Education in palliative care: a qualitative evaluation of the present state and the needs of general practitioners and community nurses.

A questionnaire survey was carried out of all general practitioners, community hospital nurses and community nurses working in Worcester Health District in the west of England, to assess the present state and future needs of their education in palliative care. The overall response rate of the survey was 72%. The respondents were an experienced group of doctors and nurses. They felt that their undergraduate or basic training did not prepare them to care for dying patients in the community. Educational needs were identified: control of symptoms other than pain and bereavement care were priorities for doctors. Community hospital nurses rated pain control education as a major need. Alternative medicine and caring for dying children were additional areas for further education for the general practitioner and community nurses. Ninety per cent of general practitioners, 84% of community hospital nurses and 95% of community nurses felt that multi-disciplinary teaching sessions would be helpful. Analysis of their responses revealed that these would be most likely to succeed it they were arranged in the middle of the day during lunch or in the evenings. The doctors felt that they lacked protected learning time. Nurses also felt this, but in addition, identified lack of finance as a limiting factor in their post-basic education. There was evidence that existing educational resources in the district are under-utilized.