Open-Access Curriculum Available for Interprofessional Training About Primary Palliative Care
Key findings
- Like specialty palliative care, primary palliative care is best delivered by interprofessional teams, and team-based serious illness care is a skill that must be learned and practiced
- Brook A. Calton, MD, MHS, and an interprofessional team of colleagues developed a nine-hour curriculum to equip small interprofessional groups with the foundational knowledge, skills, and attitudes needed to practice primary palliative care
- In a pilot study of three groups (total n=32), learners reported significant improvements in their confidence across all 25 course learning objectives, with an average improvement of 2.8 points on a scale of 0 to 10
- Participants agreed or strongly agreed the curriculum was relevant, interactive, and represented an interprofessional viewpoint; the vast majority would recommend the course to a colleague
According to the Institute of Medicine, all clinicians who care for patients and families with serious illness should have the knowledge and skills needed to practice primary palliative care. Moreover, just like specialty palliative care, primary palliative care is best delivered by interprofessional teams, and team-based serious illness care is a skill that must be learned and practiced.
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Brook A. Calton, MD, MHS, now palliative medicine faculty at Massachusetts General Hospital and medical director of palliative care for Mass General Brigham Population Health Management, and an interprofessional team of colleagues from the University of California, San Francisco (UCSF), developed a nine-hour, open-access primary palliative care curriculum at UCSF for delivery to interprofessional teams of learners. They describe the curriculum and the results of a pilot study in Palliative Medicine Reports.
Curriculum Overview
The curriculum was developed by five specialists in palliative care: two board-certified hospice and palliative medicine physicians, a nurse practitioner, a social worker, and a chaplain. All had previously served as faculty in designing and facilitating interprofessional palliative care education.
The final curriculum includes nine 55-minute modules, each consisting of a PowerPoint slide deck and facilitator guide. The modules are designed to be delivered to small groups of 8 to 12 graduate trainees and/or practicing clinicians from different disciplines, in person or virtually (synchronously). Each module features group activities, a case for discussion, and questions for reflection.
Modules can be freestanding or offered as a series, and they can be adapted for clinicians of various roles, specialties, and experience levels, including single-profession groups. They are designed to be taught by a pair of clinicians from different professions, and only two (Pain Management and Symptom Management) require one of the facilitators to be a physician or nurse.
Pilot Study Methods
The curriculum (originally presented as eight modules) was piloted in three interprofessional settings:
- An urban skilled nursing facility (n=12)
- An amyotrophic lateral sclerosis center (n=10)
- A chaplain residency program (n=10)
Each group's leader chose the attendees, and participation was mandatory. Members of the curriculum development team taught the sessions.
All participants had significant experience with seriously ill patients and families, but there was no prerequisite knowledge. The number of modules delivered in one sitting varied from one to four, depending on learner and faculty availability and needs. The goal was to complete each group's training within eight weeks; the actual range was four to 10 weeks.
Pilot Study Evaluation
The 32 learners received electronic surveys before and after the small group meetings:
- Learner confidence improved significantly (P<0.01) for each of the 25 learning objectives, with an average improvement of 2.8 points on a scale of 0 to 10
- For each module, respondents agreed or strongly agreed that the cases and examples were relevant to their practice, reflected an interprofessional viewpoint, and were interactive
- Most respondents felt the time allotted to each module was ''just right,'' but Psycho-Social-Spiritual-Cultural Care was later divided into two modules because of concerns about too little time
Learners also received a survey after completing the full curriculum, which 14 (44%) completed:
- Five rated the overall quality of the course as "excellent," and eight rated it "very good"
- Four rated the course as "extremely" useful to their clinical practice, and eight rated it "very" useful
The final evaluation included a Net Promoter Score (NPS), a proprietary instrument in which a single question asks respondents to rate the likelihood they would recommend a product or a service. The NPS ranges from −100 to 100, with a score >50 considered "excellent."
For this project, the NPS question asked how likely participants were to recommend the course to a colleague. The resulting score was 64.
Special Helps
A supplement to the paper provides a hyperlink to the online curriculum and facilitator guides. For healthcare systems considering creating their own primary palliative care training, the authors give detail about how this curriculum was developed and implemented. They review lessons learned from the pilot study.
Learn more about the curriculum here.
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