Skip to main content
Wiley Open Access Collection logoLink to Wiley Open Access Collection
. 2026 Jul 16;35(7):e70520. doi: 10.1002/pon.70520

The American Psychosocial Oncology Society's Psychosocial Oncology Virtual Academy: Enhancing Access to Specialized Psychosocial Oncology Care

Sharla Wells‐Di Gregorio 1,2,✉, Brad McAlister 3, Karen Kayser 4, Amy Siston 5, Stacy Flowers 6, Cathy Donnell 7,8, George Fitchett 9, Tamryn F Gray 10,11, Jesse R Fann 12,13,14, Jessica Vanderlan 15, Debbie Snyder 16, Nicole Bates 12,17, Teresa Deshields 18, Sarah Baltimore 1,2, Madison Voinovich 1,2, Tanya Smit 1,2, Donald R Marks 19
PMCID: PMC13375950  PMID: 42463988

ABSTRACT

Objective

By 2040, there will be 26 million cancer survivors in the United States, with approximately 40% experiencing cancer‐related challenges warranting psychosocial care. Simultaneously, the US has a psychosocial workforce shortage. The American Psychosocial Oncology Society (APOS) created the Psychosocial Oncology (PSO) Virtual Academy in 2022 to expand the PSO workforce. This study provides a formative evaluation of this curriculum.

Methods

The PSO Virtual Academy is a 15‐session training program provided via the Trusted Provider Network (TPN), a continuing education platform. The majority of registrants come from West Virginia (n = 28) and California (n = 21), states in which APOS has partnered to increase access to evidence‐based PSO care. After finishing each session, course participants completed a brief mixed methods survey. In this study, we examine feasibility (educational, technical, and operational), acceptability, learning effectiveness, strengths, and areas for improvement.

Results

Since 2022, 262 behavioral health specialists have registered, and 147 (56%) have completed the certificate course. Eighty‐four percent reported satisfaction with their overall experience with the program. Technology use was satisfactory for 76% of participants. Ninety‐six percent reported learning an average amount to a great deal. Areas of strength included engaging faculty and inclusion of clinical discussions. Areas for improvement included providing slide handouts, greater focus on clinical interventions, and assessment tools.

Conclusions

The PSO Virtual Academy 1.0 has provided satisfactory and useful training to over 147 behavioral health professionals, helping APOS to expand the PSO workforce in several mental health shortage areas. Work is underway to complete a summative evaluation and develop version 2.0, which will incorporate a briefer, standardized format for didactic content, in‐person skills‐based training components, and a case‐based community of practice.

Keywords: access to care, cancer supportive care, health equity, professional training, psychosocial oncology, rural health, virtual education, workforce development

1. Background

Currently, there are more than 18 million cancer survivors in the US, with the number expected to increase to 26 million by 2040 [1]. Most individuals with cancer experience some level of cancer‐related distress, defined as an unpleasant psychological, social, spiritual, financial, and/or physical experience related to cancer [2]. Cancer survivors experience lower health‐related quality of life and poorer physical and mental health compared to age‐matched peers [3]. An estimated 32%–35%, or 6 million, of the 16.9 million cancer survivors will experience significant mental health consequences related to cancer although rates are higher among certain cancer types (e.g., breast, head and neck, lung) and for those with advanced stage cancers [4, 5, 6]. Emotional challenges include adjustment difficulties related to functional and/or cognitive changes, depression, anxiety, in addition to social, caregiver, and work‐related stress [7, 8]. Other common and distressing cancer‐related symptoms include fatigue, pain, insomnia [9, 10, 11, 12]. In fact, cancer‐related symptoms are the most consistent predictor of persistent distress across the cancer trajectory [13] potentially because those symptoms serve as a reminder of cancer progression and inflate anxiety [14]. Disease progression and end of life bring increased stress and burden for families [15].

Psychosocial distress and disruptions to a patient's life can hinder cancer patients' adherence to and completion of treatment [6], as well as their ability to manage medical complications and side effects of therapy. Psychosocial distress can also result in individuals overutilizing medical resources (e.g., increased emergency department visits) [16, 17, 18]. Social factors such as isolation, insecure housing, lack of education or social support, and inadequate health insurance can add to a patient's emotional distress and ultimately affect cancer outcomes [19, 20, 21].

Evidence‐based psychosocial care is an essential component of comprehensive, whole‐person oncology care, with benefits including decreased distress, anxiety, and depression, reduced associated medical costs, fewer emergency department visits and hospitalizations, improved symptom management, and improved quality of life [10, 11, 12, 22, 23, 24, 25, 26]. Addressing patients' emotional, social, and behavioral needs also positively impacts treatment adherence and survivorship outcomes [27, 28, 29, 30]. Despite the importance of addressing the psychosocial needs of patients, the US healthcare system is not adequately prepared to meet the needs of the growing population of cancer patients and their caregivers. The demand for psychosocial oncology care far exceeds supply. Drawing figures from the US professional association memberships, there are approximately 1000 psychosocial oncology professionals in the American Psychosocial Oncology Society (APOS), 1200 oncology social workers in the Association of Oncology Social Workers (AOSW), 900 consult‐liaison psychiatrists in the Academy of Consult‐Liaison Psychiatry (ACLP), and 2800 oncology nurse practitioners in the Oncology Nursing Society (ONS) [31]. These data suggest that the staff‐to‐patient ratio in the US is 1:9980. A broader lens reveals a shortage of mental health practitioners overall. Currently, 65% of non‐metropolitan counties have no psychiatrists, 47% have no psychologists, and by 2030, there will be a projected critical shortfall of social workers in rural areas, more pronounced in key states [32].

The mission of the APOS is to advance equitable, evidence‐based psychosocial cancer care through research, education, practice, and advocacy. The complexity of cancer‐related psychosocial distress requires highly skilled professionals trained to provide assessment and intervention throughout the continuum of care. To build workforce capacity to deliver quality, evidence‐based care to optimize cancer outcomes, the APOS Professional Education Committee established a core curriculum designed to train behavioral health providers to provide evidence‐based psychosocial oncology care [33]. From the core curriculum, APOS created the Psychosocial Oncology Virtual Academy, a 15‐session certificate training program launched in 2022.

The purpose of this study is formative evaluation of the PSO Virtual Academy using the Sloan Consortium Quality Framework [34]. This framework applies five pillars to assess the quality of distance learning: access, cost‐effectiveness, learning effectiveness, student satisfaction, and faculty satisfaction. Specifically for this study, we examine feasibility (educational, technical, and operational), learning effectiveness, acceptability, strengths, and areas for improvement.

2. Methods

2.1. Psychosocial Oncology Virtual Academy Curriculum

The curriculum is focused on the 10 domains defined by our previous core curriculum Delphi study [33] (See Table 1). Content includes 15 didactic videos in each of the 10 listed domains, with a preferential focus on the Psychosocial Assessment & Treatment domain. Speakers incorporate information to enhance cultural competence in their topic areas and 10–15‐min question‐and‐answer sessions at the end of each recording. Each session is approximately 60–90 min, followed by a brief 10‐ to 15‐question content‐related quiz and a 12‐question utility and accessibility assessment. The Virtual Academy is asynchronous so that participants can complete the curriculum any time within a one‐year period.

TABLE 1.

PSO virtual academy curriculum domain descriptions.

