Background: The National Cancer Advisory Board of the Institute of Medicine with the National Research Council called for improved physician education in palliative care in its 2001 report. The Education in Palliative and End-of-life Care (EPEC) Project is an ambitious train-the-trainer program that aims to reach, through its EPEC Trainers, all practicing physicians in the USA with education about the competencies they must possess to play their role in good end-of-life care. It has become a gold standard in palliative care education, and a programmatically sustainable, enduring virtual college. ? ? As medical education relies increasingly on distance learning, it is important to provide the EPEC education in a distance learning form. However, little distance learning exists for palliative care. Indeed, distance learning is also in its infancy. A meta-analysis indicates that interactivity is helpful. However, few studies are rigorous, and few programs are designed according to principles of education. ? ? Aims and Methods: This resubmission of our previously well-reviewed, and now further improved proposal aims to compare two distance learning programs that use the EPEC curriculum with the traditional EPEC conference-based learning (Conference). One will be built as an interactive distance learning course (IDLCourse). The other is a non-interactive web program (W-Course). We will then recruit a cohort of 550 professionals who have not previously attended an EPEC Conference. We will randomize them to one of three arms: 150 will receive the Conference, 200 to IDL-Course and 200 the W-Course. All three arms will cover the same curricular content. ? ? Evaluation: Evaluation will examine the impact of each course on: knowledge acquisition; attitude development; skills acquisition; behavior change; ability to teach the material; and participation in a palliative care education community. Evaluation will entail use of appropriate metrics and will occur at the start and end of the program and again after 3 months. We hypothesize that all arms will achieve similar knowledge gains but will show differences in other outcomes, namely that W-Course will achieve lest, IDL-Course moderate and Conference most gains in attitudes, skills, behaviors, teaching capacity and professional participation. Outcomes of this 3 year study will include: 1. A new, interactive distance learning palliative care education program; 2. Some needed metrics for evaluating palliative care education; and 3. Information on which features of distance learning result in the greatest educational impact. ? ? ?
