Palliative care training addressed to hospital healthcare professionals by palliative care specialists: a mixed-method evaluation

Abstract

Background: Despite the great advances in the concept of palliative care (PC) and its benefits, its application seems to be delayed, leaving unfulfilled the many needs of patients and family members. One way to overcome this difficulty could be to develop a new training programme by palliative care specialists to improve PC primary skills in healthcare professionals. The aim of this study was to evaluate the training's impact on trainees within a hospital setting using Kirkpatrick’s and Moore's models. Methods: We adopted a mixed-method evaluation with concurrent triangulation. The evaluation followed the first three steps of Kirkpatrick’s and Moore’s models and included a pre- and post-training evaluation through self-administered questionnaires and focus groups. We used the McNemar statistical test. Results: The results highlighted the significant amount of knowledge acquired by the hospital professionals after training, in terms of increasing their knowledge of palliative care and in terms of the change in meaning that they attributed to phenomena related to chronicity and incurability, which they encounter daily in their professional practice. In both quantitative and qualitative research, the results, in synthesis, highlight:the development of a new concept of palliative care, centred on the response to the holistic needs of people; that palliative care can also be extended to non-oncological patients in advanced illness stages (our training was directed to Geriatrics and Nephrology/Dialysis professionals); the empowerment and the increase in self-esteem that healthcare professionals gained, from learning about the logistical and structural organization of palliative care, to activate and implement PC; the need to share personal aspects of their professional life (this result emerges only in qualitative research); the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes. Conclusion: It is necessary to further develop rigorous research on training evaluation, at the most complex orders of the Kirkpatrick and Moore models, to measure primary PC skills in health care professionals. This will develop the effectiveness of the integration of I- and II-level palliative care competencies in hospitals and improve outcomes of patients’ and families’ quality of life.

Perception of social inequities in the access to the kidney transplant waiting list by nephrology trainees: a national survey

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“Teach for ethics in palliative care”: a mixed-method evaluation of a medical ethics training programme

“…We implemented a pre-post evaluation [32,33] of the training after adopting a specific methodology, which led us to describe the development of new knowledge, new awareness and changes in both performance and competence [34]. On the contrary, most of the training programmes described by literature have been evaluated only in terms of participants' perception and satisfaction [5,12,13].…”