Cancer Basics Cancer 101. Cancer diagnosis and staging, basic treatment and side effect information, cancer epidemiology, mortality and cancer disparities, and differential impact by disease type, developmental phase, and phase of illness. Survivorship trajectory and services available to cancer patients, including supportive care, survivorship, palliative care, and hospice care.
graphic file with name PON-35-e70520-g004.jpg
Emotional & psychological impact PSO 101. Common psychological issues experienced by cancer patients and their families throughout the disease trajectory, including coping with functional changes, anxiety and uncertainty (e.g., “scanxiety”), and demoralization. Healthy and unhealthy coping strategies. Basic psychological diagnoses of mood, anxiety, personality disorders, as well as psychosis.
graphic file with name PON-35-e70520-g011.jpg
Sexual & relationship challenges Body and sexual changes during cancer. Body image challenges related to cancer treatment, impacts of hormonal changes on patient well‐being, especially the impact of endocrine therapies, and how patients navigate dating after a cancer diagnosis. Sexual anatomy, sexual development, and common sexual and relationship problems experienced by cancer patients and their partners, including the impact of some treatments on fertility. Basic understanding of specific issues faced by LGBTQ+ individuals with cancer.
graphic file with name PON-35-e70520-g012.jpg
Spiritual & religious considerations Spiritual and religious beliefs that impact the approach to and coping with cancer care. Screening patients for spiritual distress and basic religious tenets that may impact medical care. Non‐western religious traditions, spiritual beliefs, and practices. Self‐reflection on how religious and spiritual beliefs impact care. Existential impact of cancer across the developmental spectrum and patient/family meaning‐making in this context.
graphic file with name PON-35-e70520-g001.jpg
Health care communication & decision making Patient‐centered communication and shared decision‐making. Challenges of informed consent in the cancer setting. Common communication problems for cancer patients and their families and strategies to de‐escalate challenging communication scenarios. Advance directive discussions and advance care planning basics. Strategies to enhance communication for underserved communities, including the use of interpreters, managing health literacy challenges, and consulting within health care institutions as a psychosocial provider.
graphic file with name PON-35-e70520-g003.jpg
Social & practical problems Social and practical problems following a cancer diagnosis. Financial toxicity, job/career loss, family medical leave, and health insurance options. Common coping and support issues and strategies to support patients. Community‐based and national cancer resources and basic support and family interventions designed to assist patients and families living with cancer.
graphic file with name PON-35-e70520-g005.jpg
Caregiver experience Caregiver emotional issues, role adjustment, and factors contributing to caregiver strain and burnout throughout the cancer trajectory. Anticipatory grief/mourning, as well as community‐based and supportive resources for caregivers. How various cultural and spiritual attitudes, beliefs, and behaviors can impact burnout and strategies to help reduce compassion fatigue.
graphic file with name PON-35-e70520-g006.jpg
Cognitive function Normal age‐related cognitive changes, hormonal changes associated with aging and/or cancer treatments, and medication‐induced changes in cognition (e.g., steroid‐induced mood changes or psychosis). Brief cognitive screening, including basic mental status testing. Most common signs/symptoms associated with “chemobrain,” or treatment‐induced cognitive changes and the difficulty of causal interpretations without pre‐treatment testing. How to conduct capacity evaluations. Education of family members regarding differences between delirium, dementia, and brain tumor‐related functional changes and strategies for coping and supporting patients.
graphic file with name PON-35-e70520-g008.jpg
Physical symptoms Basic symptom screening and assessment, including measures commonly used in cancer settings to determine the severity of pain, insomnia, and fatigue. Basic mechanisms of nausea/vomiting, pain, and insomnia. Evidence‐based behavioral interventions for pain, insomnia, and fatigue. Opioid risk management strategies.
graphic file with name PON-35-e70520-g009.jpg
Psychosocial assessment & treatment Evidence‐based screening and intervention as the foundation to improve quality of life. Validated distress screening measures and basic distress interventions (e.g., relaxation exercises, problem‐solving therapy, behavioral activation), as well as an introduction to basic grief interventions and motivational interviewing. Basic psychopharmacology in the cancer setting, including side effects of psychotropic medications. Other evidence‐based interventions for depression and anxiety (i.e., CBT, ACT), as well as how to tailor interventions for patients with varied cultural beliefs and disease stages.
graphic file with name PON-35-e70520-g002.jpg

2.2. Curriculum Delivery

The PSO Virtual Academy was initially offered to all APOS members as a membership benefit with marketing through the APOS Update, the organization's monthly newsletter. APOS then developed a partnership with Cigna‐Evernorth, a behavioral health insurance panel in California, to train behavioral health providers in their network. Network members received a discount for participating in the PSO Virtual Academy and were highlighted with a specialist designation within their provider panel after completing the certification course. In an effort to reach underserved communities, APOS also established a partnership with the West Virginia Cancer Coalition Quality of Life Committee to sponsor 48 scholarships covering costs associated with the Virtual Academy. In January 2024, APOS switched delivery of the curriculum from an internal website to Trusted Provider Network (TPN), a national interactive platform of behavioral health professionals offering advanced continuing education opportunities. Over 82,000 behavioral health professionals are registered in TPN, including licensed social workers, counselors, nurses, and psychologists.

2.3. Ethical Considerations

This study was determined to be exempt by The Ohio State University Office of Responsible Research Practices IRB (STUDY20252676) as research conducted in educational settings and secondary research on existing data, with no consent required.

2.4. Measures

Using the Sloan Consortium Quality Framework [34], we examined two different aspects of feasibility for the PSO Virtual Academy: access, which ensures that technology enables broad participation, and cost effectiveness, or the financial viability and efficiency of delivery of the online curriculum. We also reviewed learning effectiveness focused on learning outcomes. Finally, we reviewed learner satisfaction via several measures of acceptability. We did not measure faculty satisfaction but will assess this in future versions of the Academy.

2.4.1. Feasibility

We assessed educational, technical, and operational aspects of feasibility, defined as follows:

  • Educational Feasibility: Curriculum alignment with standards for the field, viability of the assessment strategy, and completion rates. Viability of assessment was determined based on whether participants were able to complete the virtual quizzes and module feedback (% with technical difficulties with this evaluation component).

  • Access/Technical Feasibility: Participant ratings of accessibility accommodations and course technology.

  • Cost‐Effectiviness/Operational Feasibility: Resource requirements (administration, marketing, partnerships), return on investment (ROI), sustainability, and scalability of the curriculum includes qualitative data provided by the APOS Executive Director.

2.4.2. Acceptability

The following survey items were used to assess acceptability:

  • Content was current and relevant (strongly agree, agree, neutral, disagree, strongly disagree)

  • Presenter was knowledgeable on the subject matter (strongly agree, agree, neutral, disagree, strongly disagree)

  • Presenter teaching style was effective (strongly agree, agree, neutral, disagree, strongly disagree)

  • How useful was the content for your practice or other professional development? (extremely useful, very useful, useful, slightly useful)

  • How much did you learn as a result of this program (a great deal, above average, average amount, little, very little)

  • How was your overall experience (highly satisfied, satisfied, neutral, dissatisfied)

2.4.3. Learner Effectiveness

Participants complete a quiz at the end of each session, requiring 75% for passing. We report session‐level evaluation outcomes.

2.4.4. Qualitative Responses—Strengths and Areas for Improvement

Overall Program: Qualitative responses to two questions were also asked of our Cigna‐Evernorth group including What was the most helpful part of the PSO Virtual Academy and what modifications would you recommend? Thematic analysis was used for these responses given that we had 38 most helpful responses and 25 suggestions for modifications. Module Feedback: When the learning platform changed to TPN, participants were asked to provide qualitative responses, specifically if they had additional comments or feedback after each module.

2.5. Analyses

Data were exported directly from TPN and de‐identified for analyses. Completion rate was determined by the percentage of participants who completed post‐registration as of September 2025. Descriptive statistics were used to analyze technical feasibility and accessibility via SPSS Version 31.0. Operational feasibility incorporated qualitative feedback provided by APOS Executive Director, Brad McAlister of Parthenon Management Group. Thematic analysis was used to summarize narrative feedback given the limited number of qualitative responses.

