Development and evaluation of an online training program for palliative care in India

Varun Raj Passi, Sreedevi Warrier, Rajalekshmi Balu, Sunilkumar MM, Parth Sharma
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Abstract

Objective: Palliative care training at the undergraduate level is poor in India. With the need for palliative care rising in India and globally, it is possible to train physicians in resource-limited settings in palliative care via online training programs owing to ease of access and convenience. However, there is limited evidence available from India on the development and implementation of such a training program. This study aims to describe the development of an online training program offered by the Trivandrum Institute of Palliative Sciences (TIPS), Kerala, and the impact of the program on the confidence of physicians in managing various palliative care needs of their patients. Material and Methods: The course was developed by an interdisciplinary expert team from TIPS. The course content was made keeping in mind the local sociocultural factors in India and was peer-reviewed by two external experts. The program was started in 2018 and updated and revised over the years. Currently, the program has 20 sessions, each lasting for 90 minutes. The course content was disseminated using project-ECHOs tele mentoring model. To assess the impact of the training program, self-reported change in confidence from twenty-two batches of physicians, trained from January 2020 to August 2023. Feedback from participants was also assessed to identify areas of improvement in the training program. Results: A total of 1159 physicians were trained during the study period. At the end of the course, 51.2% of the participants completed the evaluation survey and had a statistically significant (p<0.05) improvement in confidence in pain, gastrointestinal symptoms and breathlessness management, morphine prescription, and psychosocial communication. The duration of each session and the entire course was reported to be ideal by 88.6% and 87.9% of participants, respectively. Conclusion: Our results show that online training can be effectively used to build confidence in physicians in managing various palliative care needs.
印度姑息关怀在线培训项目的开发与评估
目的:在印度,本科阶段的姑息关怀培训很薄弱。随着印度和全球对姑息关怀的需求不断增加,在资源有限的环境下,通过在线培训项目对医生进行姑息关怀培训是可行的,因为这样既容易获得又方便。然而,印度在此类培训项目的开发和实施方面提供的证据有限。本研究旨在描述喀拉拉邦特里凡得琅姑息治疗科学研究所(Trivandrum Institute of Palliative Sciences,TIPS)提供的在线培训项目的发展情况,以及该项目对医生管理病人各种姑息关怀需求的信心的影响:该课程由 TIPS 的跨学科专家团队开发。课程内容考虑了印度当地的社会文化因素,并由两名外部专家进行了同行评审。该课程于 2018 年启动,历经数年更新和修订。目前,该课程共有 20 节,每节课 90 分钟。课程内容采用项目-ECOs 远程指导模式进行传播。为了评估培训计划的影响,从2020年1月至2023年8月接受培训的22批医生自我报告了信心的变化。此外,还对参与者的反馈意见进行了评估,以确定培训计划需要改进的地方:研究期间,共有 1159 名医生接受了培训。课程结束时,51.2%的学员完成了评估调查,他们在疼痛、胃肠道症状和憋气处理、吗啡处方和社会心理沟通方面的信心有了显著提高(p<0.05)。分别有 88.6% 和 87.9% 的参与者对每次课程和整个课程的持续时间表示满意:我们的研究结果表明,在线培训可以有效地帮助医生建立处理各种姑息关怀需求的信心。
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