Learning Objective #1: Describe content and teaching methods of end-of-life cancer care courses

Learning Objective #2: Present findings regarding institutional goal development and analysis

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Disseminating End-of-Life Education to Cancer Centers (DELEtCC) is a National Cancer Institute-funded research project focused on providing clinical leaders with resources to improve end-of-life (EOL) care for cancer patients. Interdisciplinary two-person teams from nationwide cancer centers are competitively selected for annual three-day courses. Internationally recognized experts provide diverse teaching approaches on EOL issues: e.g. plenary sessions; large group interactive sessions on institutional change, and small group workshops on communication skills and symptom management.. Course content includes symptom management, communication skills, psychosocial considerations, institutional change, cultural issues, and palliative care program development. .

Teams from 140 institutions (61% nurses, 17% social workers, 11% physicians, 4% psychologists, 4% pastoral care persons, 3% other) representing 39 states completed courses in 2002, 2003, and 2004. Applicants averaged 15 years experience with cancer patients, were functioning in leadership roles, chairing committees, and interacting with community organizations. Course evaluations revealed outstanding course ratings (4.73 on a 5-point scale).

Long term evaluation included progress participants made in improving EOL care in their individual institutions. Goal analysis revealed education as the most common activity, with some institutions providing ways to assist staff in translating EOL knowledge into actual behavior changes when providing patient care. Examples include 1) manadatory classes entitled “My World: Walk in My Shoes” for staff to spend a day in the hospital as a patients with cancer; 2) establishment of a collaborative relationship between two cancer centers for teleconferencing actual case studies of patients' palliative care needs; and 3) establishment of a mentoring program for nursing staff with nurses experienced in EOL care. These goals, as well as others, will be described in this presentation. While education provides a foundation for learning new skills, application to impact patient care relies on behavior changes in staff. Experiential approaches can provide the foundation for improving EOL care.