3. Results

3.1. Participant Characteristics

Between November 2022 and September 2025, 262 behavioral health clinicians registered for the PSO Virtual Academy certificate course. Participants represented a broad mix of disciplines (Figure 1), including social workers (27.5%), counselors (27.1%), psychologists (25.2%), nurses (4.6%), marriage and family therapists (5.0%), psychiatrists (1.9%), physicians (1.1%), psychiatric nurse practitioners (0.4%), case management/discharge planning professionals (0.4%), students (3.4%), and other disciplines (3.4%). Registrants were geographically diverse (Figure 2), representing 41 US states, with the largest numbers from West Virginia (n = 28, 10.7%) and California (n = 21, 8.0%), reflecting intentional partnerships to expand psychosocial oncology training, especially in regions with mental health workforce shortages.

FIGURE 1.

FIGURE 1

Registrants' discipline. n = 262.

FIGURE 2.

FIGURE 2

Participant geographic location in the United States.

3.2. Educational Feasibility

The curriculum is aligned with curriculum core content put forth by the APOS Professional Education Committee [33]. The Virtual Academy Advisory Panel selected content from recorded webinars that fit within the 10 domains of the Psychosocial Oncology core curriculum with five recordings in the Psychosocial Assessment and Intervention domain given that this domain is foundational to the practice of psychosocial oncology. The assessment strategy was effective according to participant feedback, although with the switch to TPN, some of the original domain quiz questions were temporarily misaligned, a problem quickly resolved by TPN (< 3% of participants affected). The overall completion rate was 56% (147/262) for the full 15‐session curriculum.

3.3. Technical Feasibility

Technical feasibility was evaluated by participants' ratings of accessibility and technology (see Table 2). Across sessions, an average of 59% of participants strongly agreed or agreed that accommodation accessibility were adequate, with most remaining respondents selecting neutral rather than disagreeing. Ratings of the virtual platform were good. Most participants (75.6%) strongly agreed or agreed that “technology used during this course met my expectations,” with an additional proportion reporting neutral experiences and relatively few disagreeing.

TABLE 2.

Feasibility: Participant ratings of PSO Virtual Academy accessibility and technology.

Session N Ratings Accessibility Tech met expectations
Biomedical aspects of cancer 202 Strongly agree 26.7% 33.2%
Agree 36.6% 52%
Neutral 36.6% 10.9%
Disagree 0% 4%
Strongly disagree 0% 0%
PSO 101 152 Strongly agree 27.6% 32.2%
Agree 34.2% 42.1%
Neutral 38.2% 24.3%
Disagree 0% 0.7%
Strongly disagree 0% 0.7%
Overcoming challenges with implementing screening 147 Strongly agree 24.5% 26.5%
Agree 31.3% 36.7%
Neutral 44.2% 27.2%
Disagree 0% 7.5%
Strongly disagree 0% 2.0%
Cognitive changes associated with cancer and cancer treatment 151 Strongly agree 29.1% 34.4%
Agree 26.5% 36.4%
Neutral 44.4% 27.2%
Disagree 0% 1.3%
Strongly disagree 0% 0.7%
Tailored CBT for anxiety in adv cancer 154 Strongly agree 33.1% 39.6%
Agree 30.5% 37%
Neutral 35.7% 22.7%
Disagree 0% 0%
Strongly disagree 0.6% 0.6%
Care of the cancer caregiver 153 Strongly agree 30.1% 35.9%
Agree 32% 41.8%
Neutral 37.9% 21.6%
Disagree 0% 0.7%
Strongly disagree 0% 0%
CBT for cancer‐related fatigue 152 Strongly agree 30.9% 36.2%
Agree 27% 40.1%
Neutral 42.1% 22.4%
Disagree 0% 0%
Strongly disagree 0% 1.3%
ACT—A values‐driven approach to living with illness 153 Strongly agree 33.3% 41.2%
Agree 24.2% 32%
Neutral 42.5% 26.1%
Disagree 0% 0.7%
Strongly disagree 0% 0%
Hot topics in psychotropic medications for PSO professionals 150 Strongly agree 26.7% 31.3%
Agree 32% 41.3%
Neutral 41.3% 25.3%
Disagree 0% 1.3%
Strongly disagree 0% 0.7%
Best practice guidelines & models for depression management 187 Strongly agree 28.9% 34.2%
Agree 26.2% 43.3%
Neutral 44.9% 18.7%
Disagree 0% 3.2%
Strongly disagree 0% 0.5%
Caring for patients' spiritual needs 163 Strongly agree 30.1% 35.6%
Agree 30.7% 41.1%
Neutral 38.7% 20.9%
Disagree 0.6% 2.5%
Strongly disagree 0% 0%
Body image, intimacy, and sexual difficulties in cancer 171 Strongly agree 32.2% 39.8%
Agree 27.5% 39.2%
Neutral 40.4% 19.9%
Disagree 0% 1.2%
Strongly disagree 0% 0%
Suicidal thinking and behavior in cancer patients 171 Strongly agree 34.8% 41.6%
Agree 25.8% 39.3%
Neutral 38.8% 16.9%
Disagree 0% 1.1%
Strongly disagree 0.6% 1.1%
Under resourced: Increasing utilization of community‐based supportive care programs 157 Strongly agree 26.8% 29.9%
Agree 29.3% 40.8%
Neutral 43.9% 27.4%
Disagree 0% 1.3%
Strongly disagree 0% 0.6%
Value of PSO in supportive and palliative care 162 Strongly agree 27.2% 35.2%
Agree 33.3% 43.8%
Neutral 38.9% 19.8%
Disagree 0% 0.6%
Strongly disagree 0.6% 0.6%
Average overall ratings Strongly agree 29.5% 35.1%
Agree 29.8% 40.5%
Neutral 40.6% 22.1%
Disagree 0% 1.7%
Strongly disagree 0.1% 0.6%

3.4. Operational Feasibility

The PSO Academy 1.0 demonstrated strong operational feasibility through streamlined administration and efficient resource allocation across multiple delivery models. Strategic partnerships enhanced marketing reach and broadened engagement, while leveraging existing infrastructure minimized overhead costs. From a business perspective, the program's design supports positive return on investment by aligning participant demand with scalable delivery mechanisms. Sustainability is reinforced through diversified revenue streams and adaptable frameworks, ensuring continuity and growth for future cohorts. These factors collectively position the Academy as a cost‐effective, scalable solution for advancing psychosocial oncology education.

3.5. Acceptability of the Curriculum

Acceptability of the PSO Virtual Academy 1.0 was high (see Table 3). Globally across sessions, an average of 83.8% of respondents reported being satisfied or highly satisfied with their overall experience. The highest rated sessions were “Body Image, Intimacy, and Sexual Difficulties in Cancer” and “Suicidal Thinking and Behavior in Cancer Patients,” with 91.3% and 91% of participants reporting being satisfied or highly satisfied, respectively. The lowest rated session was the session focused on community‐based supportive care programs, with 69.4% of participants reporting being satisfied or highly satisfied. Overall acceptability was supported by high ratings of content relevance, presenter expertise, teaching style, professional utility, and perceived learning.

TABLE 3.

Acceptability—Participant ratings of PSO Virtual Academy relevance, presenter knowledge, teaching style, utility, learning, & satisfaction.

