Primary Palliative Care Education in U.S. Residencies and Fellowships: A Systematic Review of Program Leadership Perspectives

Spiker, Michael; Paulsen, Kate; Mehta, Ankur

doi:10.1089/jpm.2020.0331

Cited by 13 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is increasing recognition across medical and surgical specialties, including PM&R, of the need for and value of PC education for resident trainees. 8,9,[18][19][20][21][22][23][24] In neurology, recommendations for enhancing primary PC education for residents have recently been set forth, which include using patient simulations to practice advanced communication skills and structuring opportunities to debrief after challenging clinical scenarios. 18 Given overlapping neurology/PM&R populations, such recommendations may be valuable to consider in PM&R as well.…”

Section: Discussionmentioning

confidence: 99%

The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs

Tolchin

Brooks

Knowlton

2022

Am J Phys Med Rehabil

View full text Add to dashboard Cite

Physical medicine and rehabilitation physicians routinely care for patients with serious illness and injury who could benefit from an integrated palliative care approach due to the propensity for high or complex symptom burden. Despite this, it has been unknown whether and how physical medicine and rehabilitation residency programs are equipping residents with a foundational palliative care skillset. We report national survey results characterizing the current status of palliative care education within US physical medicine and rehabilitation residency programs. Programs vary widely in the type and amount of palliative care education provided, with nearly a third of responding programs reporting no palliative care education at all. These findings suggest the need for nationally unifying palliative care education standards for physical medicine and rehabilitation residency programs to ensure that all physical medicine and rehabilitation residents have the opportunity to develop a robust palliative lens that can be applied across rehabilitation practice settings. An articulated set of standards could both facilitate achievement of palliative care-specific objectives and support achievement of foundational physical medicine and rehabilitation residency program objectives.

show abstract

Section: Discussionmentioning

confidence: 99%

The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs

Tolchin

Brooks

Knowlton

2022

Am J Phys Med Rehabil

View full text Add to dashboard Cite

show abstract

“…7,8 Interactive palliative care education programs that incorporate participant discussion and/or coaching have shown promise towards effective practice change; [9][10][11][12] though most of these prior interventions were in-person, intended for a single provider profession, and/or focused on communication skills. [13][14][15][16] We developed and piloted CAPACITI (Community Access to PAlliative Care via Interprofessional Teams Intervention) as a virtual, comprehensive education program designed to provide advice, strategies, and plans of action to assist primary care teams in operationalizing an early palliative approach to care. This program aims to enhance the existing capacity of primary care teams without requiring ongoing nancial support.…”

Section: Introductionmentioning

confidence: 99%

Implementing palliative care education into primary care practice: A qualitative case study of the CAPACITI pilot program

Matthew

Bainbridge

Bishop

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: CAPACITI is a virtual education program that teaches primary care teams how to provide an early palliative approach to care. After piloting its implementation, we conducted an in-depth qualitative study with CAPACITI participants to assess the effectiveness of the components and to understand the challenges and enablers to virtual palliative care education. Methods: We applied a qualitative case study approach to assess and synthesize three sources of data collected from the teams that participated in CAPACITI: reflection survey data, open text survey data, and focus group transcriptions. We completed a thematic analysis of these responses to gain an understanding of participant experiences with the intervention and its application in practice. Results: The CAPACITI program was completed by 22 primary care teams consisting of 159 participants across Ontario, Canada. Qualitative data was obtained from all teams, including 15 teams that participated in focus groups and 21 teams that provided reflection survey data on CAPACITI content and how it translated into practice. Three major themes arose from cross-analysis of the data: changes in practice derived from involvement in CAPACITI, utility of specific elements of the program, and barriers and challenges to enacting CAPACITI in practice. Participants reported that the multifaceted approach of CAPACITI was helpful in teaching them how to apply a palliative approach to care in practice. Conclusions: Our findings suggest that CAPACITI training increased their identification of patients requiring palliative care, improved communication skills, and enhanced confidence in providing a palliative approach to care. CAPACITI warrants further study on a national scale using a randomized trial methodology.

show abstract

“…10 Program directors from a diverse group of fields also describe that PPC skills are important for their trainees, [28][29][30][31] and in general program directors recognize that current PPC curricula need ongoing improvement. 32 Oncology trainees recognize the importance of developing PPC skills, as Wong et al describe that two-thirds of those surveyed believe that a mandatory palliative care rotation during training is important, 33 though oncology trainees are also likely to report the quality of PC training in fellowship is poor relative to that of oncology training. 23 The variety of educational interventions described in the literature reflects both the creativity of individual programs in providing education for trainees 34 and the absence of standardized methods of providing such education, assessing the impact of education, 35 or following up longitudinally after education is completed.…”

Section: Introductionmentioning

confidence: 99%

Primary Palliative Care Education for Graduate Medical Trainees: Impacts and Needs

Pennarola

Yoshioka

Shah

et al. 2022

Am J Hosp Palliat Care

View full text Add to dashboard Cite

As demand for palliative care (PC) services rise, there are insufficient numbers of PC specialists to provide PC for the US population. “Primary palliative care” refers to PC services that are administered by non-specialist PC providers. Educating trainees in graduate medical education (GME) programs is 1 strategy for expanding primary palliative care, though questions remain regarding the impact of PC education for GME trainees and where additional education is needed. This study is a multicenter, cross-sectional, web-based survey study of GME trainees assessing the needs for and impacts of primary palliative care education. The survey assessed the implementation of and participants’ confidence with fundamental PC skills. The survey also asked about prior exposure to PC education and for participants’ beliefs regarding areas that would be particularly helpful for future education. 170 residents and fellows from diverse training backgrounds participated in the survey out of 851 potential participants (response rate 19.98%). Exposure to PC education was associated with higher confidence and increased frequency of implementation of fundamental PC skills. Of the forms of education that were assessed, clinical/experiential education was associated most often with higher confidence and higher frequency of use of PC skills. Discussing goals of care, pain management for seriously ill patients, and communicating difficult information were those skills most frequently identified as important for additional training. This study demonstrates that by improving existing PC education or increasing access to PC education for GME trainees, it may be possible to improve primary palliative care.

show abstract

Primary Palliative Care Education in U.S. Residencies and Fellowships: A Systematic Review of Program Leadership Perspectives

Cited by 13 publications

References 28 publications

The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs

The State of Palliative Care Education in United States Physical Medicine and Rehabilitation Residency Programs

Implementing palliative care education into primary care practice: A qualitative case study of the CAPACITI pilot program

Primary Palliative Care Education for Graduate Medical Trainees: Impacts and Needs

Contact Info

Product

Resources

About