In order to identify training gaps in palliative care, researchers conducted interviews with palliative care experts and surveyed 216 doctors, 1139 nurses, 89 psychosocial professionals and 46 pharmacists.
Most survey respondents said that they were not trained in palliative care during the course of their basic education, and so may lack some of the necessary skills to care for and treat patients suffering from life-limiting conditions.
The researchers identified many barriers to palliative care training, including:
- limited exposure of healthcare professionals to palliative care in basic training
- the lack of a standardised curriculum
- an aversion to sharing information (‘silo mentality’)
- difficulties experienced by smaller institutions in developing capacity and ensuring skills learnt are applied in practice.
The main patient management topics where nurses and doctors reported a lack confidence were in the psychosocial areas (such as managing psycho-emotional distress). Nurses were also concerned about pain and delirium management.
There was broad agreement among the experts on the palliative care knowledge and skills healthcare professionals should possess. These include pain and symptom management, prognostication and knowledge of disease trajectories, goals of care and psychosocial care.
The survey also asked how people would prefer to receive training.
Respondents reported preferring training modes that were interactive, administered in small groups and conducted in the workplace setting. Examples of such training modes include clinical attachments and on-the-job training. Most respondents preferred blended learning, which is a combination of face-to-face instruction and online learning.
The palliative care experts unanimously agreed that mentorship and attachments were the ideal means of developing skills and thereby building capacity. However, they also recognised the importance of other approaches, especially given that mentorships and attachments are resource intensive.
The Report of a National Education Needs Assessment of Healthcare Professionals for Palliative Care in Singapore can be downloaded from the website of the Lien Centre for Palliative Care.