Advertisement

Expanding the Interdisciplinary Palliative Medicine Workforce: A Longitudinal Education and Mentoring Program for Practicing Clinicians

      Abstract

      Context

      The disparity between gaps in workforce and availability of palliative care (PC) services is an increasing issue in health care. To meet the demand, team-based PC requires additional educational training for all clinicians caring for persons with serious illness.

      Objectives

      To describe the educational methodology and evaluation of an existing regional interdisciplinary PC training program that was expanded to include chaplain and social worker trainees.

      Methods

      From 2015 to 2017, 26 social workers, chaplains, physicians, nurses, and advanced practice providers representing 22 health systems completed a two-year training program. The curriculum comprises biannual interdisciplinary conferences, individualized mentoring and clinical shadowing, self-directed e-learning, and profession-focused seminar series for social workers and chaplains. Site-specific practice improvement projects were developed to address gaps in PC at participating sites.

      Results

      PC and program development skills were self-assessed before and after training. Among 12 skills common to all disciplines, trainees reported significant increases in confidence across all 12 skills and significant increases in frequency of performing 11 of 12 skills. Qualitative evaluation identified a myriad of program strengths and challenges regarding the educational format, mentoring, and networking across disciplines.

      Conclusion

      Teaching PC and program development knowledge and skills to an interdisciplinary regional cohort of practicing clinicians yielded improvements in clinical skills, implementation of practice change projects, and a sense of belonging to a supportive professional network.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pain and Symptom Management
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kamal A.H.
        • Bull J.H.
        • Wolf S.P.
        • et al.
        Prevalence and predictors of burnout among hospice and palliative care clinicians in the U.S.
        J Pain Symptom Manage. 2016; 51: 690-696
        • Kavaliertos D.
        • Siconolfi D.E.
        • Steinhauser K.E.
        • et al.
        It's like heart failure. It is chronic … and it will kill you. A qualitative analysis of burnout among hospice and palliative care clinicians.
        J Pain Symptom Manage. 2017; 53: 901-910
        • Lupu D.
        • Quigley L.
        • Mehfoud N.
        • Salsberg E.S.
        The growing demand for hospice and palliative medicine physicians: will the supply keep up?.
        J Pain Symptom Manage. 2018; 55: 1216-1223
      1. Center for Advancing Palliative Care. America's care of serious illness 2019 state-by-state report card on access to palliative care in our nation's hospitals.
        (Available from)
        https://reportcard.capc.org/
        Date accessed: December 15, 2019
        • O'Mahony S.
        • Levine S.
        • Baron A.
        • et al.
        Palliative workforce development and a regional training program.
        Am J Hosp Palliat Care. 2017; 53: 728-737
        • Kamal A.H.
        • Wolf S.P.
        • Troy J.
        • et al.
        Policy changes key to promoting sustainability and growth of the specialty palliative care workforce.
        Health Aff (Millwood). 2019; 38: 910-918
        • Spetz J.
        • Dudley N.
        • Trupin L.
        • et al.
        Few hospital palliative care programs meet national staffing recommendations.
        Health Aff (Millwood). 2016; 35: 1690-1697
        • Schenker Y.
        • Arnold R.
        The next era of palliative care.
        JAMA. 2015; 314: 1565-1566
        • Carroll T.
        • Weisbrod N.
        • O-Connor A.
        • Quill T.E.
        Primary palliative care education: a pilot survey.
        Am J Hosp Palliat Med. 2018; 35: 565-569
        • Quill T.E.
        • Abernathy A.P.
        Generalist plus specialist palliative care—creating a more sustainable model.
        N Engl J Med. 2013; 368: 1173-1175
        • Head B.A.
        • Schapmire T.
        • Hermann C.
        • Earnshaw L.
        • et al.
        The Interdisciplinary Curriculum for Oncology Palliative Care Education (iCOPE): meeting the challenge of interprofessional education.
        J Palliat Med. 2014; 17: 1107-1114
        • Fineberg I.C.
        • Wenger N.
        • Forrow L.
        Interdisciplinary education: evaluation of a palliative care training intervention for pre-professionals.
        Acad Med. 2004; 79: 769-776
        • Supiano K.P.
