While patient portal use continues to become mainstream, direct mobile and digital
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communication with patients outside of portals remains via SMS text messaging and email,
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respectively. The majority of healthcare systems have protected servers to send encrypted, secure
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email messages to those outside of the healthcare organization (e.g. patients, family members,
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etc.), and many organizations also utilize encrypted text messaging services to allow secure texts
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for both provider-provider communication and provider-patient communication. These safety
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measures ensure compliance with the Health Insurance Portability and Accountability Act
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(HIPAA) of 1996. Text messaging has proven to help increase clinical trial enrollment, improve
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medication adherence, encourage tobacco or alcohol cessation, or increase screening uptake
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(Lim, Wright, Hellard, 2014; Kannisto, Koivunen, & Välimäki, 2014). A 2015 literature review
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(Nasi, Cucciniello, & Guerrazzi, 2015) found limited SMS text messaging use in cancer care,
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however more evidence-based research and publication is needed in this area as text messaging
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is a well-known method of communication in oncology nursing practice with head and neck
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patients, for example, who may be unable to speak due to treatment effects. Evidence regarding
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this practice is grossly missing from the health care literature.
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Just as technologies are shifting to focus on longitudinal population health management, so
are public health and health accrediting agencies. Within oncology specifically, the American
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College of Surgeons Commission on Cancer, which accredits more than 1,500 cancer programs
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throughout the United States, now requires all programs to focus on long-term patient care
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through cancer survivorship care plans (SCPs) via Standard 3.3. Treatment summaries and SCPs
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are provided to patients at the end of treatment to ease the transition into cancer survivorship,
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detailing necessary ongoing surveillance and care, which must be effectively communicated to
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the patient and care unit and reinforced throughout a lifetime (Commission on Cancer, 2012).
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Changing Roles of Oncology Nursing in Education
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The nursing process remains foundational, yet the implementation of the process varies with
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time. In order to effectively educate patients and the public, oncology nurses must assess the
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population first. This assessment, however, now expands beyond assessing readiness to learn and
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basic and health literacy to also encompass computer and digital literacy (Nelson, Joos, & Wolf,
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2013). Without adequate literacy and fluency, nurses’ education methods may fail patients’
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needs and lead to poor health outcomes.
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Health
Literacy
Reading
Literacy
Overall Patient Computer
Comprehension Literacy
Digital
Literacy
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Changing education methods and tools require the oncology nurse to adapt, as well. Just as
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there is no “one-size-fits-all” education intervention, nurses must remain competent with all
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patient and public teaching methods and the rapidly-growing technology to reach appropriate
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populations with effective information. This may be a significant barrier to oncology nurses as
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technologies used in education can easily outpace professionals’ use, especially among digital
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immigrants. Conversely, digital natives may have to work to remain competent with more
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traditional education methods and hardcopy tools to also provide culturally- and age-appropriate
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education interventions.
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While many health professionals express the value of social media tools, adoption and use of
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these resources are lagging (Keller, et al., 2014). Nurses must advocate and exhibit professional
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use of the changing tools, educating and empowering patients and the public to continue to use
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them for positive health outcomes (Tomsik & Briggs, 2013).
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As electronic and social media tools are adopted for continued professional educational use,
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oncology nurses must remember they are tools of communication and apply the same rigor and
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professionalism as in traditional methods of education and communication, understanding body
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language and tone can be lost via certain education methods (Lim, Wright, Hellard, 2014).
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Oncology nurses should be mindful examples of all technology and social media ethical and
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professional principles, whether published nationally or at the healthcare organizational level, as
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in a social media policy, for example (Grajales, Sheps, Ho, Novak-Lauscher, & Eysenbach,
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2014; American Nurses Association, 2011). Just as in working to develop in-person rapport with
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patients, oncology nurses must also work to develop an online, caring presence for effective
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education (Mastel-Smith, Post, & Lake, 2015; Cox-Davenport, 2014).
