An Evaluation of a Nationwide Palliative Training Program in Israel

Primary care medical professionals play a key role in providing care to terminal patients. To increase the number of professionals capable of providing appropriate palliative care so as to serve a large numbers of patients, the UJA Federation of New York, ESHEL (the Association for Planning and Developing Services for the Aged in Israel), Ben-Gurion University of the Negev, the Israel Cancer Association, and the “Support” organization (a multi-disciplinary organization for palliative care in Israel) worked together to implement a nationwide palliative training program. The program was initiated in 2005 and during the first three years of its implementation fifteen courses were conducted all over Israel. Some 400 participants took part, about two-thirds of them nurses, a sixth of them social workers, a sixth of them physicians, and a small number of professionals from other areas. The courses comprised six sessions and all followed a uniform 43-hour curriculum. The study examined the program during 2006, focusing on its contribution to the participants, specifically the changes in their perceived knowledge, sense of confidence, perceived ability to care for terminal patients and their families, and the extent that they have made use of the material and knowledge acquired. The study included telephone interviews with135 participants prior to the course and three months after its conclusion.

Among the findings:

  • Improvement was found in the participants’ perceived knowledge, sense of confidence, and perceived ability to care for terminal patients. The improvement in knowledge was the greatest; the least was in the perceived ability to give palliative care.
  • Three months after completing the course, 28% reported that they were using the knowledge and material they had acquired to a very great extent, 42% to a great extent, 15% to a moderate extent and 15% to a small or very small extent. Most of these are currently not working with terminal patients.
  • Most of the topics included in the course were perceived by 70% or more participants to be essential and the 76% of them believed them to be relevant to a great or very great extent to their own practical work and to that of other participants.
  • More physicians and nurses than social workers reported that the course had contributed to them – in all dimensions. Further, more doctors and nurses reported that they were using the knowledge and tools they had acquired and they were more satisfied than the social workers with the material included in the course.

The findings of the study have been presented to those developing and implementing the program, to the program steering committee, and to others engaged in developing palliative care in Israel. The findings have provided insights regarding the continued implementation of the program and contributed to discussions on future directions for palliative training. For example, the study has contributed to initiating activities aimed at increasing the participation of professionals from nursing institutions and planning courses especially for them. The program is one of a range of activities and processes that together raise the status of palliative care in Israel (such as the “Recommendations of the Committee for the Development of Palliative Services” submitted to the director general of the Ministry of Health), and are aimed at improving the quality of life for terminal patients.

The study was funded by the UJA Federation of New York, ESHEL, and the Myers-JDC-Brookdale Institute.