The modules were launched earlier this year at the Indian Association of Palliative Care Conference (IAPCON) in Pune, India.
Following the successful collaborative project in 2014 developing and launching 20 open access e-learning modules for palliative care in cancer in sub Saharan Africa, the same model of delivering education in palliative care was reviewed with the intention of developing a similar resource for India.
The African programme consisted of short filmed interviews and teaching sessions with fact slides and interaction embedded within the modules. The Editorial Board for India comprised ecancer (Bristol, UK), Karunashraya Hospice Trust (Bengaloru) and three consultants in palliative care from Cardiff.
Work began in July 2014, identifying colleagues across India who could review the modules from the Africa course, and suggest modifications for relevance for the Indian population and palliative care world.
Revising the content
Although the learning style and programme was felt to be appropriate, it was very clear that all the content needed to be refilmed and revised.
The intended level, module topic and titles, learner group and feasibility of access were discussed. Learning aims and objectives were created for each module which informed the development of interview scripts, appropriate experts from India were approached and invited to take part in filming taking place in February 2015.
During 2015 IAPCON conference in Hyderabad, and the Spirituality colloquium in Bengaloru in February 2015, the team from ecancer and Cardiff filmed interviews with palliative care doctors, patients and key workers from India.
This content was reviewed and developed into the programmes of short video clips in between fact slides. In October, Dr Nagesh Simha, Medical Director of Karunashrarya Hospice Trust, gathered together palliative care figures from across India who were able to ‘road test’ or informally review the modules and give accurate and honest feedback.
Further content need was identified and filmed, resulting in further preparation during November to make the modules ready for their formal peer review from colleagues across India which took place in December 2015.
January 2016 was the time of final amendments leading up to the launch in February.
Adding to existing education programmes
There are already well established palliative care education courses across India at various sites and provided by various organizations.
We felt it was important not to duplicate courses already present, but that a more basic level, aimed at health care professionals just completing their studentships or first few years post qualification would be the most beneficial addition to the existing education programmes.
The modules could be used by anyone without prior knowledge of palliative care, but with a basic knowledge of physiology, pathology, pharmacology and healthcare.
Providing undergraduate education in palliative care
In India, palliative care is not routinely included in undergraduate curricula. These modules being available as online and open access will start to provide some education for these students.
The module, however, would also be suitable for anyone in healthcare who has had no prior knowledge or teaching in palliative care and wants to gain a basic understanding of the core topics
Format of the modules
The modules are each one hour long and cover topics such as: basic principles of palliative care, communication and counselling skills, ethics, end of life care, pain management, opioids medications, malignant and non-malignant disease and different aspects of symptom management. Psychosocial and spiritual care has their own modules.
Each module has short videos lasting usually between one and three minutes of interviews and delivered teaching sessions and lectures on a specific topic.
These are then followed by fact slides which outline the key facts presented in the clips, with some additional material if it is felt that additional facts will help the learner to understand the main points of the topic.
They are free to access, hosted on the ecancer.org website and each would take about an hour of study.
The developing process has raised a number of issues which we are keen to share with anyone interested in developing similar initiatives.
These included: responsibility for content being globally available is important when discussing participation with people accessing palliative care and their relatives, and ensuring content is as accurate as possible in a rapidly shifting political and legal environment.
Another consideration was to avoid duplication with what is already available – and ensuring that the same care in educational design and development is given to e-learning as it is to any education event or lesson.
E-learning does not suit all topics and doesn’t suit all learning styles, but as a way of contributing to sharing palliative care knowledge it has a place alongside more traditional courses and teaching.
The importance of face-to-face learning
They do not replace face-to-face learning, however, and participants are strongly encouraged to make links with their local palliative care teams across India.
They should consider undertaking further study on any of the course already provided and use their knowledge to contribute to increasing awareness of palliative care issues for India.
The way forward
The team will continue to collect feedback and review the perceived impact of the e-learning on clinical practice. It is hoped that a prospective longitudinal evaluation of this impact will help inform future education developments.
Palliative care has been recognised by the Government of India as an important component of the care of cancer patients. All State Governments are required to establish palliative care at the District level hospitals.
This will need a huge number of trained professionals. This learning resource will stimulate interest in palliative care among health professionals in India.