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Oncology nurses must continue to be able to discriminate between reliable sources of
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information and also be able to effectively educate patients and the public to do the same,
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especially with social media which blurs the lines between novice and expert (Garg,
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Venkatraman, Pandey, & Kumar, 2015; National Cancer Institute, 2012). As patients live longer
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and the majority of healthcare organizations shift toward population health, oncology nurses
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must broaden the inclusiveness of their education to extend to the entire care unit all throughout
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the continuum of care, spanning a single patient’s/family’s lifetime.
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Contemporary Trends and Trends for the Future of Education
The future of education will continue to morph as technology shifts into Web 3.0/4.0 and the
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line between humans and technology blurs into one experience and everything and everyone is
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connected for instant, personalized information. Adoption of mobile and electronic education via
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smartphones, applications, social media, and EHR patient portals will exponentially grow
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(Cahill, Gilbert, & Armstrong, 2014; Jones, Weiner, Shaw, Stewart, 2015). This is true not only
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for patients but for the entire patient care unit as dyadic care (e.g. care of the caregiver in
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addition to the patient) and family proxy to patients’ individual health portals rises. The
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oncology nurse will educate the entire family, requiring maintained competence in all facets of
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patient and family education – assessing for the right communication style and excelling in its
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use (O’Malley, Cohen, Grossman, 2010).
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As technology and connectivity becomes more ubiquitous, so will the education provided by
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oncology nurses. Federal legislation as well as healthcare accrediting agencies will continue to
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make large strides to patient-centered care and enhanced education throughout the course of a
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lifetime to improve overall health outcomes. Theories surrounding Web 3.0 and Web 4.0 include
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technologies mining patient/population health information to learn about the patient over time to
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individualize care as well as benefit the collective population’s health (Nelson, Joos, & Wolf,
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2013). While it may seem far-fetched, this reality is already in its infancy. Oncology nurses must
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be prepared to take the foundation elements of the nursing process and shift its implementation
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in order to remain effective healthcare professionals.
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And even as technology advances, “traditional” educational methods are changing to include
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more than the patient alone. Dyadic care and education – focusing on the patient and the primary
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caregiver – or the entire family, – continues to be researched and found to be an effective means
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of providing holistic care to the patient/caregiver unit (Northouse, Mood, Schafenacker,
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Kalemkerian, Zalupski, et al., 2013). While educating a family unit together may not be a “new”
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concept to oncology nurses, many caregivers and family members desire to be educated
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alongside the patient, and this method may lead to improved and/or more desired health
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outcomes (Potter, Olsen, Kuhrik, Kuhrik, & Huntley, 2012; McCarthy, 2011).
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The changing methods in technology and education that are reflected above should be kept in
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mind within the context of the next section which defines the standards, their rationales and
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methods for evaluation of outcomes.
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Standards of Oncology Education - Patient/
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Significant Other and Public
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Standard I. Oncology Nurse
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The oncology nurse at both the generalist and advanced practice level is responsible for
meeting the educational needs of the patient/significant others related to cancer.
The oncology nurse provides formal and informal cancer-related public education
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commensurate with personal education and experience.
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Rationale
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Patients and their significant others have a wide variety of educational and informational
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needs in relation to a cancer diagnosis, treatment, side effect management and survivorship. This
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requires education work with the patients and their significant others to meet these needs at every
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point along the cancer care continuum. All oncology nurses provide education to meet these
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needs as they are both the most trusted health care professionals and the professionals who have
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the greatest amount of direct patient contact.
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All oncology nurses also provide required or requested education to meet the specific needs
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of the public as they are educated regarding the promotion of health and are trusted as health care
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providers.
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Measurement Criteria
The oncology nurse:
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1. Practices health behaviors consistent with health promotion as a role model for the
patient/significant other and public.
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2. Promotes healthy lifestyles of individuals and groups through education.
