Using web-based training to optimize pediatric palliative care knowledge transfer

Marie-Charel Nadeau, Karine Bilodeau, Lysanne Daoust


Nurses play a central role in delivering palliative care, given their influence on the quality of care provided (Montgomery, Sawin, & Hendricks-Ferguson, 2016). They are professionals of choice when it comes to assessing disease symptoms or psychological distress, ensuring symptoms are managed effectively, as well as accompanying patients and families through the decision-making process regarding both adult and pediatric care (Contro, Larson, Scofield, Sourkes, & Cohen, 2004). Optimal palliative care practices can prevent or alleviate the suffering of patients of all ages at the end of life, particularly if the care includes the assessment of symptoms and provides the patient and his or her family with psychological and social support (Qaseem et al., 2008). Although the majority of patients receiving palliative care are adults, more than 4,000 children in Canada have an incurable disease for which they will require quality palliative care (Widger, Cadell, Davies, Siden, & Steele, 2012). However, a number of studies carried out with nurses have revealed that they experience anxiety with regard to the pediatric palliative care (PPC) they deliver (Mullen, Reynolds, & Larson, 2015) and difficulties communicating with families of patients (Montgomery et al., 2017), as well as managing their emotions when they attend to a child who is at the end of life (Roberts & Boyle, 2005). Based on the first hypothesis suggested by Contro et al. (2004), such behaviour can be explained by a lack of knowledge regarding PPC.

Full Text:



Anneser, J., Kunath, N., Krautheim, V., & Borasio, G. D. (2014). Needs, expectations, and concerns of medical students regarding end-of-life issues before the introduction of a mandatory undergraduate palliative care curriculum. Journal of Palliative Medicine, 17(11), 1201–1205.

Arenella, C., Yox, S., Eckstein, D. S., & Ousley, A. (2010). Expanding the reach of a cancer palliative care curriculum through web-based dissemination: A public–private collaboration. Journal of Cancer Education, 25(3), 418–421.

Bastable, S. B. (2014). Nurse as educator: Principles of teaching and learning for nursing practice (4th ed.). Burlington: MA. Jones & Bartlett Learning.

Bidet, G., Daoust, L., Duval, M., Ducruet, T., Toledano, B., Humbert, N., & Gauvin, F. (2016). An order protocol for respiratory distress/acute pain crisis in pediatric palliative care patients: medical and nursing staff perceptions. Journal of Palliative Medicine, 19(3), 306–313. doi:10.1089/jpm.2015.0100

Bloomer, M., O’Connor, M., Copnell B., & Endacott, R. (2015). Nursing care for the families of the dying child/infant in paediatric and neonatal ICU: Nurses’ emotional talk and sources of discomfort. A mixed methods study. Australian Critical Care, 28, 87–92.

Bobb, B. (2016). Dyspnea and delirium at the end of life. Clinical Journal of oncology Nursing, 20(3), 244–246.

Brennan, C., & Mazanec, P. (2011). Dyspnea management across the palliative care continuum. Journal of Hospice and Palliative Nursing, 13(3), 130–139. doi:10.1097/NJH.0b013e3182148314

Brown, S. T., Kirkpatrick, M. K., Mangum, D., & Avery, J. (2008). A review of narrative pedagogy strategies to transform traditional nursing education. Journal of Nursing Education, 47(6), 283–286.

Cabana, M. D., Rand, C. S., Powe, N. R., Wu, A. W., Wilson, M. H., Abboud, P. A., & Rubin, H.R. (1999). Why don’t physicians follow clinical practice guidelines? A framework for improvement. Journal of American Medical Association, 282(15), 1458–1465.

Canadian Hospice Palliative Care Association. (2006). Pediatric Hospice Palliative Care.

Contro, N. A., Larson, J., Scofield, S., Sourkes, B., & Cohen, H. J. (2004). Hospital staff and family perspectives regarding quality of pediatric palliative care. American Academy of Pediatrics, 114(5), 1248–1252.

Deffner, J., & Bell, S. (2005). Nurses’ death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education: A quantitative study. Journal for Nurses in Professional Development, 21, 19–23.

Dubois, S., & Giroux, M.-N. (2012). L’innovation pédagogique chez les infirmières dans un contexte de début d’expérience professionnelle. Recherche en soins infirmiers, 111, 71–80. doi:10.3917/rsi.111.0071

Dunn, N. (2000). L’innovation par la technologie et l’apprentissage : le défi d’un programme d’études à forte composante technologique : Réseau des Écoles Innovatrices (REI) du programme canadien Rescol.

Government of Canada. (2006). Advance Care Planning: the Glossary Project - Final Report.

Graham, I. D., Logan, J., Harrison, M. B., Straus, S. E., Tetroe, J., Caswell, W., & Robinson, N. (2006). Lost in knowledge translation: Time for a map? Journal of Continuing Education in the Health Professions, 26(1), 13–24.

Grimshaw, J. M., Shirran, L., Thomas, R., Mowatt, G., Fraser, C., Bero, L., Grilli, R., Harvey, E., Oxman, A., & O’Brien, M. A. (2001). Changing provider behavior: An overview of systematic reviews of interventions. Medical Care, 39(8), 112–145.

Grol, R., & Wensing, M. (2004). What drives change? Barriers to and incentives for achieving evidence-based practice. Medical Journal of Australia, 180, 57–60.

Hall, W. A. (2009). Whither nursing education? Possibilities, panaceas, and problems. Nurse Education Today, 29, 268–275.

Institut national d’excellence en santé et services sociaux (INESSS). (2017). Protocol medical.

