Face to face course is better than a webinar. You work in the same institution, why go virtual? 

I worked as a palliative care advanced practice nurse in a community based non-profit organisation and was linked to one of the major hospitals in my area. I took part of a basic palliative care class (a full day class/workshop) where a number of guest speakers discussed several aspects of palliative care from symptom management, to end-of-life care etc. The audience was then asked to evaluate that one day class. based on the comments, we designed a master class over two days with advanced areas in palliative care. The feedback was extremely good. I do agree with Richmond, face-to-face is much better than a webinar if you work in the same institution. You can invite international guest speakers and invite people who do not work in the same institution to attend. 

I spearheaded the development of a course entitled " Concepts of Palliative Care'in the undergraduate nursing curriculum in Pakistan. Face to Face is definitely a better option but if you need to invite experts then webinars do serve their purpose

Debra, send me your email and we can discuss this further o

Hi, Im Duke.

I recommend outcome based education as the design...

Let us say, this is a 6 months programme post basic certificate: 

The recommended mode of delivery: 3 months theory and 3 months practice. 

The method of delivery: face-to-face on both lecture, tutorial and practical. Find clinical placement where palliative care are done hands-on. You must also use the mock hospitals in your university/college as a laboratory for tutorials to enhance their skills before the real life exposure happens during the 3 months theory.  During the 3 months practice, tutorials may also be done by clinical instructors. 

In this way, you can integrate knowledge, skills and attitude domains on your core subjects.  

Attitude can be measured by formulating your learning outcomes with affective domains and documented by requiring reflections as a partial requirement. While the knowledge and skills are measured by formulating cognitive and psychomotor domains on your learning outcomes.  These are documented using skills logbooks and case studies (skills) and multiple choice questions/modified essay questions (knowledge). 

However, the 3 domains can still be measured even if palliative care is only a subject for the undergraduate programmes such as the BSc in Nursing. 

All the best. 

duke 

Debra, I concur with the comments left by our colleagues, that face to face education programs are best when educating hospital staff about palliative care. However, in my role as Clinical Instructor in Palliative Medicine, I find the most important question is: What should be the content of palliative care education programs? It is important to address the distinction between palliative and hospice care, the 4 primary goals of care, palliative care consultation etiquette, interdisciplinary team work, dynamics of family meetings (in which goals of care are determined), opioids and other interventions as they relate to pain and symptom management, and caregiver burden. I applaud you for identifying staff education as an important component of your role - it may well be the difference in a successful palliative care service in your hospital. Please feel free to contact me. Regards,

Charlene A. Sexton, Ph.D.

Louisville, KY 

Debra, my background is not in education but in leadership and management; yet I believe in continuous staff training as a means of developing and improving their competence and performance, in addition to other staff motivation approaches. I therefore think that you are on the right track. However, I believe that training staff on the job is a little different from training students although the trainer still targets improving knowledge, enhancing skills and changing attitude. I suggest that you conduct thorough training needs assessment focusing on what is unique with the people you want to training so that you also identify where you can put more emphasis on. After that you work on the contents, duration and methodology followed by identifying effective facilitators/teachers for each topic. I believe that you are outcome focused and your employer would like to get positive results in quality of care.

The second issue is that I believe you are focusing on hospital/institution based palliative care. In my environment I would also seek focus in the training on linkage between home based care and hospital/institution based care or transition of care, what other call transfer or referral taking into consideration Charlene's input.

I hope this, in addition to what has been said above, is useful. Wish you well.

I once directed a large nursing research and education department in a hospital with 2,000 nurses at the time.  I also worked as a hospice/palliative care coordinator.   I'd recommend face to face education spread out over a few weeks with some clinical application and 'homework' in between.

Most people enjoy one day workshop type activities.  It is often interesting and fun to listen to speakers and have lunch provided and so forth.  You get high scores for satisfaction. The learner during these sessions is passive.  The information is presented but less likely to be absorbed with learners in this passive mode.

We did a research study on different approaches using writing for publication content.  We had over time over 100 nurses attend an all day workshop taught by editors of well known nursing journals.  The nurses loved the workshop.  We got excellent feedback but only 2 or 3 actually wrote up even a query letter for a publication.  When we took the same content with the same number of hours and spread that content out over 4 weeks every other week and required writing different aspects of a publication as homework, we had over 80% of the students submit at least a query letter and many submitted completed articles. 

In your role, I'm sure you have some wonderful ideas about how nurses can apply the information they are receiving in the classroom in a longer presentation series.

Good luck with your efforts.