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3. Applies the ANA Standards (2010) and ONS (2013) Statement on the Scope and
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Standards of Oncology Nursing Practice – Generalist and Advanced Practice when designing
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education for patients/significant others and the public.
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4. Has a basic prerequisite understanding of the principles, practice and process of teaching
and learning to carry out their professional responsibilities with efficiency and effectiveness.
5. Applies teaching-learning principles to the development, implementation, and evaluation
of all educational offerings.
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6. Functions as a facilitator of learning for patients, their significant others and the public.
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7. Identifies educational strategies, technologies, and resources that support health
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promotion and cancer prevention, detection, treatment, and care.
8. Employs teach back and pictorial images to promote education in patients/significant
others with low literacy and/or low health literacy.
9. Values potential outcomes of education on the knowledge, skills, and attitudes of
patients/significant others and the public.
10. Assesses the accuracy and applicability of cancer information prior to endorsement and
dissemination.
11. Critically appraises clinical recommendations for level of evidence prior to endorsement
using reliable resource such as ONS PEP® Resources and NCCN Guidelines.
12. Demonstrates respect for the religious, social, cultural, and ethnic practices of
patients/significant others and the public.
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13. Identifies risk factors for the learner/target audience with special consideration to
disproportionate risk.
14. Collaborates with community leaders, volunteers, and groups to advocate for, plan,
and/or provide public education/cancer screening.
15. Incorporates and applies research findings into practice and into educational activities.
Standard II. Resources
Adequate resources to achieve the objectives of patient/significant other education related to
cancer care are available and appropriate.
Resources for public education related to cancer prevention, detection, treatment, and care
are adequate, current, accurate, and appropriate to achieve educational objectives
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Rationale
The literature supports the idea that patients want as much information as they can get about
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their illness and treatment plans. Individuals have different learning styles and abilities.
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Therefore a variety of resources must be available to meet the learning needs of each individual,
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including printed material with relevant pictures, the internet assuring trustworthy sites,
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computer assisted learning, audiotapes and videotapes. All materials must be culturally sensitive
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and address the various educational and reading levels of the population.
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Public education resources must also be adapted to the learning styles and abilities of the
individual.
Measurement Criteria
1. An environment conducive to learning is maintained
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2. Current educational materials and supplies specific to health promotion, cancer
prevention, detection treatment and care are available and easily accessed
3. Educational materials are appropriate for individuals of varied age, sex, race, creed,
culture, education, physical and cognitive ability levels, health literacy and health beliefs
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4. Personnel resources are sufficient to implement the process of education
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5. Educational materials and information about community resources are reviewed for
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accuracy and relevance on a regular basis.
6. Educational materials are validated for use in culturally diverse populations.
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Representative members of the population perform this validation
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Standard III. Curriculum
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Knowledge, skills, and attitudes related to the management of human responses to cancer are
reflected in the educational activity for the patient and significant others experiencing cancer.
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Rationale
The content of the education must address the unique educational needs of the
patient/significant other and the public.
Individuals require information that assists them in making healthy lifestyle decisions,
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participate in health promotion activities, as well as making treatment decisions, manage
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treatment side effects and symptoms of their disease and coping with cancer.
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Measurement Criteria
The educational activity designed for the patient/significant other includes:
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1. Accurate, current, and credible information about cancer prevention, detection, diagnosis,
treatment, rehabilitation, survivorship, and supportive care
2. Risk factors for cancer development including genetic, environmental, occupational, and
lifestyle risks for cancer
3. Methods to modify health behaviors and practices for cancer prevention and health
promotion
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4. Recommended site-related self-examination and screening guide- lines
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5. Signs and symptoms that require follow-up by healthcare providers as well as
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information regarding contacting the provider.
6. Strategies to improve consumer accessibility to cancer prevention, detection, and
treatment facilities
7. Strategies to modify health behaviors for health promotion and cancer prevention,
detection, treatment, and care
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8. Strategies to evaluate cancer prevention, detection, and treatment facilities.