        Weaving interdisciplinary and discipline-specific content into palliative care education: one successful model for teaching end-of-life care.
        Omega (Westport). 2013; 67: 201-206
        • Saylor J.
        • Vermoony S.
        • Selekman J.
        • Cowperthwait A.
        Interprofessional education using a palliative care simulation.
        Nurse Educ. 2016; 41: 125-129
        • Ellman M.S.
        • Schulman-Green D.
        • Blatt L.
        • et al.
        Using online learning and interactive simulation to teach spiritual and cultural aspects of palliative care to interprofessional students.
        J Palliat Med. 2012; 15: 1240-1247
        • Levine S.
        • O'Mahony S.
        • Baron A.
        • et al.
        Training the workforce: dscription of a longitudinal interdisciplinary education and mentoring program in palliative care.
        J Pain Symptom Manage. 2017; 53: 728-737
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • et al.
        Research electronic data capture (REDCap)—metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
        • Institute of Medicine
        Dying in America: Improving quality and honoring individual preferences near the end of life.
        The National Academies Press, Washington, DC2015
        • Ferrell B.R.
        • Twaddle M.L.
        • Melnick A.
        • Meier D.E.
        National consensus project clinical practice guidelines for quality palliative care guidelines, 4th edition.
        J Palliat Med. 2018; 21: 1684-1689
        • Damen A.
        • Labuschagne D.
        • Fosler L.
        • et al.
        What do chaplains do: the views of palliative care physicians, nurses, and social workers.
        Am J Hosp Palliat Care. 2019; 36: 396-401
        • Glajchen M.
        • Berkman C.
        • Otis-Green S.
        • et al.
        Defining competencies for generalist-level palliative social work.
        J Pain Symptom Manage. 2018; 56: 886-892
        • Cooper D.
        • Aherne M.
        • Pereira J.
        The competencies required by professional hospice palliative care spiritual care providers.
        J Palliat Med. 2010; 13: 869-875
        • Lee A.
        • McGinness C.E.
        • Levine S.
        • et al.
        Using chaplains to facilitate advance care planning in medical practice.
        JAMA Intern Med. 2018; 178: 708-710
        • Clevenger C.
        • Pugliese K.
        • O'Mahony S.
        • et al.
        Study of shadowing experiences among chaplains in the Coleman Palliative Medicine Fellowship.
        J Health Care Chaplain. 2019; 29: 1-19
        • Head B.
        • Schapmire T.
        • Earnshaw L.
        • et al.
        Evaluation of an interdisciplinary curriculum teaching team-based palliative care integration in oncology.
        J Canc Educ. 2016; 31: 358-365
        • Dahlin C.
        • Coyne P.J.
        • Casell J.B.
        The advanced practice registered nurses palliative care externship: a model for primary palliative care education.
        J Palliat Med. 2016; 19: 753-759
        • Fitchett G.
        • Pierson A.L.
        • Hoffmeyer C.
        • et al.
        Development of the PC-7, a quantifiable assessment of spiritual concerns of patients receiving palliative care near the end of life.
        J Palliat Med. 2020; 23: 248-253
        • Johnson T.
        • Walton S.
        • Levine S.
        • et al.
        Racial and ethnic disparity in palliative care and hospice use.
        Am J Manag Care. 2020; 26: e294-e298
        • Thiel M.
        • Harden K.
        • Brazier L.J.
        • Marks A.D.
        • Smith M.A.
        Evaluation tools for interdisciplinary palliative care learning experiences: a literature review.
        J Palliat Med. 2019; https://doi.org/10.1089/jpm.2019.0394
        • Donesky D.
        • De Leon K.
        • Bailey A.
        • et al.
        Excellence in post licensure interprofessional palliative care education: consensus through a Delphi survey.
        J Hosp Palliat Nurs. 2020; 22: 17-25
        • Fink R.M.
        • Arora K.
        • Gleason S.E.
        • et al.
        Interprofessional master of science in palliative care: on becoming a palliative care community specialist.
        J Palliat Med. 2019; https://doi.org/10.1089/jpm.2019.0108
        • O'Mahony S.
        • Gerhart J.
        • Levy M.
        • et al.
        Posttraumatic stress disorder symptoms in providers: prevalence and vulnerability through avoidant and inflexible coping.
        Palliat Med. 2016; 30: 189-192
        • O'Mahony S.
        • Ziadni M.
        • Hoerger M.
        • et al.
        Compassion fatigue among palliative care clinicians: findings on personality factors and years of service.
        Am J Hosp Palliat Med. 2018; 35: 343-347