I think training should be a multi-layer approach - yes, a day's training can be really useful but also so can 'role-modelling' talking to a family with a couple of nurses present to show them how to communicate well with a family.  I have also written about Reflective Debriefing Sessions following a death (Hockley: International Journal of Older People Nursing)  In the care home setting I did this every month for the deaths that had occurred during the previous month - my research has shown that not only do people learn about basic information from you as a teacher and other members of the group but these sessions are supportive as well as improving communication across the team.

Dear Debra

I agree with Mohammad , Richmond and others that you need to arrange the guideline and training face to face at the beginning of establishment of the department.

In Middle East group we arranged training according to guidelines more than 10 days two times yearly for 3 years to follow the improvement of palliative care and compare the outcome

I would recommend a blended approach that is managed by your clinical leaders (Nurses)

look at a college that specialises in the subject matter and particular for you it should be in aged care work

I recommend www.acclm.edu.au

Chers

www.acclm.edu.au

There are some great suggestions above - from a psycho-social point of view I would recommend you include discussion around Self Care and emotional coping.  Palliative Care work is wonderful and rewarding but VERY demanding and all types (and levels) of staff can find themselves burnt out.  What we witness every day in Palliative Care settings can deplete us all - you need to nurture and grow your team, not have them exhausted!  All the best...

Very thoughtful work that you are doing. I have been engaged with end stage disease management for 20 years and beleive that the Nurse Practitioner can holistically manage patients at the end of life collaborativley with the Pallitive RN case manager. Many of the Palliative physician consult me for cases that are complex. 

Bedside nurses have little time to complete webnairs unless it is on their own time and they are supported in some way by time or finacialy incentives. I am a beleiver in 2 page inservices with 5 questions to answer which supports knowledge enhancement in the subject matter. Keep up this most important work.

I have worked w staff, students, family, and patients who are dealing with end of life issues. I realized that concerns may vary bt groups. Less experienced care givers are more concerned about their role in hastening death. All look for guidance in dealing w families. As a Clinical Nurse Specialist and Nurse Educator, I would explain that care is not being withdrawn. It is now time to focus on helping their loved one be as comfortable and functional as possible. Sometimes encouraging the family to talk about what their loved one likes to do helps.. If watching TV is a hobby, providing adequate pain meds may allow for the pts  hobbies ( social media, gaming, knitting, etc). Pts who have been on opioids or benzos have a high tolerance and need a higher dose than usual. It is I pt that staff are comfortable teaching family to administer meds at these doses and in combinations needed. One method that has been found effective is the  "Teach-back Method " Various public tools can be obtained from teachback.org. 

Hi Debra,

I have appended few articles hope find these readings helpful.

Best wishes, 

Salma Amin Rattani

Hi again,

At Aga Khan University School of Nursing and Midwifery, we offer concepts in palliative care nursing course in undergraduate nursing programme (BScN). In that we use multiple strategies; f2f sessions, a-synchronize  discussion forums, working in clinical to integrate theory into practice. The course participants also write a paper focusing on a component within the course.

However, as you are planing a course for working staff this will be continue education session so you may need to factor in the time spent is to be paid by the institution, or individuals' own time, what will be duration of the course, what will be the value added to the individuals, sure acknowledging the fact that it will add to the knowledge, but would it be certificate course and what will be value of that certificate, like counting towards their hours for required continue education if it is the mandatory or other as appropriate. Support; finance, material human support that you will receive for offering the course. I know you are looking for answer and I am adding questions but reflecting on them may facilitate your decision making process.

Take care!

Salma Amin Rattani

Good Morning Debra- I am the Director of Palliative Care Services at Univeristy Hospital in San Antonio, Texas.  We have many different levels of training here in our system.  Two of the most effective trainings we offer here have been quite successful.  We offer unit training for nursing staff for each different unit here in our hospital.  We have a 30min, 1hr, and 2.5hr training option.  The unit directors are approached and informed of the opportunity to educate their staff.  These trainings have been very successful and the feed back from the nurses has been overwhelmingly positive.  The presentations are mainly pulled from ELNEC material and source but we also add in unit specific points for the population each unit serves.   Our second training offer is a monthly luncheon series for physician (anyone can attend but the MD's can get CE's).  Each month we focus on a different aspect of palliative care that is related to bedside palliative practice.  In the three years we have been offering this series we have educated over 800 physicians alone. 

I hope this helps in your practice and ability to educate. 

Best, Julieanne Wisloff, RN, BSE, CHPN

Julieanne, this is a very informative in put. i like the flexibility and involvement of unit managers.

I created a Power-Point presentation for the staff at the supportive facility living centre at which I work. Unfortunately, their educator sent it to the RNs and LPNs email for them to read. I was very disappointed, as I feel face-to-face is the best way to discuss fears around things such as administering high does of opiods and other medications so essential in palliative care.