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9. Criteria to evaluate questionable information/cancer therapies and accurate, current, and
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credible information about treatment alternatives
10. Community resources for health promotion, early detection and cancer related
information and services
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11. Legal and ethical rights of people at risk for cancer and for those experiencing cancer.
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12. Recognition and incorporation of religious, ethnic, and cultural values and beliefs that
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influence health practices
13. Cognitive, psychomotor, and affective skills needed for problem solving, decisionmaking, and self-care.
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14. Signs and symptoms of potential physical and psychosocial responses related to cancer
and/or treatment, including those that should be reported to the interdisciplinary healthcare team
15. Psychosocial strategies to facilitate adaptation to the cancer experience
Standard IV. Teaching-Learning Process
Teaching-learning theories are applied to the development, implementation, and evaluation
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of learning experiences related to cancer education. Given the ease of access to health
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information, the oncology nurse often plays the role of facilitator in the learning process and not
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so much the provider of information.
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Rationale
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Adult learning principles establish that adults are self-directed learners. The learning
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experiences provided must assist the learners in discovering and obtaining the appropriate
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resources, taking appropriate actions to maintain or regain health and empowering them in an
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independent approach to learning. Learners are provided with guidance and relevant information
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if they are struggling to understand or are incapable of comprehending.
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Criteria
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The oncology nurse:
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1. Collects data systematically from the learner to assess literacy, learning needs, learning
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styles, readiness to learn, and situational and psychosocial factors influencing comprehension.
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2. Analyzes assessment data to identify cognitive, psychomotor and affective learning
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needs.
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3. Develops a teaching plan in collaboration with the patient/significant other or public that
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includes behavioral objectives, specific content to meet the identified objectives, teaching
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strategies/learning experiences that are appropriate for and promote active learner participation
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and criteria for evaluation of outcomes.
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4. Implements the teaching plan in an environment conducive to learning. Provides material
that is clear, well organized and in “plain language.”
5. Uses evidence-based practice to determine the best way to provide education on a
specific topic.
6. Utilizes appropriate instructional methods, including the use of technology, based on an
assessment of the learners’ preferences.
7. Collects data from the patient/significant other and public using teach-back techniques, to
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evaluate achievement of learning objectives, effectiveness and efficiency of instruction, and the
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need to revise the teaching plan.
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8. Modifies the teaching-learning process based on evaluation data.
Standard V. Learner: Patient/Significant Other and the Public
The patient and/or significant other apply knowledge, skills, and attitudes to management of
actual or potential human responses to the cancer experience.
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Personal behaviors and public policy related to cancer prevention, detection, treatment,
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rehabilitation, and supportive care are influenced by formal and informal public education.
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Rationale
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Learners are the target of the education process. Individuals may learn in a variety of styles
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including visual, auditory, read-write, and kinesthetic. Using the learners’ predominant learning
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style will move the individual from passive to active learning.
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Criteria
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The patient/significant other:
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1. Is able to verbalize an understanding of extent of disease and treatment plan at a level
377
consistent with age, educational and cultural background.
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2. Participates in decision making regarding the plan of care if desired and possible.
379
3. Utilizes appropriate community and personal resources to seek out information and
380
381
services.
4. Describes self-care measures and verbalizes the appropriate action for common
382
outcomes, oncologic emergencies, and problems associated with the disease, treatment and side
383
effects.
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5. Understands the planned treatment schedule and the instructions provided to them.
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6. Participates in conversation regarding survivorship, advance care planning, and end-of-
386
life care decisions as appropriate.
387
7. Identifies personal genetic risk factors and their implications when indicated.
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8. Describes health promotion strategies and survivorship care plan when cancer treatment
389
is complete.
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The public that has been reached by cancer education:
391
1. Demonstrates realistic attitudes about cancer and cancer risk factors.
392
2. Describes lifestyle choices that minimize personal risks for cancer and promote health.
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3. Participates in appropriate or recommended cancer screening activities.
