Education and training in palliative care
In May 2014 WHO published its resolution entitled ‘Strengthening of palliative care as a component of comprehensive care throughout the life course’. It recognised that 40 million people require palliative care (PC) every year and that the avoidable suffering of treatable symptoms is perpetuated by the lack of knowledge of PC. Projections from the EU suggest that by 2050 the proportion of the European population over the age of 65 will rise from the current 17% to 28%. An ageing population is likely to lead to an increased number of patients with cancer and other chronic, incurable diseases, requiring increasing palliative care support at the end of life. These changes in health and demographic variables present a major challenge to national health care systems. The Worldwide Hospice Palliative Care Alliance identified that in 2015 almost 18 million people worldwide died in “unnecessary” pain.
The provision of future care for the increased number of patients with palliative needs is unlikely to come from a parallel increase in the number of specialist acute and community PC teams. One approach is to ensure that during undergraduate training all those working in the field have an appropriate opportunity to learn PC. However, this is an area that has traditionally received little or no attention within existing curricula. Recent data have highlighted great variability as to the presence of mandatory training in palliative care for trainee physicians and persons of other professions. Further, the practical, emotional and interpersonal difficulties encountered in preparing to care for dying patients and their families have been extensively reported, as have the challenges in integrating palliative medicine within a crowded curriculum. Nevertheless, there is an increasing recognition that PC should be fully integrated within education and training in order to ensure a best possible preparation to meet all mentioned needs.
1. To ensure that appropriate curricula exist for each profession working in the field of PC at both undergraduate and post-graduate levels.
2. To support the development of professional specialisation.
3. To support development of comparable and reproducible assessment systems leading to comparable certifications and qualifications.
4. To support research underpinning the evaluation of teaching contents and methods.
Year 1 and 2 (May 2019 – April 2021)
Make connections with persons of all PC corresponding professions who are interested in PC education to build up sustainable structures.to guarantee an ongoing working process on the update of the existing curricula on an under- and postgraduate level (e.g. EDUPALL).
• to describe existing structures of PC education and to develop specialization at each professional level and also to develop comparable and reproducible assessment systems leading to comparable certifications and qualifications.
• to evaluate teaching contents and methods. Accompanying research projects (e.g. IMEP) will be continued and/or new projects will be initiated and coordinated. The outcome here is to get a clearer view on the education outcomes.
Methods: Establishing workgroups/taskforces for three main fields of work:
• Curricula development and updates (EDUPALL)
• Structures, specialization, certification and qualification (e.g. European Study on Undergraduate Palliative Care Medical Education)
• Accompanying research projects (IMEP)
• First updates of already existing curricula
• Atlases/Mapping of structures of undergraduate education (European Study on Undergraduate Palliative Care Medical Education)
• First publications of European and worldwide questionnaire data of the IMEP project.
Year 3 and 4 (May 2021 – April 2023)
To deepen collaboration between already existing partners and structures and to build up the EAPC Network on Education
• to update existing curricula in a peer-reviewed and 4-years-period, both on under- and postgraduate level. Updates will be published on the EAPC website subsequently.
• to update atlases on structures of PC education and to develop a register on country-specific specialization conditions and assessment methods referring to corresponding certifications and qualifications, both on under- and postgraduate level.
• to evaluate teaching contents and methods. Accompanying research projects (such as IMEP) will be continued. The primary outcome here is to get a clearer view on the education outcomes.
Methods: Coordinate taskforces for the three defined main fields of work:
• Curricula updates – ongoing
• Structures, specialization, certification and qualification
• Accompanying research projects (IMEP)
• Continuing updates of existing curricula
• Continuously updated atlases on structures of PC education and a register on country-specific specialization conditions and assessment methods on under- and postgraduate level.
• Further publications of the IMEP project of European and worldwide questionnaire data.
Paal, P., Brandstötter, C., Lorenzl, S., Larkin, P. and Elsner, F., 2019. Postgraduate palliative care education for all healthcare providers in Europe: Results from an EAPC survey. Palliative & supportive care, pp.1-12.
Paal, P., Brandstötter, C., Bükki, J. et al. One-week multidisciplinary post-graduate palliative care training: an outcome-based program evaluation. BMC Med Educ 20, 276 (2020). https://doi.org/10.1186/s12909-020-02200-7