Outcome evaluation of the palliative care emphasis program on symptom management and assessment for continuous medical education: Nationwide physician education project for primary palliative care in Japan

Objective: Palliative care is an essential part of medicine, but most physicians have had no formal opportunity to acquire basic skills in palliative care. In Japan, the Palliative care Emphasis program on symptom management and Assessment for Continuous Medical Education (PEACE) was launched to provide formal primary palliative care education for all physicians engaged in cancer care. This study sought to determine whether PEACE could improve physicians' knowledge of, practices in, and difficulties with palliative care.

Methods: In 2011, we conducted questionnaire-based surveys before, just after, and 2 months after completion of the PEACE program in physicians participating in the program at each of 15 designated cancer hospitals in Japan. Knowledge was measured using the palliative care knowledge questionnaire for PEACE (PEACE-Q). Practices and difficulties were evaluated using the Palliative Care self-reported Practice Scale (PCPS) and the Palliative Care Difficulties Scale (PCDS), respectively.

Results: Among 223 physicians participating in the program, 85 (38%) answered the follow-up survey. Significant improvements were noted on the PEACE-Q compared with baseline immediately after completion of the program, and this progress was maintained at 2 months (21.7±5.56 versus 29.5±2.10 versus 28.7±3.28, respectively; p<0.0001). Similarly, significant improvements were noted for total scores on both the PCPS and the PCDS at 2 months after completion of the program (62.1±13.9 versus 69.6±9.94 [p<0.0001] for the PCPS; 44.4±9.96 versus 39.4±10.7 [p<0.0001] for the PCDS).

Conclusions: The PEACE education program improved physicians' knowledge of, practices in, and difficulties with palliative care.