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4. Identifies a course of action for early detection when signs and symptoms of cancer are
discovered.
5. Identifies sources of cancer information, care, rehabilitation, and supportive care in the
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community.
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Resources
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400
Printed and audiovisual materials related to patient/significant other and public education are
available from numerous sources, including the following.
401
American Cancer Society
402
800-ACS-2345 www.cancer.org
403
ANA’s Social Networking Principles Toolkit:
404
http://www.nursingworld.org/socialnetworkingtoolkit.aspx
405
406
American Society of Clinical Oncology
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Patient information from the American Society of Clinical Oncology. Includes cancer types,
408
409
treatments, survivorship, advocacy, resources, podcasts, and news.
http://www.cancer.net/
410
411
412
Cook, D.A., & Dupras, D.M. (2004). A practical guide to developing effective web-based
learning. Journal of General Internal Medicine, 19, 698-707.
413
414
Leukemia and Lymphoma Society
415
212-573-8484
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416
http://www.lls.org/ LIVESTRONG Foundation
417
http://www.livestrong.org
418
419
National Cancer Institute (NCI)
420
800-4-CANCER
421
www.cancer.gov
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Cancer and treatment information in multiple languages
423
424
NCI Clinical Trials Web site
425
http://www.cancer.gov/about-cancer/treatment/clinical-trials
426
427
NCI Complementary Therapies Web site
428
https://nccih.nih.gov/
429
430
NCI Office of Communications
431
Office of Communications and Public Liaison (OCPL)
432
National Cancer Institute
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BG 9609 MSC 9760
434
9609 Medical Center Drive
435
Bethesda, MD 20892-9760
436
Phone: 240-276-6600
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http://www.cancer.gov/about-nci/organization/ocpl
438
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NCI’s Evaluating Online Sources of Health Information:
440
http://www.cancer.gov/about-cancer/managing-care/using-trusted-resources
441
442
ONS Online
443
https://www.ons.org/ ONS has an:
444
 Educator Resource Center, a subscription based database which encompasses information in
445
all areas of oncology practice and includes power point presentations, case studies, test
446
questions and competencies.
447
 http://erc.ons.org/
448

449
Practice) information which is reliable research based information to share with patients,
450
fellow practitioners and the public. https://www.ons.org/practice-resources/pep
The website also contains practice resources such as the PEP (Putting Evidence into
451
452
http://www.cancer.gov/publications/pdq
453
Cancer Patient Education Network
454
154 Hansen Rd, Suite 201
455
Charlottesville, VA 22911 USA
456
Tel: 434.284.4697 Fax: 434.977.1856
457
[email protected]
458
http://www.cancerpatienteducation.org/
459
460
Printed and online resources for the educator
461
Cleveland Clinic Partnership with The Scott Hamilton CARES Initiative
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http://www.chemocare.com
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Online site for information on chemotherapy including drug information, managing side
464
effects, eating well during chemotherapy, what is chemotherapy?, before and after
465
chemotherapy, survivor testimonials, frequently asked questions, educational videos,
466
chemotherapy resources, complementary medicine and self-help. Information in English and
467
Spanish.
468
Using What Works
469
Format: Web-based self-study
470
Time: Self-paced
471
Using What Works is a train-the trainer course for health promotors and educators. It teaches
472
users how to plan a health education program using evidence-based programs.
473
http://cancercontrol.cancer.gov/use_what_works/start.htm
474
Guidelines for Establishing Comprehensive Cancer Patient Education Services (1998,
475
reprinted 6/99, revised 2013), Cancer Patient Education Network,
476
http://www.cancerpatienteducation.org/publications.shtml
477
478
479
Making Health Communications Programs Work: A Planner’s Guide (2002), NCI Office of
Communications, http://cancer.gov/pinkbook
Theory at a Glance: A Guide for Health Promotion Practice (2005) NCI Office of
480
Communications, http://sbccimplementationkits.org/demandrmnch/ikitresources/theory-at-a-
481
glance-a-guide-for-health-promotion-practice-second-edition/ Teachback Toolkit
482
http://www.teachbacktraining.org/
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484
485
Terminology
Advanced Practice Level—Level of practice for a nurse with a master’s, doctoral, or
postdoctoral education who applies theoretical knowledge in a specialized field.
