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Table 1 Literature sample thematic analysis

From: Interprofessional palliative care education for pediatric oncology clinicians: an evidence-based practice review

Author (year)

Country

Design

Setting/sample

Discipline/roles

Relevant findings

Theme(s)a

Head et al. (2014) [15]

US

Pre–post-mixed-methods design

A large public metropolitan university, students participating in an interdisciplinary palliative oncology curriculum

Medical, nursing, social work, and chaplaincy students

Successful interdisciplinary palliative care education requires formative feedback, compromise, and focus on desired learning outcomes

Content included case-based didactic modules, clinical rotations, and clinical reflective writing

#2

Head et al. (2016) [21]

US

Pre–post-mixed-methods design

373 students at a large public metropolitan university, students participating in an interdisciplinary palliative oncology curriculum

Medical, nursing, social work, and chaplaincy students

Quantitative evaluation revealed a significant improvement in student’s palliative care knowledge, skills, and interprofessional education readiness

Qualitative results showed that experiential learning components including clinical shadow experiences and simulation with fellow students were reported as most valuable

#3

Hedlund (2013) [23]

US

Descriptive pilot study

A large community-based oncology practice, three pilot sites selected

Nurses, physicians, medical assistants, non-clinical staff

Fifty-four percent of nurses surveyed reported having increased confidence in their end of life skills

Following initiation of program only three percent of patients discussed at clinical case conferences received chemotherapy in last 14 days of life

Educational for clinical and non-clinical staff improved awareness and confidence in caring for patient with advanced cancer

Staff reported improved communication and empathy across professions

#2, #3

Henderson et al. (2016) [26]

Australia

Qualitative study using semi-structured face-to-face interviews

10 bachelor of Nursing Science students in their final semester of their program at a regional Australian university, purposeful sample

Nursing students

All participants participated in the palliative care curriculum for undergraduates and had received clinical palliative care experiences. However, participant responses were not consistent in reflecting high degrees of self-efficacy in the four documented palliative care capabilities

Further educational interventions focused on developing student self-efficacy are necessary to improve graduate nursing student’s belief in their palliative care capabilities

#3

Hermann et al. (2016) [19]

US

Descriptive study

A large public metropolitan university, interprofessional faculty team who developed the iCOPE curriculum

Medical, nursing, social work, and chaplaincy faculty and students

Framework selected to guide curriculum development was based on Clinical Practice Guidelines for Quality Palliative care developed by the National Consensus Project for Quality Palliative Care

iCOPE Curriculum components: (1) four online didactic modules, (2) palliative care observational clinical experience, (3) critical reflective writing assignment, and (4) interdisciplinary evidence-based practice simulated case experience

Challenges: developing content relevant for multiple disciplines, curriculum placement, scheduling interdisciplinary sessions, representation of students, finding psychometrically sound instruments to measure IPE outcomes; sustainability of funding

#1, #2

Morita et al. (2014) [25]

Japan

Randomized control trial using the waiting list control (nurses who participated in the second education session were the control group)

76 nurses recruited through Japanese palliative care and nursing journals with: (1) three or more years of experience, (2) experience caring for 50 or more terminally ill cancer patients per year, and (3) working at palliative care units/inpatient hospices, in palliative care teams, or general medical wards

Nurses

Two-day, nine-session workshop led by a multidisciplinary team

Teaching modalities: lectures, case vignette, small group discussion, and role-plays

Program found to have a significant effect on nurses’ level of confidence

Strengths of program: structure, delivered by trained facilitators, and existing standardized assessment tools

#1, #3

Nicholl, Price and Tracey (2016) [17]

Ireland

Mixed-methods: quantitative and qualitative

15 students representing practicing professionals in pediatric palliative care delivery

Nurses, social workers, psychotherapists, and chaplains

Modules provided opportunity for interprofessional learning. Program promoted awareness of teamwork required in pediatric palliative care. Face-to-face time important in sharing clinical experiences

#1, #2, #3

Roze des Ordons et al. (2017) [22]

Canada

Longitudinal, evidence-based study

7 critical care medicine fellows in an academic medical center

Physicians (fellows)

Program content informed by literature review and assessment survey results from fellows, attending physician, nurses, and social workers. Curriculum included five 4-h classroom-based sessions. Most helpful instruction methods: instructor-led presentations, simulated practice with actors, observation, debriefing

#1, #3

Schulz et al. (2015) [18]

Germany

Longitudinal, mixed-methods pilot study

University setting, medical student enrolled in palliative education curriculum

Medical students

Students requested additional direct patient contact, opportunities to address personal emotions, and respond to patient needs. Interprofessional, e-learning, and blended-learning approaches were the most valued. Self-efficacy and self-perceived competence regarding care for dying patients improved

#1, #2, #3

Wagner et al. (2013) [24]

Germany

Mixed-methods study

125 healthcare professionals from 35 countries who attended the International Paediatric Palliative Care Course in 2010 and 2012

Physicians, nurses psychologists, social workers, and other healthcare professionals

Course goals: to provide palliative care knowledge and skills, share experience with colleagues, network, and improve multi-professional work. Course included lectures and workshops on challenging cases in pediatric palliative care and clinical observational experiences at a local pediatric palliative care center

#1, #2

Widger et al. (2016) [12]

Canada

Pre–post-test design and integrated knowledge translation approach

Five master facilitators to train 3–5 regional team members at each of the 16 participating pediatric oncology program sites. Regional team members to deliver curriculum to end-users at each of the 16 pediatric oncology programs

Oncology, palliative care, and community home care nurses and community pediatricians

Implement and evaluate national roll-out of the Education in Palliative and End-of-Life Care for Pediatrics (EPEC-Pediatrics) using a ‘Train-the-Trainer’ model. Palliative care QI projects led by regional teams

Plan to assess: (1) self-assessed knowledge of health professionals;(2) knowledge dissemination outcomes, (3) practice change outcomes, and (4) quality of palliative care. Patients and families will complete assessments about quality of palliative care

#1, #2, #3

Wittenberg et al. (2014) [16]

US

Pre–post-test design

177 self-selected participants who were continuing education university-based health system account holders or had completed an End-of-Life Nursing Education Consortium course

Nurses, physicians, and other (unidentified) disciplines

End-of-life and disease recurrence were the most challenging conversations. Findings support the value and accessibility of the COMFORT online palliative care communication training and its use in interprofessional palliative care education

#1, #2, #3

Wittenberg et al. (2016) [20]

US

Pre–post-test design

58 interprofessional palliative care team members (29 teams) competitively selected to attend a 2-day training using the COMFORT Communications for Palliative Care Teams curriculum

Nurses, social workers, physicians, chaplains, and psychologist

Moderate communication in participants’ institutions. Bereavement and survivorship care were the weakest areas of communication. Participants of the statewide course taught 962 providers statewide and implemented institution-specific trainings and education materials. Lack of institutional support was the primary barrier

#1, #2, #3

  1. aThemes: #1 effective modalities and teaching strategies, #2 interprofessional curriculum, #3 evaluating programs