The impact of a children's palliative care education and mentoring program (Project ECHO) on healthcare providers' knowledge, confidence, and attitudes in Bhutan.

Abstract

Background: Palliative care services are unavailable for the vast majority of children in Bhutan. Children's palliative care has not been incorporated into training programs for health professions, leading to limited knowledge and awareness of how best to support children facing serious or life-threatening conditions.

Objectives: To describe the impact of the Project ECHO children's palliative care course on participants' knowledge, comfort, and attitudes and to evaluate the overall acceptability of an online training to support palliative care training in Bhutan.

Methods: Before-and-after surveys of program participants were conducted, assessing changes in knowledge, comfort, and attitudes. Participants' overall experiences and acceptability of the learning program were assessed through an end-of-program survey.

Results: Participants were primarily nurses (49%) or physicians (34%). Most participants (68%) worked in pediatric and/or neonatal care. Participants' knowledge of core palliative care concepts improved significantly between the beginning and end of the course. Participants' comfort and attitudes toward palliative care also improved, with significance effect sizes in most domains (11/18). Satisfaction with the program was high, with 100% of participants agreeing that the training was applicable to their clinical practice. Although most participants (56%) identified a personal need for additional clinical training to support practice change.

Significance of results: Project ECHO can be used to deliver palliative care education, with improved palliative care knowledge, comfort, and attitudes among program participants. A short online training program can generate interest in palliative care, which can be leveraged to further develop palliative care services in settings where palliative care is currently unavailable.