Pilot Program a Success, End-of-Life Training Extended to Entire VA System

Veterans Affairs faculty fellows program in end-of-life care

Between 1998 and 2000, the U.S. Department of Veterans Affairs (VA) in Washington, worked to improve end-of-life and palliative care training in internal medicine residency training programs affiliated with the VA.

Key Results

  • Thirty educators at VA-affiliated internal medicine residency programs across the United States were selected to develop training opportunities for residents in end-of-life and palliative care. To encourage collaboration among the Faculty Leaders and like-minded colleagues, the project:
    • Convened three Faculty Leaders meetings and an interim planning meeting in conjunction with a VA national conference on pain management and end-of-life care to develop benchmark curricula and strategies.
    • Developed a private online discussion group in which Faculty Leaders conferred about issues related to end-of-life care and curricula development.
    • Launched a Web site targeted at educators who teach palliative medicine in academic and clinical settings (the Web site is no longer active).
  • Faculty Leaders reported measurable increases in satisfaction with their knowledge, skills and attitudes associated with excellent end-of-life and palliative care.

Key Findings

A survey of project sites measured educational and curricular changes. The survey found the following:

  • Some 29 of the 30 project sites developed curricula and strategies for implementation.
  • The number of sites with a formal curriculum devoted to end-of-life and palliative care increased from 3 to 19.
  • Some 10 additional sites developed and implemented informal curricula into their internal medicine residency training programs.
  • Project sites reported increases ranging from 30 to 54 percent in the number of clinical settings where residents are trained (i.e., inpatient acute care, inpatient and community hospice, nursing homes, geriatrics rotations) that are devoted to end-of-life and palliative care training.

Funding

The Robert Wood Johnson Foundation (RWJF) provided $943,180 in grant support for the effort.