486
Cancer Control—A term including the entire spectrum of cancer care (i.e., prevention,
487
screening and early detection, diagnosis, treatment, rehabilitation, survivorship and palliation).
488
Cancer Detection—Performance of tests to make a diagnosis of cancer in symptomatic
489
490
491
492
clients.
Cancer Eradication—The obliteration of cancer and restoration of the client to a normal life
expectancy.
Cancer Prevention—Strategies to minimize client exposure to sub- stances known to
493
increase the risk of cancer or to promote optimal client exposure to substances known to
494
decrease the risk of cancer.
495
496
Cancer Rehabilitation—A process by which individuals within their environment are
assisted to achieve optimal function within the limits imposed by cancer.
497
Cancer Screening—Strategies designed to detect cancer in asymptomatic clients.
498
Carcinogenesis—The production or origin of cancer.
499
Complementary Therapy—Scientifically accepted treatment options considered in clinical
500
501
decision making.
Cultural Competence—Refers to being sensitive and responsive to issues related to culture,
502
race, ethnicity, gender, age, socioeconomic status, and sexual orientation. Cultural competence
503
indicates translation of cultural sensitivity and awareness into credible behaviors and actions.
504
505
Culture—A set of values, beliefs, and rules for behavior. Culture provides the structure for
meaning and decision making.
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506
507
Domains of Learning—Cognitive: Refers to rational thought, knowledge of the basic
concepts of identified topics
508
Psychomotor: Refers to the physical skills needed to perform a task
509
Affective: Refers to attitudes, values, and cultural beliefs regarding the subject being
510
presented
511
Education—The process of inducing measurable changes in knowledge, skills, and attitudes
512
513
514
515
through planned learning activities.
Generalist Level—Level of practice for a registered nurse who possesses general knowledge
and skills applicable to diversified health concerns of individuals.
Health Literacy - is the degree to which individuals have the capacity to obtain, process, and
516
understand basic health information and services needed to make appropriate health decisions.
517
Health Promotion—Strategies to achieve a dynamic state in which the well-being and
518
519
520
521
522
523
health potential of individuals are realized to the fullest extent.
Nursing Diagnosis—A description of an actual or potential health problem that nurses, by
virtue of their education and experience, are capable of diagnosing and licensed to treat.
Nursing—The diagnosis and treatment of human responses to actual or potential health
problems.
Oncology Nursing—Nursing care of people with an actual or potential diagnosis of cancer
524
ranging from prevention of disease to rehabilitation, survivorship, or terminal care.
525
Outcome Criteria—Descriptions of the desired end results of specific actions.
526
Palliation—Control of symptoms when disease is beyond cure.
527
Person at risk for or experiencing cancer—The individual, significant other, group, or
528
community for whom the oncology nurse provides formally specialized services.
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529
530
Process Criteria—Descriptions of the major sequence of events and activities required to
obtain desired outcomes.
531
Public—The people of an organized community.
532
Questionable Therapies—Cancer treatments or therapies that have not been shown to be
533
active in tumor animal models or acceptable clinical trials and yet are promoted as effective
534
methods for the cure, palliation, or control of cancer.
535
536
537
538
539
540
Significant Others—People who are related or who represent a significant support group for
the person at risk for or experiencing cancer.
Standards—A norm that expresses an agreed-upon level of practice that has been developed
to characterize, measure, and pro- vide guidance for achieving excellence.
Structure Criteria—Descriptions of the environment and resources needed to achieve
desired outcomes.
