Statewide Initiative to Disseminate End-of-Life Educati

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DESCRIPTION (provided by applicant): Improving practice patterns of physicians in delivering end-of-life (EOL) care to cancer patients requires a multi-modal approach to teaching and learning. Although EOL curricular content exists, the availability of curricular material alone has not improved physician practice patterns. We will use sound educational theory to construct an EOL curriculum for the emerging generation of practicing physicians - resident physicians and medical students. This curriculum will foster a longitudinal comprehensive approach to educate learners on EOL care issues, impacting learner knowledge, skills and attitudes. Within California, we have developed an unprecedented EOL Consortium of all 5 University of California Schools of Medicine, and over 10 residency programs in pediatrics, family medicine and internal medicine. First, we will identify key EOL competencies, and develop a modular, interactive web-curriculum augmented by small-group sessions, to promote self-reflection and practice-based learning. Second, we will implement this curriculum with learners at multiple UC sites. Third, we will perform a comprehensive learner and program evaluation. Learner outcomes will include pre/post-curricular testing of knowledge, skills and attitudes around EOL care, objective structured clinical evaluations for communication skills, and practice-based learning assessment. Program performance evaluation will include detailed site monitoring, utility/satisfaction surveys, and timeline adherence. Finally, we will develop a plan for broad national dissemination of this EOL curriculum for physicians and other health care providers. Through our Continuing Medical Education divisions and the California Department of Health Services, we have access to 80,000 practicing California physicians. We have already obtained support of educators across the country, the California DHS, and our federal Congressman. This unique collaboration with renowned educators, researchers and clinicians will provide the infrastructure to successfully implement the EOL curriculum, to tailor it to the learner's needs, to provide formative feedback, and to affect the culture of EOL care in California. Outcomes will include development of a validated, flexible educational product for nationally dissemination, an understanding of practical facilitators/inhibitors to curricular implementation, a better understanding of learner needs, and an improvement of the climate in which EOL cancer care is delivered.