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Discussion 5.2 : Training and Barriers

6 months ago
CLOSED: This discussion has concluded.

Pallium Canada provides training through LEAP, an inter-professional palliative and end-of-life care education developed by a pan-Canadian network of academic health leaders and skilled community practitioners. Focusing on current best practices, LEAP provides a standardized, competency-based approach to enhancing palliative care services across Canada.

Are there barriers preventing you from accessing training to acquire palliative care skills and knowledge? If so, what are they?


This consultation is now closed.


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  • CFHI_FCASS over 1 year ago
    The service provider teams that CFHI is currently working with clearly indicate the need for training to include structured opportunities to practice and access to clinical mentors and supports as they deliver and refine new skills. These teams also express a need for data and metrics – such as the impact of clinical interventions on symptoms – to support ongoing efforts to refine skills and target the most important areas for improvement. Some of the most common issues raised within the service provider teams are education, practice and support to have difficult conversations and to provide support for grief and loss. These are difficult skills to develop through static content approaches, which is why CFHI provides funding and support, skilling up interprofessional teams in quality improvement and specific best practices while supporting them through an implementation process that includes access to expert coaches. The teams often use this funding to cover training costs and backfill positions.It is worth asking though whether sufficient priority is placed on palliative care in service provider education and continuing professional development.
  • yinyang over 1 year ago
    La reddition de compte associée à l'application du Cadre de référence sur le développement des compétences en SPFV (indicateurs de suivi) semble indiquer un certain ralentissement... malgré l'adhésion aux objectifs visés et une bonne volonté d'y souscrire, la capacité des établissements semble limitée...les facteurs explicatifs suivants ont été mentionnés : les effets de la réorganisation du réseau de la santé et des services sociaux (Loi 10), le manque de ressources RH et $, la concurrence des besoins en formation sur le terrain, le concept de "mentorat" difficile d'application, plus précisément pour les préposés aux bénéficiaires (pénurie importante aussi à souligner dans ce secteur). Par ailleurs, la "formation initiale" des intervenants constitue aussi un enjeu et il faut aussi soutenir et poursuivre les efforts entamés par certains milieux universitaires dans ce cadre... il en va de l'amélioration de l'offre de service en SPFV dans une perspective d'approche globale et interdisciplinaire.
  • arcticfox over 1 year ago
    Location. There is little local resources available and budgets are not available for travelling outside the region for training.
  • PallRNKaren over 1 year ago
    The barriers to receiving the skills and knowledge to provide palliative care are cost, time and availability of the courses.
  • melmay over 1 year ago
    The barriers are geography, limited trained educators, manpower, and simply, time. Not enough trained facilitators expected to do all the education while still maintaining their full time work load.
  • Kjpt11 over 1 year ago
    Lack of opportunity. LEAP training is available however courses are only held locally once a year and it is difficult to get registered for these as there is such a demand in our area that they are often filled quickly.
  • JenniferM over 1 year ago
    it's not required for Doctors to take the training
  • kott over 1 year ago
    Not enough opportunity or frequency of it. I am not sure what they cover
  • Gingerbugnp over 1 year ago
    I have been fortunate to find several courses to facilitate my training in palliative care both in class and online. What was also very beneficial was obtaining CNA certification which went much more in depth but was self directed. I have looked at the LEAP courses previously but found them very limited in availability. Barriers I initially faced to obtaining training was time to attend education, a lack of incentive from the organization and cost. Now that I am interested in becoming an educator myself, I find there is a lack of opportunities to facilitate the acquisition of these skills and knowledge.
  • palliumcanada over 1 year ago
    Pallium is growing and we are working hard to engage with partners, enhance our programs and program delivery models, grow sustainably, and find new ways to make our courses more accessible. To date, Pallium has adapted its LEAP courses to meet the needs of different health care professions, disease specializations, and care settings including LEAP Core, LEAP Mini, LEAP Paramedic, LEAP Long-Term Care, LEAP Oncology, and LEAP Renal. New LEAP courses, including LEAP Hospital, LEAP Pediatric, and LEAP Emergency Department are under development to meet the needs and expectations of our clients. We also continue to enhance and develop our educational supports and resources including the Pallium Pocketbook and the Pallium APP. We are committed to ensuring that our products and our product development approach meet the needs of the individuals and organizations that we serve and support. To respond to the geographical barriers, we are currently developing online courses to adapt to the needs of remote health professionals who cannot travel to attend a LEAP course in person. We are also working with partners in BC, and other jurisdictions, to pilot new models to train certified facilitators to build palliative care capacity in rural BC. We will continue to innovate, pilot, and scale new solutions that allow broader access to LEAP courses for all health care professionals. The fees that Pallium charges for its courses and materials are essential to supporting the on-going development and maintenance of the products and ensuring the on-going financial sustainability of Pallium to enable us to deliver on our vision of