Palliative care education programs are accelerating regionally, giving some hope for a “domino effect” that would spur growth.
Without widespread change, the demand for palliative care in the United States is expected to exceed the supply of clinicians trained to provide it over the next decade. A major barrier to building this workforce is that most clinicians have little or no exposure to these types of care during their training.
A 2018 study showed that most students in clinical disciplines do not feel prepared to provide end-of-life family care.
In response to growing needs, more and more educational and academic institutions have created new pathways for clinical training in palliative and palliative care.
Regional programs are multiplying
One such example is the recent launch of CARE-7, a four-year palliative care program started at the University of Pennsylvania’s Perelman School of Medicine.
“As these programs expand, I think it will become more apparent how critical these skills are,” said Dr. Alana Sagin, associate professor of hospice and palliative care at Perelman and director of the CARE-7 program, to Hospice News in an email. “Those who lead the way really make it easier for others to follow. I hope it changes the culture enough for a program like this to be an integral part of medical education.
Educators and health care providers are increasingly collaborating to move the needle.
Giving medical students early exposure to palliative care experts, coaches and interdisciplinary team members will hopefully further underscore the importance of these services and ultimately broaden the workforce, according to Dr. Nadia Bennett, associate dean of Perelman’s clinical sciences and health systems program and a CARE-7 program advisor.
“Palliative care providers can continue to benefit from the fact that learning to care for patients with critical illness is an essential skill for all healthcare providers, no matter what field they are moving into” , Bennett told Hospice News. “Fortunately, more and more institutions are recognizing this.”
A number of universities have independently developed new programs focusing on palliative care, palliative care, goal of care conversations, and other home health services, including the University of New Mexico, the University of Nebraska, the University of Arizona and the University of Maryland.
New Mexico University of Health Sciences recently launched a new palliative care program aimed at improving care for patients facing life-threatening or end-of-life illnesses. New Mexico’s ECHO Palliative Care Program is part of the university’s Project ECHO model, which offers approximately 70 different educational programs to more than 750 organizations around the world through virtual learning courses.
The interdisciplinary program is open to all New Mexico primary care and specialty care providers, chaplains, social workers, and virtually “anyone involved in palliative and end-of-life care,” the representatives said. the university.
Flexibility is a common thread woven through all palliative care education programs, according to Christopher Piromalli, associate professor at the University of New Mexico. Piromalli is also co-medical director of the ECHO project.
“Every community has different patient populations, different cultural perspectives and lenses, different levels of workforce, different challenges and learning needs,” Piromalli told Hospice News. “It’s critical [to] really think of a community of learners. It is important to have a flexible and two-way learning didactics and to be flexible to integrate the “here and now” needs that communities and learners might have.
Pillars of palliative care program design
According to educators who spoke with Hospice News, staying nimble with program development, delivery, and supportive partnerships are keys to creating and sustaining palliative care education.
Considering the context of students’ learning environments is critical when designing and implementing these programs, Sagin said. Part of this involves understanding that learners can be pressed for time in their personal and professional environment.
Flexible lesson scheduling and offering a mix of in-person and distance learning opportunities are key, Piromalli said. Providing virtual learning opportunities over small periods of time can be beneficial in attracting and retaining interest in palliative care programs, he added.
“It leverages technology so that no matter where they are, they can be part of a community of learners who are growing and gaining those particular skills,” Piromalli said. “Technology has really expanded the ways people can get the education they need. It’s a powerful tool for getting people to share their expert knowledge and interact and engage across different platforms.
Offering virtual mentorship as students progress through palliative care programs can also boost participation, said Kyky Knowles, director of replication operations at Project ECHO.
Developing these relationships can encourage participants to stay connected after graduation and build stronger collaborative bonds between medical communities, she explained.
Integrating technology into palliative care learning can also make it easier for educators to participate and collaborate in content development, according to Piromalli. With a limited number of instructors available to deliver the training, offering virtual teaching opportunities allows educators to have a flexible schedule and opens the door to a wider range of perspectives on care delivery, he said. he declares.
“It’s about communicating regularly with learners and creating a multidisciplinary team that is truly aligned with equity and diversity,” Knowles said. “We want to make sure learners want to keep coming back. That their program is innovative, flexible and engaging.
Laying the groundwork includes developing basic skill sets for communicating with patients and families and improving knowledge about serious illnesses and end-of-life care options, according to Sagin.
“Communication skills are a major component of a palliative care program. [They] are so universally applicable,” Sagin told Hospice News. “[It’s] improve the primary palliative care skills of all our graduates, as these skills will make them better doctors and, at the same time, reduce the burden of the palliative care workforce. The goal of CARE-7 is to train physicians who are comfortable with the predictable situations that arise in conversations about serious illness, symptom management, and support.
Whether or not graduates enter the field of palliative care, learning about the building blocks of palliative care can lead to greater awareness across the healthcare spectrum – and possibly more referrals.
Many physicians are hesitant to refer patients to palliative or hospice care because they do not fully understand the nature of these services or their benefits. Many also lack the skills to lead conversations about goals of care with patients and families.
Caring for critically ill and terminally ill patients exhausts employees, which often leads to burnout.
The ability to assess and manage their own mental health needs is an important part of palliative care education, Sagin said.
‘If you build it, they will come’
According to Knowles, developing a strong curriculum with these pillars in mind is essential for stakeholder buy-in, as well as ensuring sustainability.
“If you build a really amazing program, the money will follow,” Knowles told Hospice News. “We’ve seen this happen time and time again with our partners creating these innovative programs and finding money and financial support to keep them growing. This helps the leaders of different institutions and organizations to see the benefits of the impact of this education on the quality of care for patients and families.
Funding resources take time and effort to develop, Knowles added. Building a broad network of stakeholders, including national and local agencies, healthcare providers, advocacy organizations and community leaders, can be essential. Reaching leaders from different faith groups and rural and underserved populations can also be key to long-term health equity and access, she said.
Engaging in ongoing conversations with funders helps develop partnerships that help palliative care learning programs thrive, according to Bennett.
“Once the value is recognized, hopefully the resources will follow,” Sagin added.
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