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References
542
American Medical Association Foundation (2007). Health literacy and patient safety: Help patients
543
understand: Removing barriers to better, safe care: Reducing the risk by designing a safer, shame-
544
free health care environment. Chicago, IL: American Medical Association Press.
545
546
547
548
549
550
551
552
553
554
555
556
Agency for Healthcare Research and Quality (2001). Making health care safer: A critical analysis of
patient safety practices. From http://archive.ahrq.gove/clinic/tp/ptsaftp.htm
Agency for Healthcare Research and Quality, Health literacy universal precautions toolkit. Publication
No. 10-0046-EF April 2010
American Nurses Association (2015). Code of ethics for nurses with interpretive statements. Springfield,
MD: Nursesbooks.org.
Bastable, S.B. (2003). Nurse as educator: Principles of teaching and learning for nursing practice.
Burlington, MA: Jones and Bartlett.
Bastable, S.B., Gramet, P., Jacobs, K., & Sopczyk, D.L. (2011) Health professional as educator:
principles of teaching and learning. Burlington, MA: Jones and Bartlett Learning.
Brandt, J.M. & Wickham, R. (2013). Statement on the scope and standards of oncology nursing practice:
generalist and advanced practice. Pittsburgh, PA: Oncology Nursing Society.
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Cahill, J.E., Gilbert, M.R., & Armstrong, T.S. (2014). Personal health records as portal to the electronic
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medical record. Journal of Neuro-Oncology, 117, 1-6. http://dx.doi.org/10.1007/s11060-013-1333-x
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Coaching to Always Use Teach-back: http://www.teachbacktraining.org/
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Commission on Cancer. (2012). Cancer program standards 2012: Ensuring patient-centered care.
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Cope, D.G. (2016) Education process. In J.K. Itano, J. Brant, F.A. Conde & M.G. Saria (Eds.), Core
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Cox-Davenport, R.A. (2014). A grounded theory of faculty's use of humanization to create online course
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Doak, C.C., Doak, L.G., & Root, J.H. (1996). Teaching patients with low literacy skills. Philadelphia, PA:
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Friedman, A.J., Cosby, R., Boyko, S., Hatton-Bauer, J., & Turnbull, G. (2011). Effective teaching
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recommendations. Journal of Cancer Education, 26, 12-21. http://dx.doi.org/10.1007/s13187-010-
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Jacobson et al (2012) Revision to the 2009 American Society of Clinical Oncology/Oncology Nursing
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Jones, J.B., Weiner, J.P., Shah, N.R., & Stewart, W.F. (2015). The wired patient: Patterns of electronic
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patient portal use among patients with cardiac disease or diabetes. Journal of Medical Internet
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Kannisto, K.A., Koivunen, M.H., Välimäki, M.A. (2014). Use of mobile phone text message reminders in
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health care services: A narrative literature review. Journal of Medical Internet Research, 16, e222.
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Keller, B, Labrique, A., Jain, K.M., Pekosz, A., & Levine, O. (2014). Mind the gap: Social media
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Krebs, Linda U. (2005). Application of the statement on the scope and standards of oncology nursing
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Kruse, C.S., Argueta, D.A., Lopez, L., & Nair, A. (2015). Patient and provider attitudes toward the use of
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McCarthy, B. (2011). Family members of patients with cancer: What they know, how they know and
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to manage patient-reported symptoms during cancer treatment. Clinical Journal of Oncology Nursing,
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15, 253-258. http://dx.doi.org/10.1188/11.CJON.253-258
680
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Recommended Reading
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Journal of Medical Internet Research - http://www.jmir.org
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Nelson, R., Joos, I., & Wolf, D.M. (2013). Social media for nurses: Educating practitioners and patients
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685
686
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in a networked world. New York, NY: Springer Publishing Company, LLC.
Fraser, R. (2011). The nurse's social media advantage: How making connections and sharing ideas can
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