Kavitha Ramchandran, MD, is a Clinical Assistant Professor of Medicine in the Division of Oncology and Division of General Medical Disciplines at Stanford University. She is also the Medical Director of Palliative Medicine at Stanford Cancer Institute and a Cancer.Net Associate Editor. Erika Tribett, MPH, is the program designer and course moderator at Stanford University for Palliative Care Always.
The Palliative Care in Oncology Symposium has just ended, and we know that there is room to improve and grow when it comes to delivering palliative care to people with cancer. But what steps are needed to bring this much needed progress? Here is what we are doing to move the needle forward.
Disease affects patients — and their families — physically, socially, psychologically, and spiritually. At any stage of illness, palliative care supports treatment by addressing these needs. It focuses on preventing, managing, and relieving the symptoms of cancer and the side effects of cancer treatment. It also provides comprehensive support to people living with cancer and their family, friends, and caregivers.
But the reality is that there are not many ways for both patients and health care professionals to learn about the basics of palliative care. We need to be able to answer a whole series of questions that people interested in the field might have. These questions include:
How can palliative care help people?
Who does it and how is it done?
How do I advocate for it if I don’t have access to it?
And can I find other people nearby with whom I can collaborate and learn more?
With this in mind, we and 10 Stanford Health Care faculty and staff created a massive open online course (MOOC), called Palliative Care Always, that is capable of reaching this broad audience. From oncology physicians and nurses, to social workers, chaplains, advance practice providers, and patients and their families, the hope is that everyone who participates in this course is empowered to support the many needs of patients and families. Or, if you are a patient or caregiver, how to find and receive this support.
When this course was first given in January 2016, over 1,400 people participated. About 1 of every 3 students was a patient or caregiver, and nearly half of the students lived outside the US. Our team learned a lot from this first launch, developing additional content that covers the experience of family caregivers, as well as more complete information on symptom management and communication.
Now, on September 21, Palliative Care Always will make its second launch through Stanford Online. It is a free, interactive learning resource that helps teach people about the palliative care team and the practical skills that everyone can use to support a person living with cancer.
The course has 12 parts. Each tells part of a story based on the experience of Sarah Foster. Sarah is a fictional woman who has been diagnosed with colon cancer. Through videos with Sarah and brief readings and lectures, students explore the following topics in palliative care:
Communication and decision making
Basic symptom management
Emotional and spiritual support
Addressing goals of care
The course is designed to be interactive, so students can learn from each other and reflect on their personal or professional experiences. Each week, there are interactive discussion sessions using Google Hangouts and an online discussion forum. We also plan to create a course page on Facebook so the conversation about palliative and quality-of-life care can continue.