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

Abstract

BackgroundDespite 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.MethodsWe 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.ResultsThe 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:(i) the development of a new concept of palliative care, centred on the response to the holistic needs of people;(ii) 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);(iii) 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;(iv) the need to share personal aspects of their professional life (this result emerges only in qualitative research);(v) the appreciation of cooperation and the joining of multiple competences towards a synergistic approach and enhanced outcomes.ConclusionIt 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.

Consultations’ demand for a hospital palliative care unit: how to increase appropriateness? Implementing and evaluating a multicomponent educational intervention aimed at increase palliative care complexity perception skill

“…The programme was inspired by our previous experiences [ 21 , 24 ]. We also reviewed the literature searching for systematic reviews on existing Palliative Care training programmes, focusing specifically on tumour board and/or multidisciplinary oncology discussions but no previous experiences were available.…”

“…The SPCS is active since April 2013 and currently includes seven members, three physicians and two nurses with a significant experience in the field, and a nurse and a physician dedicated to research and education. SPCS is specialized in performing training programs, research in palliative care trainings, and quality improvement programs [ 21 , 24 , 30 , 31 ].…”

“…The analysis concentrated on emerging themes, with a specific focus on possible changes in the way the professionals see palliative care and palliative care needs. This allowed for the search of any possible changes in meanings [ 21 ] from before to after the training. In order to increase trustworthiness, the overall process was conducted independently by two different researchers, GM and GA, that started assigning tags and categories, then identifying the main themes emerging, and any divergence was supervised by a third researcher (ST).…”

“…Training for the specialists of the First Level by PCTs specialists of the Second Level becomes essential [ 21 ]. In the considered hospital setting, “tumour boards” (multiprofessional and multidisciplinary discussions, where both different professionals, as nurses and medical doctors, and different specialists, as radiologists, surgeons and oncologists, were involved) often have a low number of referred patients, usually on a clinical staging basis (e.g., metastasis presence).…”

Distance learning and its impact on educational intervention on palliative care to nursing professionals–A pilot study

“…Given this reality, the importance of inserting the theme into teaching programs is emphasized, in order to contribute to the knowledge and skills in assisting these patients. [9,10] The complexity of the care required for patients in palliative care can be a stressor for nursing professionals and the lack of adequate training and education in palliative care can generate negative results. [11] The adoption of innovative teaching-learning strategies for nursing professionals can promote their debate and their adherence to educational processes, as studies indicate that continuing and/or permanent education can reduce deficiencies and promote changes in the behavior of professionals in performance of nursing care.…”