Dr Katherine Webber
About
Biography
Dr Katherine Webber graduated from the University of Newcastle Upon Tyne in 2000 and trained in general and palliative medicine in London. She was awarded a PhD from Imperial College, London for development of a cancer pain assessment tool which has been validated in multiple languages and widely used internationally for clinical and research purposes. She has an MSc from University of Bristol in Palliative Medicine with research evaluating alcohol and drug misuse in cancer populations.
Katherine was appointed as Consultant in Palliative Medicine at the Royal Surrey Foundation Trust in 2014 and as Foundation Programme Director in 2016. She has co-developed an international medical graduate foundation trust grade programme as well as deanery foundation expansion. She is a Fellow of the Royal College of Physicians and Academy of Medical Educators.
Her main research interests focus on palliative medicine and medical education. Katherine was a co-applicant on two successful NIHR grants investigating the role of artificial hydration at the end of life. She has published medical education research assessing the role of workplace-based assessments in postgraduate training. She has extensive experience of psychometric analysis and clinical assessment development.
Publications
The literature contains limited information on the problems faced by dying patients with COVID-19 and the effectiveness of interventions to manage these. The aim of this audit was to assess the utility of our end-of-life care plan, and specifically the effectiveness of our standardised end-of-life care treatment algorithms, in dying patients with COVID-19. The audit primarily involved data extraction from the end-of-life care plan, which includes four hourly nursing (ward nurses) assessments of specific problems: patients with problems were managed according to standardised treatment algorithms, and the intervention was deemed to be effective if the problem was not present at subsequent assessments. This audit was undertaken at a general hospital in England, covered the 8 weeks from 16 March to 11 May 2020 and included all inpatients with COVID-19 who had an end-of-life care plan (and died). Sixty-one patients met the audit criteria: the commonest problem was shortness of breath (57.5%), which was generally controlled with conservative doses of morphine (10-20 mg/24 h via a syringe pump). Cough and audible respiratory secretions were relatively uncommon. The second most common problem was agitation/delirium (55.5%), which was generally controlled with standard pharmacological interventions. The cumulative number of patients with shortness of breath, agitation and audible respiratory secretions increased over the last 72 h of life, but most patients were symptom controlled at the point of death. Patients dying of COVID-19 experience similar end-of-life problems to other groups of patients. Moreover, they generally respond to standard interventions for these end-of-life problems.
Background Multisource feedback provides ratings of a trainee doctor's performance from a range of assessors and enables 360 degree feedback on communication skills and team working behaviours. It is a tool used throughout palliative medicine training in the UK. There are limited data on the value of multisource feedback from a palliative medicine trainee perspective. Aim To study the views of palliative medicine trainees regarding multisource feedback as an educational tool to develop communication skills. Design A multimodal study encompassing a focus group and questionnaire mailed to all deanery palliative doctors. Setting/participants All palliative medicine trainees within a UK training deanery. Results Over half of responding trainees thought multisource feedback had little or no impact on their clinical practice. Improvements in delivery of multisource feedback to maximise learning were identified, including skilled feedback and facilitation by educational supervisors. Conclusions Despite multisource feedback currently having limited benefits, a number of recommendations are suggested to improve this.
Additional publications
Webber K, Davies AN, Waghorn M. Do physical symptoms predict psychological issues in patients with cancer? BMJ Supportive Care in Cancer 2023. doi:10/1136/spcare-2023-004228
Perceau-Chambard E, Roche S, Tricou C, Mercier C, Barbaret C, Davies A, Webber K, Filbet M, Economos GPS. Validation of a French version of the Breakthrough Pain Assessment Tool in cancer patients: Factorial structure, reliability and responsiveness. PLoS One 2023; 10:18(7): e0286947
Webber K, Selman R. UK palliative medicine trainees and multisource communication skills feedback: an educational tool? BMJ Supportive and Palliative Care 2022; 12(e4): e485-e488
Webber K, Davies AN, Leach C, Waghorn M. Symptom prevalence and severity in palliative cancer medicine. BMJ Supportive and Palliative Care 2021-002357
Oldenmenger W, Lucas A, van der Werff G, Webber K et al. Validation of the Dutch Version of the Breakthrough Pain Assessment Tool in Patients with Cancer. Journal of Pain and Symptom Management 2020; 59: 709-716
Alderman B, Webber K, Davies A. An audit of end-of-life symptom control in patients with coronavirus disease 2019 (COVID-19) dying in a hospital in the United Kingdom. Palliat Med 2020; 34(9): 1249-1255
Webber K, Davies A, Leach C, Bradley A. Alcohol and Drug Use Disorders in Cancer Patients and Caregivers: Effects on Caregiver Burden. BMJ Supportive and Palliative Care. BMJ Supportive and Palliative Care 2020; 10(2): 242-247
Davies AN, Elsner F, Filbet MJ, Porta-Sales J, Ripamonti C, Webber K. Breakthrough cancer pain management: a review of international and national guidelines. BMJ Supportive and Palliative Care 2018; 8(3): 241-249
Davies AN, Waghorn M, Webber K, Johnsen S, Mendis J, Boyle J. A cluster randomised feasibility trial of clinically assisted hydration in cancer patients in the last days of life. Palliative Medicine 2018; 32: 733-43
Davies AN, Dickman A, Farquhar-Smith P, Webber K, Zeppetella J. Incorrect use of the English language term ‘Episodic’. Journal of Pain and Symptom Management 2016; 52: e1
Davies AN, Webber K. Misuse of rapid-onset opioids? Misuse of terminology! Journal of Pain and Symptom Management 2016; 30: 513-4
Webber K, Davies AN, Cowie MR. Disparities between clinician and patient perception of breakthrough pain control. Journal of Pain and Symptom Management 2016; 51(5): 933-7
Davies A, Mundin G, Vriens J, Webber K, Buchanan A, Waghorn M. The influence of low salivary flow rates on the absorption of a sublingual fentanyl citrate formulation for breakthrough cancer pain. Journal of Pain and Symptom Management 2016; 51(3): 538-45.
Webber K, Davies AN, Cowie MR. Accuracy of a diagnostic algorithm to diagnose breakthrough cancer pain as compared with clinical assessment. Journal of pain and Symptom Management 2015; 50: 495-500.
Davies A, Webber K. Stercoral perforation of the colon: a potentially fatal complication of opioid-induced constipation. Journal of Pain and Symptom Management. 2015; 50: 260-2.
Webber K. Development of the Breakthrough pain Assessment Tool (BAT) in cancer patients. Int J Palliat Nurs 2014; 20: 424
Webber K, Davies AN, Zeppetella G, Cowie MR. Development and validation of the Breakthrough pain Assessment Tool (the “BAT”) in cancer patients. Journal of Pain and Symptom Management 2014; 48: 619-31
Webber K, Davies A. An observational study to determine the prevalence of alcohol use disorders in advanced cancer patients. Palliative Medicine 2012; 26: 360-7.
Webber K, Davies A, Cowie M. Breakthrough pain: a qualitative study involving patients with advanced cancer. Supportive Care in Cancer 2011; 19: 2041-6.
Webber K, Davies A. Validity of the Memorial Symptom Assessment Scale Short Form psychological subscales in advanced cancer patients. Journal of Pain and Symptom Management 2011; 42: 761-7.