Session N Content current & relevant Knowledgeable presenter Teaching style Utility for professional development How much learned Overall experience
Biomedical aspects of cancer 202 Strongly agree 39.1% Strongly agree 64.9% Strongly agree 43.6% Extremely useful 32.7% A great deal 42.1% Highly satisfied 40.1%
Agree 51% Agree 33.7% Agree 44.6% Very useful 37.1% Above average 30.7% Satisfied 48.5%
Neutral 7.4% Neutral 1.0% Neutral 8.9% Useful 25.2% Average amount 25.7% Neutral 9.9%
Disagree 2.5% Disagree 0% Disagree 3% Slightly useful 5% Little 1.0% Dissatisfied 1.5%
Strongly disagree 0% Strongly disagree 0.5% Strongly disagree 0% Not useful 0% Very little 0.5% Highly dissatisfied 0%
PSO 101 152 Strongly agree 39.5% Strongly agree 53.3% Strongly agree 44.1% Extremely useful 40.1% A great deal 36.8% Highly satisfied 37.5%
Agree 50% Agree 40.1% Agree 47.4% Very useful 33.6% Above average 30.9% Satisfied 45.4%
Neutral 9.2% Neutral 6.6% Neutral 7.2% Useful 21.1% Average amount 27.6% Neutral 13.8%
Disagree 1.3% Disagree 0% Disagree 0.7% Slightly useful 2.6% Little 2% Dissatisfied 2%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0.7% Not useful 2.6% Very little 2.6% Highly dissatisfied 1.3%
Overcoming challenges with implementing screening 147 Strongly agree 29.9% Strongly agree 45.6% Strongly agree 37.4% Extremely useful 28.6% A great deal 31.3% Highly satisfied 29.9%
Agree 48.3% Agree 42.2% Agree 42.2% Very useful 27.9% Above average 26.5% Satisfied 42.9%
Neutral 17.7% Neutral 12.2% Neutral 18.4% Useful 29.9% Average amount 34.0% Neutral 17.7%
Disagree 4.1% Disagree 0% Disagree 2.0% Slightly useful 7.5% Little 6.8% Dissatisfied 8.8%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0% Not useful 6.1% Very little 1.4% Highly dissatisfied 0.7%
Cognitive changes associated with cancer and cancer treatment 151 Strongly agree 39.7% Strongly agree 55% Strongly agree 35.8% Extremely useful 37.1% A great deal 37.1% Highly satisfied 35.1%
Agree 48.3% Agree 39.1% Agree 49% Very useful 33.1% Above average 33.8% Satisfied 47.7%
Neutral 10.6% Neutral 6% Neutral 12.6% Useful 23.8% Average amount 25.2% Neutral 14.6%
Disagree 0.7% Disagree 0% Disagree 2.0% Slightly useful 4.6% Little 3.3% Dissatisfied 2.0%
Strongly disagree 0.7% Strongly disagree 0% Strongly disagree 0.7% Not useful 1.3% Very little 0.7% Highly dissatisfied 0.7%
Tailored CBT for anxiety in adv cancer 154 Strongly agree 48.1% Strongly agree 59.1% Strongly agree 49.4% Extremely useful 44.8% A great deal 47.4% Highly satisfied 46.8%
Agree 44.8% Agree 35.7% Agree 41.6% Very useful 36.4% Above average 29.9% Satisfied 40.9%
Neutral 5.8% Neutral 4.5% Neutral 6.5% Useful 16.2% Average amount 20.8% Neutral 11.7%
Disagree 0.6% Disagree 0% Disagree 1.9% Slightly useful 2.6% Little 1.3% Dissatisfied 0%
Strongly disagree 0.6% Strongly disagree 0.6% Strongly disagree 0.6% Not useful 0% Very little 0.6% Highly dissatisfied 0.6%
Care of the cancer caregiver 153 Strongly agree 43.8% Strongly agree 56.2% Strongly agree 43.1% Extremely useful 41.8% A great deal 39.2% Highly satisfied 43.1%
Agree 48.4% Agree 39.2% Agree 48.4% Very useful 32.7% Above average 37.3% Satisfied 43.8%
Neutral 6.5% Neutral 4.6% Neutral 7.2% Useful 22.9% Average amount 20.9% Neutral 11.8%
Disagree 0.7% Disagree 0% Disagree 1.3% Slightly useful 2.0% Little 1.3% Dissatisfied 0.7%
Strongly disagree 0.7% Strongly disagree 0% Strongly disagree 0% Not useful 0.7% Very little 1.3% Highly dissatisfied 0.7%
CBT for cancer‐related fatigue 152 Strongly agree 48% Strongly agree 54.6% Strongly agree 45.4% Extremely useful 44.1% A great deal 41.4% Highly satisfied 39.5%
Agree 42.8% Agree 40.8% Agree 44.7% Very useful 36.2% Above average 34.9% Satisfied 48.7%
Neutral 7.9% Neutral 3.9% Neutral 9.2% Useful 16.4% Average amount 21.1% Neutral 8.6%
Disagree 0.7% Disagree 0% Disagree 0% Slightly useful 2% Little 1.3% Dissatisfied 2%
Strongly disagree 0.7% Strongly disagree 0.7% Strongly disagree 0.7% Not useful 1.3% Very little 1.3% Highly dissatisfied 1.3%
ACT—A values‐driven approach to living with illness 153 Strongly agree 54.9% Strongly agree 63.4% Strongly agree 52.9% Extremely useful 51% A great deal 48.4% Highly satisfied 52.9%
Agree 37.9% Agree 30.1% Agree 38.6% Very useful 34% Above average 28.8% Satisfied 35.9%
Neutral 7.2% Neutral 6.5% Neutral 8.5% Useful 14.4% Average amount 20.9% Neutral 11.1%
Disagree 0% Disagree 0% Disagree 0% Slightly useful 0.7% Little 1.3% Dissatisfied 0%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0% Not useful 0% Very little 0.7% Highly dissatisfied 0%
Hot topics in psychotropic medications for PSO professionals 150 Strongly agree 38% Strongly agree 44% Strongly agree 36% Extremely useful 34.7% A great deal 34.7% Highly satisfied 34%
Agree 44.7% Agree 46.7% Agree 42.7% Very useful 34% Above average 33.3% Satisfied 45.3%
Neutral 13.3% Neutral 8.7% Neutral 14% Useful 22% Average amount 27.3% Neutral 16.7%
Disagree 2.7% Disagree 0.7% Disagree 6% Slightly useful 8% Little 4.7% Dissatisfied 2.7%
Strongly disagree 1.3% Strongly disagree 0% Strongly disagree 1.3% Not useful 1.3% Very little 0% Highly dissatisfied 1.3%
Best practice guidelines & models for depression management 187 Strongly agree 47.6% Strongly agree 54% Strongly agree 42.8% Extremely useful 41.7% A great deal 42.8% Highly satisfied 42.8%
Agree 41.2% Agree 40.1% Agree 38% Very useful 33.2% Above average 28.3% Satisfied 39%
Neutral 9.6% Neutral 5.9% Neutral 15% Useful 21.4% Average amount 26.7% Neutral 15.5%
Disagree 1.6% Disagree 0% Disagree 3.7% Slightly useful 3.2% Little 1.1% Dissatisfied 1.6%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0.5% Not useful 0.5% Very little 1.1% Highly dissatisfied 1.1%
Caring for patients spiritual needs 163 Strongly agree 42.9% Strongly agree 52.8% Strongly agree 43.6% Extremely useful 38.7% A great deal 38.7% Highly satisfied 41.1%

