Using Technology to Enhance Children’s Palliative Care Education: The Project ECHO Model

Categories: Education.

The COVID-19 pandemic highlighted many strengths as well as gaps in the healthcare systems around the world. Early in the pandemic, training and mentorship systems for healthcare providers were paused, as the focus was on providing front-line care.

Fortunately, during this time, the Paediatric Palliative Care ECHO team based at the Hyderabad Centre for Palliative Care and Two Worlds Cancer Collaboration were able to leverage their experience and technology to continue to provide training and peer support using the Project ECHO model.

Project ECHO (Extension for Community Healthcare Outcomes) is a global education model where a team of experts connects with local healthcare providers for regular education sessions, through online videoconferencing.

Since 2019, the ECHO team has been partnering with the Indian Association of Palliative Care to deliver an online learning program specifically for post-graduate students in palliative medicine. This year-long program includes 25 weekly sessions on key topics in children’s palliative care, which seeks to ensure that all physicians graduating as palliative medicine specialists in India and Bangladesh are equipped with basic knowledge and skills regarding the management of common symptoms and clinical challenges in children with palliative care needs.

Over the past 4 years, there have been several key modifications to the program based on the feedback which have enhanced learning for the residents. Firstly, the program uses a ‘flipped classroom’ design, whereby residents are required to watch a 20-minute lecture video on the concerned topic, before attending the online session. This provides more time for discussion and interaction during the online sessions. Participants in the program consistently identify this as a particularly beneficial feature.

Additionally, the program uses online small groups (called breakout rooms by Zoom) where 4-6 learners and an expert discuss several pre-prepared questions about the session topic. This feature is really appreciated by learners, with one participants describing “we have other online teaching but nobody is having these breakout sessions and what I found is that it is amazing”.

Dr Xiohara Gentica, a pediatric palliative care physician describes her experiences with the Pediatric Palliative Care ECHO program in 2021. “It was during the pandemic when I started my journey in Pediatric Palliative Care that I felt a great need to further equip myself and get as much support as I can because it was really a challenging time. With the strong support of peers in this field, I was able to participate in Project ECHO”.

This ECHO program is divided into 2 parts, during Part 1 there are 12 weekly sessions. This is followed by a 6-week break and then Part 2, with 13 sessions. Sessions occur weekly on Wednesday evenings. There are also 2 written examinations (formative and final) during the ECHO, and participants are also required to submit a written reflection.

The ECHO faculty consists of regional, national, and international experts in the field of pediatric palliative care, and the faculty has been growing each year as new graduates of the ECHO program join as faculty themselves with the support and mentorship of more experienced peers.

The ECHO covers key topics in symptom management, several specific pediatric conditions and psychosocial issues as shown below.

This ECHO also has helped seed other ECHO programs on children’s palliative care, with former learners and teachers going on to develop and teach other national and regional Project ECHO programs, in India, Nepal, Bangladesh and the Philippines and East Africa.

Several academic papers have also described this and other ECHO programs on palliative care conducted by the team:

Using virtual learning to build pediatric palliative care capacity in South Asia: experiences of implementing a teleteaching and mentorship program (Project ECHO)

Exploring health Professionals’ experiences with a virtual learning and mentoring program (project ECHO) on pediatric palliative care in South Asia

Using Virtual Learning to Develop Palliative Care Skills Among Humanitarian Health Workers in the Rohingya Refugee Response in Bangladesh

All post-graduate students training in palliative medicine in South Asia are invited to attend this program. Please contact if you would like to learn more or register for the program.

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