title: Improving confidence and competence of healthcare professionals in end-of-life care: an evaluation of the 'Transforming End of Life Care' course at an acute hospital trust.
abstract: BACKGROUND
  UK policymakers, clinicians and public wish to see improvements in end-of-life care (EoLC). However, healthcare professionals' skills and knowledge to deliver high-quality care are often lacking. Since May 2012, palliative care staff in an inner-city tertiary hospital have run a 2-day Transforming End of Life Care (TEoLC) course to improve EoLC confidence, and competence among hospital and community staff.
  
  
  OBJECTIVE
  To evaluate course participants' self-rated confidence, competence and knowledge of EoLC topics.
  
  
  METHODS
  A before-and-after design using self-completion questionnaires, precourse and postcourse. 14 self-assessment questions examined confidence, understanding and knowledge of EoLC topics. Mean change scores and paired t tests were calculated and free-text responses analysed thematically.
  
  
  METHODS
  236 staff members completed the course between May 2012 and April 2014. 42% worked in hospitals and 55% in the community; the most frequent staff roles were qualified nurses (49%), senior nurses (16%) and general practitioners (15%).
  
  
  RESULTS
  All 14 self-assessment topics improved significantly (p<0.001); most improved was 'understanding and implementing Fast Track discharge'. Qualitative data showed increased knowledge and confidence in EoLC, particularly in communication, commitment to team work and holistic care. Overall, 217 (92%) participants would recommend the course and 215 (98%) indicated it would influence their practice.
  
  
  CONCLUSIONS
  The TEoLC course improved participants' self-rated confidence, competence and knowledge in EoLC. Findings have utility beyond the UK in light of the international policy recommendations to improve the palliative care skills of generalist healthcare providers.
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
authors.forename: Lucy
authors.identifier: http://orcid.org/0000-0001-5747-2699
authors.initials: L
authors.lastname: Selman
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Vicky
authors.initials: V
authors.lastname: Robinson
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
authors.forename: Lara
authors.initials: L
authors.lastname: Klass
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Khan
authors.affiliation: Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: George
authors.affiliation: King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Shepherd
authors.affiliation: King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Burman
authors.affiliation: Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Koffman
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D003695:Delivery of Health Care; D058015:Health Communication / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000592:standards*; D006801:Humans; D010166:Palliative Care / Q000592:standards*; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000592:standards*
keywords: Communication; Education and training; Hospital care; Terminal care