Abstract：
BACKGROUND: Palliative care access in Nepal is severely limited, with few health-care providers having training and skills to pain management and other key aspects of palliative care. Online education suggests an innovation to increase access to training and mentoring, which addresses common learning barriers in low- and middle-income countries. Project ECHO (Extensions for Community Health Care Outcomes) is a model of online education which supports communities of practices (COPs) and mentoring through online teaching and case discussions. The use of online education and Project ECHO in Nepal has not been described or evaluated.
METHODS: An online course, consisting of 14 synchronous weekly palliative care training sessions was designed and delivered, using the Project ECHO format. Course participants included health-care professionals from a variety of disciplines and practice settings in Nepal.
OBJECTIVE: The goal of this study was to evaluate the impact of a virtual palliative care training program in Nepal on knowledge and attitudes of participants.
METHODS: Pre- and post-course surveys assessed participants\' knowledge, comfort, and attitudes toward palliative care and evaluated program acceptability and barriers to learning.
RESULTS: Forty-two clinicians, including nurses (52%) and physicians (48%), participated in program surveys. Participants reported significant improvements in their knowledge and attitudes toward core palliative care domains. Most participants identified the program as a supportive COP, where they were able to share and learn from faculty and other participants.
CONCLUSIONS: Project ECHO is a model of online education which can successfully be implemented in Nepal, enhancing local palliative care capacity. Bringing together palliative care local and international clinical experts and teachers supports learning for participants through COP. Encouraging active participation from participants and ensuring that teaching addresses availability and practicality of treatments in the local health-care context addresses key barriers of online education.
CONCLUSIONS: This study describes a model of structured virtual learning program, which can be implemented in settings with limited access to palliative care to increase knowledge and attitudes toward palliative care. The program equips health-care providers to better address serious health-related suffering, improving the quality of life for patients and their caregivers. The program demonstrates a model of training which can be replicated to support health-care providers in rural and remote settings.
METHODS: An online course, consisting of 14 synchronous weekly palliative care training sessions was designed and delivered, using the Project ECHO format. Course participants included health-care professionals from a variety of disciplines and practice settings in Nepal.
OBJECTIVE: The goal of this study was to evaluate the impact of a virtual palliative care training program in Nepal on knowledge and attitudes of participants.
METHODS: Pre- and post-course surveys assessed participants\' knowledge, comfort, and attitudes toward palliative care and evaluated program acceptability and barriers to learning.
RESULTS: Forty-two clinicians, including nurses (52%) and physicians (48%), participated in program surveys. Participants reported significant improvements in their knowledge and attitudes toward core palliative care domains. Most participants identified the program as a supportive COP, where they were able to share and learn from faculty and other participants.
CONCLUSIONS: Project ECHO is a model of online education which can successfully be implemented in Nepal, enhancing local palliative care capacity. Bringing together palliative care local and international clinical experts and teachers supports learning for participants through COP. Encouraging active participation from participants and ensuring that teaching addresses availability and practicality of treatments in the local health-care context addresses key barriers of online education.
CONCLUSIONS: This study describes a model of structured virtual learning program, which can be implemented in settings with limited access to palliative care to increase knowledge and attitudes toward palliative care. The program equips health-care providers to better address serious health-related suffering, improving the quality of life for patients and their caregivers. The program demonstrates a model of training which can be replicated to support health-care providers in rural and remote settings.
摘要：
背景：尼泊尔的姑息治疗受到严重限制，很少有医疗保健提供者接受过疼痛管理和姑息治疗其他关键方面的培训和技能。在线教育提出了一项创新，以增加获得培训和指导的机会，解决低收入和中等收入国家常见的学习障碍。ECHO项目（社区医疗保健成果扩展）是一种在线教育模式，通过在线教学和案例讨论支持实践社区（COP）和指导。尼泊尔在线教育和ECHO项目的使用没有得到描述或评估。
方法：在线课程，设计和交付了14个同步的每周姑息治疗培训课程，使用项目ECHO格式。课程参与者包括来自尼泊尔各种学科和实践环境的医疗保健专业人员。
目的：本研究的目的是评估尼泊尔虚拟姑息治疗培训计划对参与者知识和态度的影响。
方法：课程前和课程后调查评估参与者的知识，comfort,以及对姑息治疗的态度，并评估计划的可接受性和学习障碍。
结果：42名临床医生，包括护士（52%）和医生（48%），参加了项目调查。参与者报告说，他们对核心姑息治疗领域的知识和态度有了显着改善。大多数与会者认为该方案是一个支持性的缔约方会议，在那里他们能够分享和学习教师和其他参与者。
结论：项目ECHO是一个可以在尼泊尔成功实施的在线教育模型，提高当地姑息治疗能力。汇集姑息治疗本地和国际临床专家和教师通过COP支持参与者的学习。鼓励参与者积极参与，并确保教学解决当地医疗保健环境中治疗方法的可用性和实用性，解决在线教育的主要障碍。
结论：本研究描述了结构化虚拟学习程序的模型，可以在获得姑息治疗的机会有限的环境中实施，以增加对姑息治疗的知识和态度。该计划使医疗保健提供者能够更好地解决与健康有关的严重痛苦，改善患者及其护理人员的生活质量。该计划展示了一种培训模式，可以复制以支持农村和偏远地区的医疗保健提供者。
方法：在线课程，设计和交付了14个同步的每周姑息治疗培训课程，使用项目ECHO格式。课程参与者包括来自尼泊尔各种学科和实践环境的医疗保健专业人员。
目的：本研究的目的是评估尼泊尔虚拟姑息治疗培训计划对参与者知识和态度的影响。
方法：课程前和课程后调查评估参与者的知识，comfort,以及对姑息治疗的态度，并评估计划的可接受性和学习障碍。
结果：42名临床医生，包括护士（52%）和医生（48%），参加了项目调查。参与者报告说，他们对核心姑息治疗领域的知识和态度有了显着改善。大多数与会者认为该方案是一个支持性的缔约方会议，在那里他们能够分享和学习教师和其他参与者。
结论：项目ECHO是一个可以在尼泊尔成功实施的在线教育模型，提高当地姑息治疗能力。汇集姑息治疗本地和国际临床专家和教师通过COP支持参与者的学习。鼓励参与者积极参与，并确保教学解决当地医疗保健环境中治疗方法的可用性和实用性，解决在线教育的主要障碍。
结论：本研究描述了结构化虚拟学习程序的模型，可以在获得姑息治疗的机会有限的环境中实施，以增加对姑息治疗的知识和态度。该计划使医疗保健提供者能够更好地解决与健康有关的严重痛苦，改善患者及其护理人员的生活质量。该计划展示了一种培训模式，可以复制以支持农村和偏远地区的医疗保健提供者。
