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Development and Outcomes of a Provider-Driven, Online Continuing Education Program on Integrative Palliative Care: Randomized Controlled Trial

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Date 2025 Jan 10
PMID 39790368
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Abstract

Background: Integrative therapies are increasingly in demand for both symptom management and quality of life in palliative care (PC) populations. Multidisciplinary PC professionals need continuing education/continuing medical education (CE/CME) to keep current on the evidence-informed use of integrative therapies in PC planning.

Objectives: (1) Elicit input from multidisciplinary PC providers on needs for CE/CME content on integrative care, and indicators of implementation for use in impact assessment. (2) Produce an online CE/CME program responsive to provider input. (3) Assess program impact on PC providers in a randomized controlled trial.

Methods: Focus groups with 47 multidisciplinary PC personnel assessed needs for CE/CME content and identified practice-related behaviors indicating implementation of integrative care. Qualitative analysis then informed development a 9-hour CE/CME program, and identified candidate items for an outcome measure (Integrative Practice Assessment) to assess impact. Validation testing followed with 63 new subjects. A randomized, waitlist-controlled trial then assessed program impact on (1) confidence understanding evidence-informed use of integrative therapies in PC, and (2) implementation of practice behaviors that promote integrative care.

Results: 213 subjects were randomized and 170 provided follow-up data on program impact. Subjects' confidence (10-point scale) understanding safety considerations increased from 5.4 to 8.7; recommending modalities, from 4.2 to 8.3; and explaining modalities, from 4.8 to 8.5. Direct actions promoting integrative care in the last 10 patient encounters increased (12.2 to 17.9). Indirect actions taken in the work setting increased in the past month to advocate integrative therapies (from 5.7 to 9.1), and to promote organizational change (from 10.9 to 18.2). (All outcomes < .001).

Conclusion: This provider-driven CE/CME program led to significant positive changes in practitioners' self-efficacy and implementation of integrative care practices in PC settings. The results indicate that CE/CME can have measurable impacts that benefit providers and may potentially impact patients, families and the culture of care.

References
1.
Field T . Massage therapy research review. Complement Ther Clin Pract. 2016; 24:19-31. PMC: 5564319. DOI: 10.1016/j.ctcp.2016.04.005. View

2.
Mitchinson A, Fletcher C, Kim H, Montagnini M, Hinshaw D . Integrating massage therapy within the palliative care of veterans with advanced illnesses: an outcome study. Am J Hosp Palliat Care. 2013; 31(1):6-12. DOI: 10.1177/1049909113476568. View

3.
Bradt J, Dileo C, Magill L, Teague A . Music interventions for improving psychological and physical outcomes in cancer patients. Cochrane Database Syst Rev. 2016; (8):CD006911. DOI: 10.1002/14651858.CD006911.pub3. View

4.
Hugenholtz N, de Croon E, Smits P, van Dijk F, Nieuwenhuijsen K . Effectiveness of e-learning in continuing medical education for occupational physicians. Occup Med (Lond). 2008; 58(5):370-2. PMC: 2493067. DOI: 10.1093/occmed/kqn053. View

5.
Ryan G, Lyon P, Kumar K, Bell J, Barnet S, Shaw T . Online CME: an effective alternative to face-to-face delivery. Med Teach. 2008; 29(8):e251-7. DOI: 10.1080/01421590701551698. View