How is the curriculum designed in primary care training schemes to support the delivery of palliative care training for primary care trainees? – A systematic literature review

Problem

The demand for palliative care is set to increase worldwide. Most people with palliative and end of life care needs around the world prefer to be at home in the last days of their life, however palliative care in the community is least accessible for patients. Primary care physicians (General Practitioners/GPs) as community providers of care, must have the skills to provide and meet the increased demand for palliative care. Many GPs do not feel confident in providing good quality palliative care. Training is essential to give GPs these skills; currently there is no established, consistent way to train primary care physicians in palliative care, leading to variations in care. This review seeks to find current evidence to support how curricula are designed to provide palliative care teaching for primary care trainees.The following questions will be addressed:1. How is training in palliative care for primary care trainees currently provided?2. What has been trialled to teach palliative care to primary care trainees and were they successful?3. What is the evidence to support effective ways to deliver palliative care training to primary care trainees?4. What further research needs to be undertaken to develop high quality palliative care training to primary care trainees?

Approach

The PerSPECTiF strategy was used to devise the research question and inform the search strategy. Electronic searches were carried out using MEDLINE, CINAHL, PsycInfo, CENTRAL, EMBASE and Global Health from 01/01/2000 until present. Characteristics of studies are recorded in tabular form using an Excel spreadsheet and assessed by two authors (JM, CP) with another (SM) acting as an arbiter. A data extraction table will allow comparison with other studies and a systematic narrative synthesis will be performed, identifying pervasive themes. Each paper will be critically appraised using the Joanna Briggs Institute qualitative research checklist. Risk of bias assessment will be performed using ROBINS-I, EPOC or RoB2 depending on study design. This will be carried out by two authors (JM, CP) with verification by SM. Quality of evidence will be assessed using GRADE-CERQual.

Findings

This study is currently in progress. The data collection is currently underway, and this should be completed by end of March 2024. Data analysis and discussion should be complete by end of May 2024.

Consequences

This study will inform primary care education governing bodies on the most up to date ways that palliative care can be taught to primary care trainees worldwide. This should inform future curriculum development. These findings could form part of policy on expectations for primary care physicians. It will inform qualitative and quantitative feasibility studies on proposed curricula changes and further studies on how to practically implement recommendations.