I am a fan of case -studies. There will bee lot of questions to answer in the area of palliative care. What aims my the staff find most impotent to learn about? Make a list and give the staff in case possibilities to find their answers together. Three of my students did a study about palliative care and how to manage the pain for the patients, they also find lot of attributes  how pain can be observed. The result of the study was a poster. To day the poster hangs in their coffe-room and everybody can easily find what they have to check up. My be my answer is difficult to understand, but my point are that staff have to make common decisions about how to take care of different  patients and there needs, and we have to go from a holistic view of the human being.

contact The Balm of Gilead at the University of Alabama, Birmingham

they are an award winning program and one of the longest-standing programs in the US The staff welcomes consultations

I provide workshops and webinars on palliative care by focusing on narrative approaches to holistic person-centered care, using examples drawn from my published case studies, and other qualitative research findings.  Perhaps I could be of help? Check out my website for further into. www.robertmundle.ca

Dear Debra 

I wish if this can help with kind regards.

Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study. Global journal of health science 04/2015; 7(6):331-337. DOI: 10.5539/gjhs.v7n6p331.

https://www.researchgate.net/publication/275956558_Nurse_Level_of_Education_Quality_of_Care_and_Patient_Safety_in_the_Medical_and_Surgical_Wards_in_Malaysian_Private_Hospitals_A_Cross-sectional_Study

Article Nurse Level of Education, Quality of Care and Patient Safety...

The best way to educate your staff about palliative care is through continous professional development and short course trainings. Conduct research in your institution exposing the problems and palliative care needs in your health institutions. (Refer to a palliative care need assesment and audits done in northern uganda) which findings was presented to clinicians, nurses and the administrators. Do not forget to proactively start the palliative care services provision in your institution. The little you do impacts positively to other clinicians. Basically it is about change of mindset about palliative care and the staff would be interested to do the work, hope that helps.

Conference Paper THE PRACTICE OF PAIN ASSESSMENT AND CONTROL IN CANCER AND HI...

Conference Paper WHO NEEDS PALLIATIVE CARE; ASSESSMENT OF NEEDS IN TWO REGION...

The Institute of Medicine (IOM) in the US has recently published their book entitled,

DYING IN AMERICA: Improving Quality and Honoring Individual Preferences

Near the End of Life (2015).  The book is available for around  $75 on major book seller sites but also available as a free PDF download.  There are many recommendations for care that could be included in a palliative care education program.

You might also want to consider that education might not be enough to improve palliative care.  There's an old adage that says, Just because someone knows what to do, it doesn't mean they will do it.   We have a strong curative model that tends to supersede both palliative and hospice care.  Some of our systems do not encourage the use of palliative care.  For example, are the medical/nursing records set up to support palliative care recording?  Is there reinforcement of providing palliative care in data collection? 

A follow up evaluation on the use of what is taught in your course might pinpoint issues staff have in implementing the content.

www.acclm.edu.au and www.frontlinecaresolutions.com has wonderful online courses in evidenced based healthcare and for taking a palliative approach in long term , hospice and aged care specifically 

The training is cheap and flexible and all done online 

Have fun

www.acclm.edu.au

www.frontlinecaresoluitons.com

http://www.frontlinecaresolutions.com/palliative_care_course

http://www.facsonline.com.au/content/online-store/store.jsp?category=Health%20and%20Aged%20Care

sorry no answer

I agree with the answer by Drew Dwyer.  When I worked in Palliative Care we were required to complete online courses.  The courses were provided by a company that the hospital had partnered with -- in order to use the software/program provided.  We acquired CEUs at the completion of courses.  These courses were required and offered a opportunity to become certified in Palliative Care or Hospice.  I hope this is of some help.

I am aware of Pallium Foundation of Canada a not for profit corporation which has been involved in inter-professional care giver education since 2001. Please go too the website if you are interested.

A colleague and I just completed a nursing paper about instructing seasoned nurses on the psychosocial aspect of palliative and end-of-life care.  We chose to do is a training session over a few days.  I am attaching a copy of the power point that we developed.  I hope this will be helpful to you.

Thank you Victoria!!

Thank you both Srini and Victoria. Lovely resources.....

You are both welcome, Debra and Hari!

It is so important for nurses to understand Palliative services and learn how to navigate difficult conversations with patients/family/caregivers. Did you consider developing a shadowing program? A nurse from each unit can shadow a member of your team for a day and become "unit champions/resources" for their unit. I am sure many staff would be interested, as I often am told by my staff that this is an area they feel ill-prepared to managed.

Kim