early, effective, and compassionate palliative care for every Canadian. As part of our current pricing strategy, we have standardized our pricing structure across our courses and have set prices at levels to be affordable for health care providers and organizations across different professional and care settings. To minimize the direct costs for health professionals, Pallium is working to build partnerships with health organizations that can cover the course costs for their staff. Through our train-the-trainer model, we also work with health organizations to build capacity: we organize LEAP Facilitator Training Workshops and train the staff of the organization to become certified facilitators. These facilitators will go on to deliver LEAP courses to their colleagues within the organization. On challenge that has been identified in our research is the large volume of material covered in a short period of time. To address this, some learners and facilitators have recommended lengthening the courses. Pallium recognizes, however, that a longer course would also increase costs and create new barriers to access. We will continue to explore optimal delivery models and work to strike an appropriate balance between course length, depth of learning, learning pace, and accessibility.Pallium utilizes a Plan, Do, Study, Act model to deliver continuous improvement of its courses and products and we are always open and welcoming of feedback that can help reduce barriers and improve access and quality.Finally, there are continuing challenges related to integrating palliative care education, specifically LEAP or other similar material, into undergraduate and postgraduate curricula due to funding and resource limitations in these sectors.
  • jcruikshank over 1 year ago
    The CHPCA has identified barriers to access for palliative care skills and knowledge training as primarily geographical and funding-based. Language of delivery can also be a barrier to access; for all professionals and patients to benefit funding must be made available to translate resources appropriately. The CHPCA has identified capacity building in primary care teams as essential, as well as access to resources, equipment and supplies. Further, the CHPCA has identified Canada’s geographic vastness as a barrier and recommends that digital methods be developed to improve access to palliative care knowledge in remote and underserved areas.The CHPCA recommends making accreditation of home and community based healthcare services contingent on palliative care service provision to nationally accepted standards, which will ensure that the training and knowledge delivered adhere to nationally-accepted standards.
  • Robin over 1 year ago
    Perhaps online modules with moderators/facilitators would make education more accessible. Not all practitioners are able to attend face-to-face sessions. Any educational program should be interprofessional in nature with some fundamental content that is relevant to all healthcare providers and special modules that are relevant to particular disciplines and leveled according to the degree of specialty. One size does not fit all.
  • alliedhealthworker over 1 year ago
    I've been really interested in taking the LEAP course but have never been able to. In my geographic region, the website often indicates that I need to request permission to enroll. Locations/times are also not always convenient. More offerings would be helpful.
  • applebee1 over 1 year ago
    Funding is required to support the continued professional development of existing and new palliative professionals.
  • NurseDar over 1 year ago
    As a community RN there is little consideration by the health authority I work for the amount of expertise required to provide excellent palliative care. We have new grads and nurses with NO palliative experience who join our team who learn on the job. They are given a basic 2 or 3 day orientation to palliative care. Palliative care takes YEARS to learn not days or months. Patients and families have but one chance to die and the nurses providing that care need to have the education and experience to provide excellent care. It is not fair to the nurse or the patient and family to have someone learning on the job and stumbling through someone's final journey. I have undertaken many courses in advanced palliative care on my own without recognition or reimbursement from my health authority. There is little incentive for other nurses to to seek higher education as it comes only at their own time and expense. Mentoring of new nurses or those without palliative care experience by experienced nurses is also sadly lacking as a priority. There are plenty of best practice education opportunities available but they need to be offered to staff both new and experienced to keep up to date.
  • PalliativeMD over 1 year ago
    Not every medical school in Canada has a department of Palliative Medicine. How exactly are family Physicians and specialists going to acquire the necessary skills to provide primary level PC if there is no academic home for this activity?The Royal College recognized Palliative Medicine as a specialty in 2014 yet some medical schools have ignored this. This would not be tolerated for any other area of medicine. Imagine a medical school that did not have a department of OB/GYN, Family Medicine, Diagnostic Imaging, etc. It simply shows that the attitude towards PC is that it is somehow optional or viewed as less important than "curative" medicine.Every medical school in Canada should be mandated to have a department of Palliative Medicine. Every doctor that graduates from a Canadian medical school should have the basics skills in providing palliative care to their patients. We should train enough specialists to coach and mentor current physicians and manage complex cases as well as provide frontline patient care as a safety net for all patients requiring a palliative approach to care.Also easily generalized to schools of nursing, social work, pharmacy, etc.
  • PallMedDoc over 1 year ago
    LEAP is really good. Additionally, if there's funding to support more health care staff to take this, this would likely promote uptake (as the current fee structure is a potential barrier).