Agree 47.2%

Agree 42.3% Agree 42.9% Very useful 32.5% Above average 25.2% Satisfied 38.7%
Neutral 8% Neutral 4.9% Neutral 12.3% Useful 22.1% Average amount 31.9% Neutral 17.2%
Disagree 1.8% Disagree 0% Disagree 1.2% Slightly useful 6.1% Little 3.1% Dissatisfied 2.5%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0% Not useful 0.6% Very little 1.2% Highly dissatisfied 0.6%
Body image, intimacy, and sexual difficulties in cancer 171 Strongly agree 50.3% Strongly agree 64.9% Strongly agree 52.6% Extremely useful 47.4% A great deal 49.1% Highly satisfied 51.5%
Agree 43.9% Agree 29.8% Agree 39.2% Very useful 33.3% Above average 32.2% Satisfied 39.8%
Neutral 5.8% Neutral 5.3% Neutral 7.6% Useful 18.1% Average amount 18.1% Neutral 8.2%
Disagree 0% Disagree 0% Disagree 0.6% Slightly useful 0.6% Little 0% Dissatisfied 0%
Strongly disagree 0% Strongly disagree 0% Strongly disagree 0% Not useful 0.6% Very little 0.6% Highly dissatisfied 0.6%
Suicidal thinking and behavior in cancer patients 171 Strongly agree 51.7% Strongly agree 63.5% Strongly agree 52.8% Extremely useful 48.9% A great deal 46.6% Highly satisfied 51.1%
Agree 42.7% Agree 33.1% Agree 41% Very useful 32% Above average 30.3% Satisfied 39.9%
Neutral 4.5% Neutral 2.8% Neutral 5.1% Useful 18% Average amount 21.3% Neutral 7.9%
Disagree 1.1% Disagree 0% Disagree 0% Slightly useful 1.1% Little 1.1% Dissatisfied 0.6%
Strongly disagree 0% Strongly disagree 0.6% Strongly disagree 1.1% Not useful 0% Very little 0.6% Highly dissatisfied 0.6%
Under resourced: Increasing utilization of community‐based supportive care programs 157 Strongly agree 29.9% Strongly agree 42% Strongly agree 33.1% Extremely useful 28.7% A great deal 30.6% Highly satisfied 31.2%
Agree 51.6% Agree 47.1% Agree 45.2% Very useful 24.2% Above average 23.6% Satisfied 38.2%
Neutral 15.9% Neutral 10.8% Neutral 18.5% Useful 32.5% Average amount 36.3% Neutral 24.2%
Disagree 1.9% Disagree 0% Disagree 2.5% Slightly useful 10.2% Little 7.6% Dissatisfied 4.5%
Strongly disagree 0.6% Strongly disagree 0% Strongly disagree 0.6% Not useful 4.5% Very little 1.9% Highly dissatisfied 1.9%
Value of PSO in supportive and palliative care 162 Strongly agree 40.7% Strongly agree 56.8% Strongly agree 43.8% Extremely useful 42% A great deal 38.9% Highly satisfied 43.8%
Agree 46.3% Agree 36.4% Agree 45.7% Very useful 34% Above average 34% Satisfied 42.6%
Neutral 11.1% Neutral 6.2% Neutral 9.9% Useful 19.1% Average amount 23.5% Neutral 12.3%
Disagree 1.2% Disagree 0% Disagree 0% Slightly useful 4.9% Little 3.7% Dissatisfied 1.2%
Strongly disagree 0.6% Strongly disagree 0.6% Strongly disagree 0.6% Not useful 0% Very little 0% Highly dissatisfied 0%
Average overall ratings Strongly agree 42.9% Strongly agree 55.3% Strongly agree 43.8% Extremely useful 40.2% A great deal 40.3% Highly satisfied 41.3%
Agree 45.9% Agree 38.4% Agree 43.4% Very useful 33% Above average 30.6% Satisfied 42.5%
Neutral 9.4% Neutral 6.2% Neutral 10.7% Useful 21.5% Average amount 25.4% Neutral 12.7%
Disagree 1.4% Disagree 0% Disagree 1.7% Slightly useful 4.1% Little 2.6% Dissatisfied 2.0%
Strongly disagree 0.3% Strongly disagree 0.2% Strongly disagree 0.4% Not useful 1.3% Very little 0.8% Highly dissatisfied 0.8%

Globally, approximately 88.8% of respondents (range across sessions: 78.2%–94.4%) agreed or strongly agreed that Academy content was current and relevant. Presenter quality was also highly rated: 93.7% of respondents (range: 87.8%–98.6%) agreed or strongly agreed that presenters were knowledgeable, and 87.2% (range: 78.3%–93.8%) agreed or strongly agreed that teaching style was effective.

Participants reported high satisfaction with the relevance and amount of learning gained from the Virtual Academy. Overall, 94.7% of participants (range: 85.4%–98.9%) rated sessions as useful for professional development (i.e., useful, very useful, or extremely useful). Learning gains were substantial. Overall, 40.3% of respondents reported learning a great deal, 30.6% reported learning above average, and 25.4% reported learning an average amount, such that 96.3% (range: 90.5%–99.4%) endorsed learning at least an average amount from the program. Together, these findings indicate that the curriculum was perceived as educationally robust, relevant, and effective in enhancing participants' psychosocial oncology knowledge.

3.6. Session‐Level Evaluation Outcomes

Session‐level evaluations highlighted both consistently strong performers and sessions that may benefit from refinement. Sessions with the highest ratings for utility and satisfaction tended to be skill‐focused and clinically applied, including Acceptance and Commitment Therapy (ACT), Cognitive‐Behavioral Therapy (CBT) for cancer‐related fatigue, tailored CBT for anxiety in advanced cancer, body image, intimacy, and sexual difficulties in cancer, and suicidal thinking and behavior. For these sessions, approximately 80.3%–85% of respondents rated the content as very or extremely useful, and 87.7% or more were satisfied or highly satisfied with their overall experience.

Although the majority of participants still endorsed them as useful, several sessions received comparatively lower ratings. For example, sessions on overcoming challenges with implementing screening and on community‐based supportive care programs had smaller proportions of participants who rated the content as very or extremely useful (52.9%–56.5%), and satisfaction for these sessions ranged from 69.4% to 72.8%, with a larger proportion of neutral or dissatisfied responses compared with other topics. Qualitative comments for these lower‐rated sessions frequently cited technical issues, perceived redundancy, excessive length, and a desire for more practical, case‐based content.

3.7. Qualitative Responses—Strengths and Areas for Improvement

3.7.1. Overall Program

Qualitative feedback suggested that the PSO Virtual Academy deepened participants' understanding of the unique psychosocial needs of people with cancer and their caregivers, provided concrete therapeutic strategies that could be immediately applied in practice, and enhanced clinicians' preparedness to address complex issues such as suicidality, body image and sexual concerns, and spiritual distress. Several participants noted that the Academy represented their first formal training in psychosocial oncology and reported feeling more confident and equipped to support cancer patients and families following completion.

Participants identified several consistent strengths of the PSO Virtual Academy. They highlighted faculty expertise and engagement, describing the presentations as evidence‐based, informative, and highly relevant to psychosocial oncology practice. Many participants appreciated the breadth of topics spanning the cancer continuum, including depression, suicidality, sexuality and body image, caregiving, spirituality, fatigue, and cognitive changes. The inclusion of specific therapeutic skills and interventions, particularly those based on ACT and CBT tailored to cancer populations, was described as “extremely valuable,” with participants appreciating the applicability of the information in their practice settings. Learners also valued the self‐paced, asynchronous format, which allowed them to complete sessions without disrupting existing clinical responsibilities. Several noted that certain speakers' presentation styles were especially compelling—prompting requests to feature more presenters with similar teaching approaches, including use of case examples, identification of best practices, and description of cancer‐specific intervention strategies, in future versions of the Virtual Academy.

