St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Cancer Med. 2023 Feb;12(3):3657-3669. doi: 10.1002/cam4.5213. Epub 2022 Sep 8.
Pediatric palliative care (PPC) is a priority to improve pediatric hematology oncology (PHO) care in Eurasia. However, there are limited regional opportunities for PPC education. We describe the adaptation and implementation of a bilingual end-user Education in Palliative and End-of-Life Care (EPEC)-Pediatrics course for PHO clinicians in Eurasia.
Due to COVID-19, this course was delivered virtually, consisting of prerecorded, asynchronous lectures, and a bilingual workshop with interactive lectures and small group sessions. A pre-postcourse design was used to evaluate the knowledge acquisition of the participants including their knowledge alignment with World Health Organization (WHO) guidance, ideal timing of palliative care, and comfort in providing palliative care to their patients. Questions were mostly quantitative with multiple choice or Likert scale options, supplemented by free-text responses.
A total of 44 (76%) participants from 14 countries completed all components of the course including pre- and postcourse assessments. Participant alignment with WHO guidance improved from 75% in the pre- to 90% in the postcourse assessments (p < 0.001). After participation, 93% felt more confident controlling the suffering of children at the end of life, 91% felt more confident in prescribing opioids and managing pain, and 98% better understood how to hold difficult conversations with patients and families. Most participants (98%) stated that they will change their clinical practice based on the skills and knowledge gained in this course.
We present a successful regional adaptation of the EPEC-Pediatrics curriculum, including novel delivery of course content via a virtual bilingual format. This course resulted in significant improvement in participant attitudes and knowledge of PPC along with an understanding of the ideal timing of palliative care consultation and comfort in providing PPC to children with cancer. We plan to incorporate participant feedback to improve the course and repeat it annually to improve access to high-quality palliative care education for PHO clinicians in Eurasia.
儿科姑息治疗（PPC）是改善欧亚儿科血液肿瘤学（PHO）护理的优先事项。然而，PPC 教育的区域机会有限。我们描述了为欧亚地区的 PHO 临床医生改编和实施双语终端用户姑息治疗和临终关怀教育（EPEC）-儿科课程的情况。
由于 COVID-19，该课程以虚拟方式提供，包括预先录制的异步讲座以及双语研讨会，其中包括互动讲座和小组会议。采用课前课后设计来评估参与者的知识获取情况，包括他们与世界卫生组织（WHO）指南的知识一致性、姑息治疗的理想时机以及为患者提供姑息治疗的舒适度。问题主要是定量的，包括多项选择或李克特量表选项，并辅以自由文本回答。
共有来自 14 个国家的 44 名（76%）参与者完成了课程的所有部分，包括课前和课后评估。参与者与 WHO 指南的一致性从课前的 75%提高到课后的 90%（p<0.001）。参与后，93%的人更有信心控制临终儿童的痛苦，91%的人更有信心开阿片类药物和管理疼痛，98%的人更好地理解如何与患者和家属进行艰难的对话。大多数参与者（98%）表示，他们将根据本课程获得的技能和知识改变临床实践。
我们展示了 EPEC-儿科课程的成功区域改编，包括通过虚拟双语格式提供课程内容的新颖方式。该课程显著提高了参与者对 PPC 的态度和知识，以及对姑息治疗咨询的理想时机和为癌症儿童提供 PPC 的舒适度的理解。我们计划根据参与者的反馈意见改进课程，并每年重复该课程，以改善欧亚地区 PHO 临床医生获得高质量姑息治疗教育的机会。
