Purpose: Palliative medicine is assuming an increasingly important role in patient care. Yet, most physicians did not learn this during their formal training. The Education for Physicians in End-of-life Care (EPEC) Project aims to increase physician knowledge in palliative care by disseminating the EPEC Curriculum through a train-the-trainer approach. An assessment of its use to help the project reach its targets was performed.
Method: An independent evaluation pursued a two-step qualitative and quantitative approach to assess the ways that the curriculum is used by EPEC Trainers.
Results: The main findings are: (1) The EPEC Curriculum is well regarded by a quota sample of 200 physicians who were trained to use the curriculum between January 1999 and March 2000. When asked, "How would you rate the effect of EPEC training on your knowledge of end-of-life care?," 62% (123/200) selected 'greatly improved it.' When asked, "What was the effect of the EPEC conference on your ability to teach end-of-life care?," 72% (144/200) selected 'greatly improved it.' (2) Dissemination has been effective. Ninety-two percent (184/200) use the curriculum for teaching. Of these, 83% (153/184) presented the material in 30-60 minute sessions as part of regularly scheduled conferences. We estimate that these 184 EPEC Trainers have presented 1 or more of the 16 EPEC Curriculum modules to approximately 120,000 professionals.
Discussion: There is evidence that physicians selected to be EPEC Trainers judge the EPEC Curriculum to be high in quality, respected, and most importantly, usable. They use the EPEC Curriculum as part of a train-the-trainer dissemination strategy. The interpretation of this enthusiastic assessment is tempered by the study's limitations including respondent bias and possible acquiescence. Nevertheless, it appears that the EPEC Curriculum has set a standard of knowledge in the field and is an example of disseminating new information to physicians in practice. We conclude that the EPEC Curriculum is an effective vehicle to transmit palliative care information to physicians in practice.