3.7.2. Module Feedback

Participants also articulated clear areas for improvement that will guide future refinements. Many requested access to slide handouts, ideally including slides in advance, along with assessment tools and other downloadable resources to facilitate implementation of skills in their own practice settings. Others expressed a desire for more interactive elements, such as live question‐and‐answer segments, case demonstrations, video examples, or simulation‐based learning, rather than relying primarily on video didactics. Several sessions were perceived as overly long, repetitive, or in need of content updates, with some participants remarking that select material was “10 years old,” underscoring the importance of regularly updating content. Learners also emphasized wanting to “see” the speaker while listening, rather than only hearing audio over slides, and requested the addition of more clinical, case‐based components across sessions. Finally, participants noted opportunities to refine the platform experience itself, including smoother video playback, the ability to navigate within recorded talks, and rationales for quiz answers.

4. Discussion

Psychosocial oncology workforce shortages in the US highlight the need for a new educational paradigm that broadens access to training and services, particularly in non‐metropolitan areas where mental health provider shortages, greater unmet psychosocial needs, and more adverse social determinants of health impact cancer survivors. The development and implementation of a virtual platform, such as the PSO Virtual Academy for psychosocial oncology training, can help build behavioral health expertise in communities that have historically lacked access to specialists in psychosocial oncology. Almost two years after launching the Virtual Academy, 262 behavioral health specialists representing approximately 10 professional disciplines and 41 states registered for the 15‐session certificate course. Course evaluation results support strong educational, technical, and operational feasibility, as well as high acceptability of the PSO Virtual Academy 1.0.

Feasibility was supported by favorable ratings of accessibility accommodations and the virtual platform, with more than 75% of participants indicating that the technology met their expectations. Operationally, the PSO Virtual Academy was successfully implemented across diverse organizational settings, indicating that the program was both feasible to deliver, well received, and scalable in a virtual format.

Curriculum acceptability was strong. On average, 84% of participants were satisfied or highly satisfied with their overall experience, and the overwhelming majority (95%) rated sessions as useful for their professional development. Participants from diverse specialties and settings consistently rated session content as current and relevant, with high levels of agreement regarding presenter expertise and teaching effectiveness. Session level rating further supported high acceptability. The highest‐rated sessions were ACT, CBT for cancer‐related fatigue, CBT for anxiety in advanced cancer, body image and sexuality, and suicidal thinking and behavior. In contrast, sessions on overcoming challenges in implementing screening and on working in under‐resourced settings were the only ones to fall below a 75% satisfaction rating. Qualitative feedback suggested that lower ratings were driven primarily by technical and format issues rather than content quality, including technical difficulties, session length or redundancy, and a preference for more practical, case‐based application.

For the past 2 decades, online learning platforms have been more widely adopted to facilitate active and enriching educational experiences. The demand for programs delivering specialized training has continued to grow, with widespread utilization across specialties [35, 36, 37]. Prior literature highlights several advantages of online learning, including improved access to specialized educational training for health care providers who might otherwise lack such resources, accessibility regardless of geographical location, greater flexibility and convenience that allow learners to balance personal and professional commitments, and cost‐effectiveness compared to in‐person programs [38, 39, 40].

The findings of the current study align with prior research of online behavioral health training programs, demonstrating high acceptability, positive training experiences, and significant knowledge gains upon program completion. Consistent with previous work, the PSO Virtual Academy 1.0 also attracted a highly qualified and professionally diverse group of clinicians, which may have enhanced participants' capacity to engage with and apply training content [41]. Additionally, virtual training formats offer more convenience and are better suited to accommodate health care providers' demanding schedules and growing preference for online learning programs [37, 41]. Importantly, these programs also have the potential to reach a more geographically diverse audience, further expanding access to specialized training opportunities.

4.1. Limitations of PSO Virtual Academy 1.0

While the PSO Virtual Academy 1.0 demonstrated strong overall success, we identified a number of limitations. First, there is potential for selection bias, as participants who chose to enroll may have been more motivated or required to complete the training, potentially contributing to higher levels of satisfaction. Second, participants noted that the training program lacked access to supplemental materials (e.g., handouts and assessment tools) that could have enhanced learning outcomes and strengthened participants' ability to practice and implement the skills learned in the training. Third, the training did not provide opportunities for “real‐time” practice of clinical skills and observation, representing a missed opportunity to refine clinical competencies. Fourth, the absence of longitudinal follow‐up limited the ability to evaluate whether participants were able to implement newly acquired knowledge and skills over time. Establishment of a community of practice and supplemental case‐based learning would also enhance implementation. Finally, although the training included a broad representation of professional disciplines, hospital chaplains, oncologists, and palliative care specialists were underrepresented.

4.2. Future Directions

Future curriculum revisions will include updating content and the addition of standardized patient encounters of evidence‐based interventions via an in‐person workshop. These simulations will enable participants to actively apply learned skills with constructive peer feedback [42]. Furthermore, we will incorporate a Community of Practice including case discussions as well as longitudinal surveys to facilitate implementation into participant practice settings. The Community of Practice will provide an opportunity to discuss real‐time clinical experiences, network, and develop a support community, which have been reported in prior studies as highly valued by learners [43]. These methods will enrich the curriculum by supporting a more comprehensive evaluation of the virtual program's effectiveness and inform subsequent curriculum revisions. Training programs focused on meaning‐centered psychotherapy, targeting psychosocial oncologists utilizing similar methodologies, have demonstrated high participant satisfaction, significant improvement and utilization of clinical skills, and changes to delivery of clinical care practices [41, 44].

The high completion and participant satisfaction rates suggest that the content and delivery methods employed in this initial version of the PSO Virtual Academy will be successfully employed in future versions, offering a similar spectrum of psychosocial oncology content in a more robust format (e.g., offering additional content at a variety of skill levels) and using more interactive methods (e.g., standardized patient experiences, community of practice). Feedback from the current version will be used to guide future enhancements and strategies for scaling the program. In line with our Advisory Panel mission to reach underserved areas, we are planning our next dissemination effort in the Deep South, specifically Alabama, Arkansas, and Mississippi, three states with high rates of cancer mortality and mental health care professional shortage areas. The primary goal is to train existing behavioral and oncology professionals in these states to expand the workforce available to meet the tremendous unmet cancer‐related needs in this area of the United States [45, 46].

4.3. Clinical Implications

Persistent shortages in the psychosocial oncology workforce, particularly in rural and underserved settings, limit access to evidence‐based psychosocial support for individuals with cancer. The PSO Virtual Academy 1.0 represents a scalable, accessible approach to addressing this gap by providing behavioral health and allied health providers with foundational competencies in psychosocial oncology. By delivering standardized, high‐quality training across geographically diverse settings, the PSO Virtual Academy has the potential to expand the reach of providers capable of delivering psychosocial oncology care within routine clinical practice.

Importantly, the development of a standardized curriculum and alignment with emerging PSO certification pathways may help formalize psychosocial oncology as a recognized specialty [47], promoting consistency in training and care delivery. This is particularly critical for ensuring that patients have access to competent providers who can address the complex psychological, behavioral, and social dimensions of cancer regardless of geographic location or care setting. Ultimately, broader dissemination and scaling of the PSO Virtual Academy could help bridge the gap between workforce capacity and patient need, increasing access to psychosocial oncology services and improving quality of life and clinical outcomes for individuals living with cancer.

Author Contributions

Sharla Wells‐Di Gregorio: conceptualization, data curation, formal analysis, investigation, methodology, supervision, writing – original draft. Brad McAlister: data curation, project administration, resources, software. Karen Kayser: conceptualization, writing – original draft. Amy Siston: writing – original draft. Cathy Donnell: conceptualization, writing – review and editing. George Fitchett: writing – original draft. Tamryn F. Gray: validation, writing – original draft. Jesse R. Fann: writing – review and editing. Jessica Vanderlan: writing – review and editing. Debbie Snyder: conceptualization, methodology, writing – original draft. Nicole Bates: writing – review and editing. Teresa Deshields: writing – review and editing. Sarah Baltimore: data curation, formal analysis, validation, visualization. Madison Voinovich: project administration, visualization. Tanya Smit: writing – review and editing. Donald R. Marks: conceptualization, investigation, writing – original draft, writing – review and editing.

