Dissemination of the Education in Palliative and End-of-life Care–Pediatrics (EPEC-Pediatrics) Train-the-Trainer Curriculum: Phase 2

University Of California, San Francisco, San Francisco CA

Investigators

Abstract

Most children living with advanced cancer experience highly distressing symptoms, and many do not have access to subspecialist pediatric palliative care (PPC) services or clinicians trained in primary palliative care. Despite the call from national organizations for the integration of palliative care for patients with cancer, a lack of high-quality PPC education persists as a barrier to PPC implementation. From 2012-2017 the investigators of the current proposal developed and disseminated the most comprehensive PPC curriculum worldwide to date: Education in Palliative and End-of-Life Care (EPEC)-Pediatrics (NIH/NCI grant #R25 CA151000-01). The 24-module curriculum is designed to teach clinicians how to teach and advance PPC concepts. The primary target audience was pediatric oncology prescribing clinicians. The curriculum is delivered through combined online learning and face-to-face conferences. When the COVID-19 pandemic emerged, an online training platform was created, enabling remote worldwide participation. Forty conferences have been held to date, training 1,992 clinicians from 122 countries. Most participants have reported improvement in PPC knowledge, attitudes, and skills, and advancements in patient care for children with cancer and serious illnesses. Further dissemination has been achieved through five publications and dozens of academic presentations. The primary goal of this project is to improve EPEC-Pediatrics accessibility and inclusivity by targeting participants from US pediatric oncology programs outside of large tertiary centers, including non-prescribing interprofessional clinicians (e.g. social workers). The project will also address disparities in PPC education by adding faculty from underrepresented communities, such as infants. Further, the curriculum will be updated to ensure content is current and inclusive, reflecting the needs of all children with cancer and families, including those with special needs. Specific aims are to: 1) Disseminate the EPEC-Pediatrics curriculum through five annual EPEC-Pediatrics Train-the-Trainer conferences in previously geographically underrepresented areas of the US (e.g., Southern region). 2) Update and expand the existing EPEC-Pediatrics curriculum and dissemination project by: a) Seeking guidance from an interprofessional group of clinical experts (e.g., bereaved parents) to improve curriculum content and ensure it includes equitable and inclusive content; b) Strengthening the psychosocial-spiritual curriculum content through emphasis of care for special populations (e.g., infants with cancer); and c) Designing a learning pathway for non-prescribing clinicians. Successful adaptation and dissemination of a more holistic EPEC-Pediatrics curriculum will promote transfer of PPC best practices to underserved communities, ultimately changing clinician behavior and improving care for children with cancer and their families.