Assessing needs for palliative care education of primary care physicians: results of a mail survey

The purpose of this study was to determine continuing education needs in the area of palliative care, as defined by family practice physicians. The methodology consisted of an anonymous questionnaire mailed in October, 1991, to all family practitioners in the city of Regina, Saskatchewan having admission privileges at any of the city's three hospitals. Replies were received from 31.1% of that population; the worst-case estimate is that about half of the city's palliative care caseload in 1991 was under the care of these respondents. In a priority-ranking format, physicians rated pain assessment and management as the patients' greatest need and their greatest continuing education need. Although emotional support and communication were highly ranked among other needs of patients, they were not highly ranked among education needs. Grand rounds was indicated as the educational venue of preference. Longer, more intensive educational formats were not selected. Communication of palliative status, including "Do not resuscitate" status, has reportedly become a routine practice. We have concluded that palliative care education should focus on the felt needs of family practice physicians for technical competence in pain assessment and management, using abbreviated formats. Cautious introduction of content areas and educational methods more likely to address patient needs is warranted. A one- or two-day workshop devoted to bereavement guidance might be a concrete focus for communication-oriented continuing education.