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Evaluating End-of-life and Medical Assistance in Dying Communication Learning - A Literature Review

Konia Trouton, Jolanta Vaitekonyte, Brittany Clark

Aim: Our literature review assesses the available End of Life (EOL) and Medical Assistance in Dying (MAiD) communication training for clinicians and trainees. By analyzing training program evaluations, we assess their impact to learners’ practice and improvements to patient care. We then highlight the effective training programs, which could be considered to support further development of continuing education curriculum for EOL and MAiD discussions.

Background: Healthcare providers are facing an ongoing need for education in EOL communication with patients and families to support patient-centered care. Since legalization of MAiD in 2016 in Canada, number of patients seeking this option is growing. Currently, there is no widely accessible, standardized EOL or MAiD discussion curriculum to support clinicians of diverse experience levels. While jurisdiction or profession-specific training is available to some providers, it is unclear whether it translates to improvements in their practice or patient care.

Methods: We conducted a peer-reviewed and grey literature search on the topics of EOL, palliative care and MAiD-related training for healthcare providers and trainees. We targeted resources published between June 1, 2011 and June 1, 2021, in English language, worldwide. Using rapid review protocol, initial search of 9284 titles was shortlisted to 104 training programs offering training on EOL discussions with adult patients and their families. Using CRe-DEPTH framework our team evaluated the reported impact of the training.

Results: Limited scope of evaluations of most training programs posed challenges to determine their longer-term benefits to practitioners and patients, or to define which teaching approaches were the most impactful. Interdisciplinary learning helped to validate the results of some training programs, suggesting benefits of the approach in teaching EOL/MAiD discussion curricula. Despite the challenges, many great training programs emerged from the field that could serve as starting points to build high quality EOL and MAiD communications training.