Best Teaching Practices in Primary Palliative Care Education for Health Professions Students in the United States: An...

The imperative to integrate primary palliative care (PPC) into primary health care provides a compelling rationale for U.S.-based educational initiatives to prepare frontline health providers to deliver PPC across settings. Physicians, advanced practice registered nurses (APRNs), and physician assistants (PAs) are positioned as autonomous decision-makers. Therefore, their education should include PPC fundamentals critical to high-quality serious illness care.

To conduct an integrative review of best teaching practices in PPC education for medical, APRN, and PA students preparing for frontline provider roles in the United States.

A systematic search of peer-reviewed literature published between 2011 and 2025 was conducted. Studies describing PPC educational interventions or curricula for medical, APRN, or PA students were included. Data extraction and thematic synthesis were guided by the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care and Kirkpatrick's model of assessing educational outcomes.

A total of 1691 articles were identified. After screening 1256 titles and abstracts and reviewing 292 full-text articles, 64 studies met inclusion criteria. Most studies focused on medical students (94%), with fewer addressing APRN (13%), PA (2%), or interprofessional cohorts (16%). A majority were descriptive or nonempirical (88%) and focused on structural and process-oriented components of PPC education (89%). Eighty-four percent employed multifaceted teaching approaches. Five consensus themes emerged as best practices: (1) multifaceted teaching strategies, (2) interprofessional education, (3) reflective and/or humanities-based experiences, (4) early and repeated exposure, and (5) availability of teaching resources.

While the literature supports improvements in learners' knowledge, skills, and attitudes, few studies evaluate higher-level outcomes such as long-term skill retention or impact on patient and system-level care. This review provides lessons learned and evidence-informed recommendations to guide curricular development and identifies key gaps to inform future educational research to better prepare frontline health professions students in delivering high-quality PPC.