Kenny, G., Cargil, J., Hamilton, C., & Sales, R. (2016). Improving and validating children’s nurses communication skills with standardized patients in end of life care. Journal of Child Health Care, 20(2), 145–152. doi:10.1177/1367493514555588

Laferrière, T. & Gervais, F. (2008). Teacher education and professional development : Ten years of ICT integration and what? Revista Electronica de Investigation Educativa, 10, 1–24.

LégisQuébec, (2019). Loi concernant les soins de fin de vie. Récupéré à

Lützau, P., Otto, M., Hechler, T., Metzing, S., Wolfe, J., & Zernikow, B. (2012). Children dying from cancer: parents’ perspectives on symptoms, quality of life, characteristics of death, and end-of-life decisions. Journal of Palliative Care, 28(4), 274–281.

Mayer, R. E. (2003). The promise of multimedia learning: using the same instructional design methods across different media. Elsevier, 13(2), 125–139.

Montgomery, K., Sawin, K. J., & Hendricks-Ferguson, V. L. (2016). Experiences of pediatric oncology patients and their parents at end of life: A systematic review. Journal of pediatric oncology nursing, 33(2), 85–104. doi:10.1177/1043454215589715

Montgomery, K., Sawin, K., & Hendricks-Ferguson, V. (2017). Communication during palliative care and end of life. Cancer Nursing, 40(2), 47–57.

Morgan, D. (2009). Caring for dying children: Assessing the needs of the pediatric palliative care nurse. Journal of Pediatric Nursing, 35(2), 86–90.

Mullen, J. E., Reynolds, M. R., & Larson, J. S. (2015). Caring for pediatric patients’ families at the child’s end of life. Journal of Pediatric Care, 35(6), 4655. doi:

National Institute for Health and Care Excellence (NICE). (2017). End-of-life care for people living with life-limiting condition. Retrieved from

Petersen, C., Callahan, M. F., McCarthy, D. O., Hughes, R. G., White-Traut, R., & Bansal, N. K. (2016). An online educational program improves pediatric oncology nurses’ knowledge, attitudes, and spiritual care competence. Journal of Pediatric Oncology Nursing, 34(2), 130–139. doi:10.1177/1043454216646542

Pickstock, S. (2017). Breathlessness at end of life: What community nurses should know. Journal of Cancer Nursing, 31(5), 74–77.

Qaseem A., Snow, V., Shekelle, P., Casey, D. E., Cross, J. T., Owens, D. K., et al. (2008). Evidence-based interventions to improve the palliative care of pain, dyspnea, and depression at the end of life: A clinical practice guideline from the American College of Physicians. Annals Intern Medicine, 148(2), 141–146.

Registered Nurses Association of Ontario (RNAO) (2012). Toolkit: Implementation of best practice guidelines (2nd ed.). Toronto, Registered Nurses’ Association of Ontario.

Roberts, K. E., & Boyle, L. A. (2005). End-of-life education in the pediatric intensive care unit. Critical Care Nurse, 25, 51–57.

Ruiz, J., Michael, J., & Leipzig, R. (2006). The impact of e-learning in medical education academic medicine. Journal of Cancer Education, 81(3), 207–212.

Rycroft-Malone, J., Kitson, A., Harvey, G., McCormack, B., Seers, K., Titchen, A., & Estabrooks, C. (2002). Ingredients for change: Revisiting a conceptual framework. Quality and Safety in Health Care, 11(2), 174–180.

Sinclair, P., Kable, A., & Levett-Jones, T. (2015). The effectiveness of internet-based e-learning on clinician behavior and patient outcomes: A systematic review protocol. Journal of Continuing Education in the Health Professions, 13(1), 52–64. doi:10.11124/jbisrir-2015-1919

Smothers, A., & Buck, J. (2012). An evaluation of a practice change to increase understanding of the use of nonpharmacological interventions for the treatment of dyspnea in hospice patients. Journal of Hospice and Palliative Nursing, 14(8), 524–532. doi:10.1097/NJH.0b013e31825c7b2a

Straus, S., Tetroe, J., & Graham, I. D. (Eds.). (2013). Knowledge translation in health care: moving from evidence to practice. Toronto, ON. John Wiley & Sons.

Tinio, V. (2002). ICT in education. Retrieved from

Tomey, A. M. (2003). Learning with cases. Journal of Continuing Education in Nursing, 34, 34–38.

Vollenbroich, R., Borasio, G. D., Duroux, A., Grasser, M., Brandstätter, M., & Führer, M. (2016). Listening to parents: The role of symptom perception in pediatric palliative home care. Palliative Support Care, 14, 13–19. doi:10.1017/S1478951515000462

Widger K., Cadell S., Davies B., Siden H., Steele R. (2012) Pediatric Palliative Care in Canada. In: Knapp C., Madden V., Fowler-Kerry S. (eds) Pediatric Palliative Care: Global Perspectives. Springer, Dordrecht. doi:10.1007/978-94-007-2570-6_17

Wiener, L., Weaver, M. S., Bell, C., & Sansom-Daly, U. M. (2015). Threading the cloak: Palliative care education for care providers of adolescents and young adults with cancer. Journal of Clinical Oncology Adolescent and Young Adults, 5, 1–18. doi:10.2147/COAYA.S49176

Wilson, E., Morbey, H., Brown, J., Payne, S., Seale, C., & Seymour, J. (2015). Administering anticipatory medications in end-of-life care: A qualitative study of nursing practice in the community and in nursing homes. Journal of Palliative Medicine, 29, 60–70. doi:10.1177/0269216314543042.


  • There are currently no refbacks.