Vision & Principles Identified for Primary Palliative Care Course

September 29, 2021

Aquifer — supported by the Arthur Vining Davis Foundations — is moving ahead with the development of a national, standardized curriculum and quality online course that addresses critical gaps in palliative care learning across undergraduate medical and health professions education. The Aquifer Palliative Care Leadership Team, a group of expert interprofessional educators, has identified the principles and vision for the new course — “Principles and Practice of Excellence in Primary Palliative Care”

Although palliative care is an established specialty, all providers should have the skills to provide patient-centered care. By focusing on primary palliative care, the course broadens the reach beyond the specialty — moving toward overcoming provider shortages, lack of access, and lack of training — to improve outcomes and quality of life for seriously ill patients and their families. Primary palliative care knowledge and skills are critical in identifying and addressing the unmet needs of patients with serious illness, but most health professionals never receive standardized primary palliative care education.

Vision: Improve the capacity of the US health professions student to deliver humanistic, compassionate interdisciplinary care centered around patient goals of care and quality of life by applying evidence-based methods to alleviate the suffering of patients with serious illnesses and their families through the delivery of primary palliative care.

In the absence of clear national curricular standards on palliative care in medical and health professions education, the Aquifer Palliative Care Leadership Team has advanced this work by completing a needs assessment (stakeholder surveys and focus groups) and literature review. The research findings identified many common challenges that a national, standardized curriculum for health professions education could address, including educational gaps that cause providers to feel unprepared, workforce shortages among palliative care providers and faculty, balancing competing curricular demands, lack of standardization across interprofessional programs, and a lack of widely available materials for pre-professional learners. 

After completing the research activities, the leadership team held a consensus conference, synthesizing the literature review and needs assessment findings into a vision statement and key guiding principles. These principles will directly inform the development of learning objectives for the new course.

Principles of Primary Palliative Care Excellence

Based on the comprehensive needs assessment, the Aquifer Palliative Care Leadership Team has determined the Principles of Primary Palliative Care Excellence to elevate the primary palliative care education and training of all US health professions students, regardless of discipline. Each principle supports the advancement of primary palliative care as a competency for all health professionals. The principles determined by the team are:

1: Alignment of care with the goals, values, and preferences of seriously ill patients based on assessed need.

2: Interprofessional collaboration and care coordination between patients, families, healthcare teams, and systems.

3: Evidence-based and holistic approach that addresses the physical, psychological, social, and spiritual domains across the illness trajectory from diagnosis to end-of-life.

4: Equitable access to high-quality, culturally responsive palliative care services for all patient populations.

5: Education and advocacy to promote palliative care as a gold standard for serious illness care.

Next Steps

Using the vision and principles as a framework, the Aquifer Palliative Care Leadership team is now developing a national palliative care curriculum. The curriculum will be delivered via the Aquifer Principles and Practice of Excellence in Primary Palliative Care online modules and virtual patient cases. Learning objectives are now identified, and development work will begin in late 2021, using varied pedagogies to ensure that learners are equipped with the knowledge, skills, and attitudes needed to provide patient-centered care to their communities.

The Aquifer Palliative Care Leadership Team believes that elevating the primary palliative care education and training to all US health professions students, regardless of discipline, will support our goal of equipping pre-professional educational institutions to build a practice-ready healthcare workforce knowledgeable in the principles of primary palliative care and able to deliver high-value, compassionate care to seriously ill patients.

Aquifer Palliative Care Leadership Team

Academic Lead: Mandi Sehgal, MD; Florida Atlantic University Charles E. Schmidt College of Medicine/Cleveland Clinic

Aquifer Lead: Sherilyn Smith, MD; Aquifer, University of Washington

Team Members:

  • Brynn Bowman, MPA; Center to Advance Palliative Care
  • Karen Bullock, PhD, LCSW, APHSW-C; North Carolina State University
  • Rebecca Edwards, DNP, APRN, ACNP, AOCNP, ACHPN; University of Alabama
  • Susan Merel, MD; University of Washington
  • Kristen Schaefer, MD, FAAPM; Care Dimensions
  • Barbara Reville, DNP, ANP-BC, ACHPN; Harvard Medical School Center for Palliative Care
  • Paul Tatum, MD; University of Texas at Austin-Dell Medical School
  • April Zehm, MD; Medical College of Wisconsin
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