Funding

This work was supported by the American Psychosocial Oncology Society/Parthenon Management Company.

Conflicts of Interest

Sharla Wells‐Di Gregorio, Brad McAlister, Karen Kayser, Amy Siston, Stacy Flowers, George Fitchett, Tamryn Gray, Jesse Fanne, Debbie Snyder, Nicole Bates, and Donald Marks are members of the American Psychosocial Oncology Society's Virtual Academy Advisory Panel. No authors have conflicts of interest to disclose.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  • 1. National Cancer Institute , “National Cancer Survivors Month,” (2026), https://cancercontrol.cancer.gov/ocs/about/survivorship‐month.
  • 2. Riba M. B., Donovan K. A., Andersen B., et al., “Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology,” Journal of the National Comprehensive Cancer Network 17, no. 10 (October 2019): 1229–1249, 10.6004/jnccn.2019.0048. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 3. Weaver K. E., Forsythe L. P., Reeve B. B., et al., “Mental and Physical Health‐Related Quality of Life Among U.S. Cancer Survivors: Population Estimates From the 2010 National Health Interview Survey,” Cancer Epidemiology, Biomarkers & Prevention 21, no. 11 (November 2012): 2108–2117, 10.1158/1055-9965.Epi-12-0740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4. Singer S., Das‐Munshi J., and Brähler E., “Prevalence of Mental Health Conditions in Cancer Patients in Acute Care—A Meta‐Analysis,” Annals of Oncology 21, no. 5 (May 2010): 925–930, 10.1093/annonc/mdp515. [DOI] [PubMed] [Google Scholar]
  • 5. Mehnert A., Brähler E., Faller H., et al., “Four‐Week Prevalence of Mental Disorders in Patients With Cancer Across Major Tumor Entities,” Journal of Clinical Oncology 32, no. 31 (November 2014): 3540–3546, 10.1200/jco.2014.56.0086. [DOI] [PubMed] [Google Scholar]
  • 6. Zabora J., BrintzenhofeSzoc K., Curbow B., Hooker C., and Piantadosi S., “The Prevalence of Psychological Distress by Cancer Site,” Psycho‐Oncology 10, no. 1 (January–February 2001): 19–28, 10.1002/1099-1611(200101/02)10:1<19::aid-pon501>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  • 7. Cordova M. J., Riba M. B., and Spiegel D., “Post‐Traumatic Stress Disorder and Cancer,” Lancet Psychiatry 4, no. 4 (April 2017): 330–338, 10.1016/s2215-0366(17)30014-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8. Doolittle M. and Katherine N., “DuHamel. Posttraumatic Stress Disorder Associated With Cancer Diagnosis and Treatment,” in Psycho‐Oncology, ed. William Breitbart P. B., Jacobsen P., Lam W., Lazenby M., and Loscalzo M., 4th ed. ed (Oxford Press, 2021), 363–373. [Google Scholar]
  • 9. Deshields T. L., Wells‐Di Gregorio S., Flowers S. R., et al., “Addressing Distress Management Challenges: Recommendations From the Consensus Panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work,” CA: A Cancer Journal for Clinicians 71, no. 5 (September 2021): 407–436, 10.3322/caac.21672. [DOI] [PubMed] [Google Scholar]
  • 10. Mustian K. M., Alfano C. M., Heckler C., et al., “Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer‐Related Fatigue: A Meta‐Analysis,” JAMA Oncology 3, no. 7 (July 2017): 961–968, 10.1001/jamaoncol.2016.6914. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. Syrjala K. L., Jensen M. P., Mendoza M. E., Yi J. C., Fisher H. M., and Keefe F. J., “Psychological and Behavioral Approaches to Cancer Pain Management,” Journal of Clinical Oncology 32, no. 16 (June 2014): 1703–1711, 10.1200/jco.2013.54.4825. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 12. Savard J. and Savard M.‐H., “Insomnia and Cancer: Prevalence, Nature, and Nonpharmacologic Treatment,” Sleep Medicine Clinics. 8, no. 3 (2013): 373–387, 10.1016/j.jsmc.2013.04.006. [DOI] [Google Scholar]
  • 13. Curran L., Mahoney A., and Hastings B., “A Systematic Review of Trajectories of Clinically Relevant Distress Amongst Adults With Cancer: Course and Predictors,” Journal of Clinical Psychology in Medical Settings 32, no. 1 (March 2025): 1–18, 10.1007/s10880-024-10011-x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 14. Edmondson D., “An Enduring Somatic Threat Model of Posttraumatic Stress Disorder Due to Acute Life‐Threatening Medical Events,” Social and Personality Psychology Compass 8, no. 3 (March 2014): 118–134, 10.1111/spc3.12089. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15. McMillan S. C., Small B. J., Weitzner M., et al., “Impact of Coping Skills Intervention With Family Caregivers of Hospice Patients With Cancer: A Randomized Clinical Trial,” Cancer 106, no. 1 (January 2006): 214–222, 10.1002/cncr.21567. [DOI] [PubMed] [Google Scholar]
  • 16. Han X., Lin C. C., Li C., et al., “Association Between Serious Psychological Distress and Health Care Use and Expenditures by Cancer History,” Cancer 121, no. 4 (February 2015): 614–622, 10.1002/cncr.29102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 17. Hollingworth W., Metcalfe C., Mancero S., et al., “Are Needs Assessments Cost Effective in Reducing Distress Among Patients With Cancer? A Randomized Controlled Trial Using the Distress Thermometer and Problem List,” Journal of Clinical Oncology 31, no. 29 (October 2013): 3631–3638, 10.1200/jco.2012.48.3040. [DOI] [PubMed] [Google Scholar]
  • 18. Carlson L. E., “Screening Alone Is Not Enough: The Importance of Appropriate Triage, Referral, and Evidence‐Based Treatment of Distress and Common Problems,” Journal of Clinical Oncology 31, no. 29 (2013): 3616–3617, 10.1200/jco.2013.51.4315. [DOI] [PubMed] [Google Scholar]
  • 19. Coughlin S. S., “Social Determinants of Breast Cancer Risk, Stage, and Survival,” Breast Cancer Research and Treatment 177, no. 3 (2019): 537–548, 10.1007/s10549-019-05340-7. [DOI] [PubMed] [Google Scholar]
  • 20. Coughlin S. S., “A Review of Social Determinants of Prostate Cancer Risk, Stage, and Survival,” Prostate International 8, no. 2 (June 2020): 49–54, 10.1016/j.prnil.2019.08.001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21. Zettler M. E., Feinberg B. A., Jeune‐Smith Y., and Gajra A., “Impact of Social Determinants of Health on Cancer Care: A Survey of Community Oncologists,” BMJ Open 11, no. 10 (October 2021): e049259, 10.1136/bmjopen-2021-049259. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22. Faller H., Schuler M., Richard M., Heckl U., Weis J., and Küffner R., “Effects of Psycho‐Oncologic Interventions on Emotional Distress and Quality of Life in Adult Patients With Cancer: Systematic Review and Meta‐Analysis,” Journal of Clinical Oncology 31, no. 6 (February 2013): 782–793, 10.1200/jco.2011.40.8922. [DOI] [PubMed] [Google Scholar]
  • 23. Schneider S., Moyer A., Knapp‐Oliver S., Sohl S., Cannella D., and Targhetta V., “Pre‐Intervention Distress Moderates the Efficacy of Psychosocial Treatment for Cancer Patients: A Meta‐Analysis,” Journal of Behavioral Medicine 33, no. 1 (February 2010): 1–14, 10.1007/s10865-009-9227-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24. Carlson L. E., Groff S. L., Maciejewski O., and Bultz B. D., “Screening for Distress in Lung and Breast Cancer Outpatients: A Randomized Controlled Trial,” Journal of Clinical Oncology 28, no. 33 (November 2010): 4884–4891, 10.1200/jco.2009.27.3698. [DOI] [PubMed] [Google Scholar]
  • 25. Duarte A., Walker J., Walker S., et al., “Cost‐Effectiveness of Integrated Collaborative Care for Comorbid Major Depression in Patients With Cancer,” Journal of Psychosomatic Research 79, no. 6 (December 2015): 465–470, 10.1016/j.jpsychores.2015.10.012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 26. Carlson L. E. and Bultz B. D., “Benefits of Psychosocial Oncology Care: Improved Quality of Life and Medical Cost Offset,” Health and Quality of Life Outcomes 1 (April 2003): 8, 10.1186/1477-7525-1-8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27. Zebrack B., Kayser K., Bybee D., et al., “A Practice‐Based Evaluation of Distress Screening Protocol Adherence and Medical Service Utilization,” Journal of the National Comprehensive Cancer Network 15, no. 7 (July 2017): 903–912, 10.6004/jnccn.2017.0120. [DOI] [PubMed] [Google Scholar]
  • 28. Mirosevic S., Jo B., Kraemer H. C., Ershadi M., Neri E., and Spiegel D., “Not Just Another Meta‐Analysis: Sources of Heterogeneity in Psychosocial Treatment Effect on Cancer Survival,” Cancer Medicine 8, no. 1 (January 2019): 363–373, 10.1002/cam4.1895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29. Kaptein A. A., Schoones J. W., van der Meer P. B., et al., “Psychosocial Determinants of Adherence With Oral Anticancer Treatment: 'We Don't Need No Education,” Acta Oncologica 60, no. 1 (January 2021): 87–95, 10.1080/0284186x.2020.1843190. [DOI] [PubMed] [Google Scholar]
  • 30. Kissane D., “Beyond the Psychotherapy and Survival Debate: The Challenge of Social Disparity, Depression and Treatment Adherence in Psychosocial Cancer Care,” Psycho‐Oncology 18, no. 1 (January 2009): 1–5, 10.1002/pon.1493. [DOI] [PubMed] [Google Scholar]
  • 31. Bishop C., “Strengthening the Role of the Oncology Nurse Practitioner,” (2018), https://www.ashclinicalnews.org/viewpoints/strengthening‐role‐oncology‐nurse‐practitioner/.
  • 32. Columbia University , “Bridging the Gap: The Urgent Need for Social Workers,” (2026), https://socialwork.columbia.edu/news/bridging‐gap‐urgent‐need‐social‐workers.
  • 33. Wells‐Di Gregorio S., Deshields T., Flowers S. R., et al., “Development of a Psychosocial Oncology Core Curriculum for Multidisciplinary Education and Training: Initial Content Validation Using the Modified Delphi Method,” Psycho‐Oncology 31, no. 1 (January 2022): 130–138, 10.1002/pon.5791. [DOI] [PubMed] [Google Scholar]
  • 34. Moore J. C., Bourne J. R., and Mayadas A. F., “The Sloan Consortium,” in Encyclopedia of Distance Learning, Second Edition, vol. 4 (2009), 1918–1925, 10.4018/978-1-60566-198-8.ch278. [DOI] [Google Scholar]
  • 35. Winesett S. P., Amankwah E. K., Nguyen A. T. H., and Sibinga E., “Online Educational Curriculum in Pediatric Epilepsy: A Pilot Study,” Journal of the American Association of Nurse Practitioners 33, no. 11 (October 2020): 999–1006, 10.1097/jxx.0000000000000492. [DOI] [PubMed] [Google Scholar]
  • 36. Sandhu N. K., Rahimy E., Hutten R., et al., “Radiation Oncology Virtual Education Rotation (ROVER) 2.0 for Residents: Implementation and Outcomes,” Journal of Cancer Education 38, no. 3 (June 2023): 977–984, 10.1007/s13187-022-02216-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37. Matthew A. G., McLeod D., Robinson J. W., et al., “Enhancing Care: Evaluating the Impact of True North Sexual Health and Rehabilitation eTraining for Healthcare Providers Working With Prostate Cancer Patients and Partners,” Sexual Medicine 12, no. 3 (June 2024): qfae033, 10.1093/sexmed/qfae033. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38. Childs S., Blenkinsopp E., Hall A., and Walton G., “Effective E‐Learning for Health Professionals and Students—Barriers and Their Solutions. A Systematic Review of the Literature—Findings From the HeXL Project,” supplement, Health Information and Libraries Journal 22, no. S2 (December 2005): 20–32, 10.1111/j.1470-3327.2005.00614.x. [DOI] [PubMed] [Google Scholar]
  • 39. Setia S., Tay J. C., Chia Y. C., and Subramaniam K., “Massive Open Online Courses (MOOCs) for Continuing Medical Education—Why and How?,” Advances in Medical Education and Practice 10 (2019): 805–812, 10.2147/amep.S219104. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 40. Maloney S., Haas R., Keating J. L., et al., “Breakeven, Cost Benefit, Cost Effectiveness, and Willingness to Pay for Web‐Based Versus Face‐to‐Face Education Delivery for Health Professionals,” Journal of Medical Internet Research 14, no. 2 (April 2012): e47, 10.2196/jmir.2040. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41. Pessin H., Dustin A., Behrens M. R., et al., “Meaning‐Centered Psychotherapy Training Program for Cancer Care Clinicians: Efficacy and Impact of the First 5 Years,” Translational Behavioral Medicine 14, no. 9 (September 2024): 561–570, 10.1093/tbm/ibae026. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42. Piot M. A., Attoe C., Billon G., Cross S., Rethans J. J., and Falissard B., “Simulation Training in Psychiatry for Medical Education: A Review,” Frontiers in Psychiatry 12 (2021): 658967, 10.3389/fpsyt.2021.658967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43. McLeod D., Curran J., Dumont S., White M., and Charles G., “The Interprofessional Psychosocial Oncology Distance Education (IPODE) Project: Perceived Outcomes of an Approach to Healthcare Professional Education,” Journal of Interprofessional Care 28, no. 3 (May 2014): 254–259, 10.3109/13561820.2013.863181. [DOI] [PubMed] [Google Scholar]
  • 44. Polacek L. C., Reisch S., Saracino R. M., Pessin H., and Breitbart W., “Implementation of a Meaning‐Centered Psychotherapy Training (MCPT) Program for Oncology Clinicians: A Qualitative Analysis of Facilitators and Barriers,” Translational Behavioral Medicine 11, no. 1 (February 2021): 270–275, 10.1093/tbm/ibz138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45. Daniel C., Aly S., Bae S., et al., “Differences Related to Cancer Screening by Minority and Rural/Urban Status in the Deep South: Population‐Based Survey Results,” Journal of Cancer 12, no. 2 (2021): 474–481, 10.7150/jca.49676. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46. United Way of the National Capital Area , “Mental Healthcare Access by State,” (2020), https://unitedwaynca.org/blog/mental‐healthcare‐access‐by‐state/.
  • 47. Grassi L., “Psycho‐Oncology as a Specialty and the Certification of the Psycho‐Oncologist as a Profession,” Journal of Psychosocial Oncology Research and Practice 7, no. 2 (2025), 10.1097/or9.0000000000000168. [DOI] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.


Articles from Psycho-Oncology are provided here courtesy of Wiley

RESOURCES