Breaking Barriers: Towards a WHO policy for strengthening palliative care education for all healthcare professionals

Frank Elsner, Phil Larkin, Stefan Lorenzl and Piret Paal explain why it’s important that all EAPC members contribute to a new EAPC online survey to evaluate the core elements of palliative care and shape our teaching and learning strategies.

Left to right: Frank Elsner, Stefan Lorenzl, Piret Paal and Phil Larkin

The World Health Organization (WHO) has made a strong commitment to supporting and developing palliative care structures as an important component of integrated treatment for young and old throughout the life course (World Health Organization, 2014). To ensure optimal responses to palliative care needs, educating healthcare professionals and volunteers is of major importance (Elsner et al, 2016). There is some evidence that a lack of knowledge regarding palliative care among the healthcare workers limits access to palliative care services (Hawley, 2017). To break this barrier, the need for palliative care education has to be addressed at many levels simultaneously.

Understanding that palliative care is about providing the best possible health in any chronic or life-threatening condition is often misunderstood within the wider healthcare community. The possibility that palliative care could be provided parallel to curative therapies, or even integrated soon after diagnosing the life-threatening condition, is far from being a common understanding and practice. Hence, it is to be expected that many healthcare providers, due to the lack of education or personal barriers, perceive referring to palliative care as a medical failure. In such situations, only those with strong private support systems are able to take care of themselves to keep up the necessary resilience. Others, lacking self-care structures, sink deeper into tiredness, irritation, and withdrawal – all known barriers to providing good care.

To diminish the feeling of failure is to choose early palliative care over the “there is nothing we can do” approach. Here, it is important to understand that palliative care does not replace any other forms of care but complements and completes the ongoing approach to care. The strengths of palliative care lie in collaboration, networking, promoting an interdisciplinary approach, and being conscious of the need for self-care. For education, this means creating toolboxes and modules that support healthcare providers’ decision making, even in situations of limited resources.

To improve postgraduate palliative care education, the WHO European Region in collaboration with the newly proposed EAPC Reference Group on Palliative Care Education and Paracelcus Medical Private University (PMU) in Salzburg – a WHO Collaborating Centre – are working towards innovative solutions to cultivate and support interdisciplinary and intersectional collaboration across different healthcare sectors.

The collaboration between the PMU and the WHO started in 2016 to look at developing a structure for a pan-European curriculum to assist in the promotion and embedding of palliative care into healthcare professional curricula at undergraduate and graduate level. The collection and collation of diverse palliative care curricula has so far resulted in numerous educational and training programmes for specialist palliative care in nursing, medicine and paediatrics from across Europe. It should be noted that in many European countries, palliative care initiatives are just being launched, mainly as a result of the pioneering work of small voluntary working groups, without any governmental funding or recognition. For this reason the current WHO collaboration addresses in particular healthcare professionals in the Eastern European region and Central Asia. Together, we look for opportunities to support their efforts towards providing better health to their patients.

There is an agreement between WHO and PMU to provide an online learning environment for strengthening palliative care education of all healthcare professionals by 2020. The goal is to break down the myths about palliative care and support healthcare professionals’ collaborations across all fields of responsibility.

Please contribute to the EAPC online survey 

The proposed EAPC Reference Group on Palliative Care Education, which will be under the direction of Prof Frank Elsner, has agreed that the core curriculum will be built along the ten competencies proposed by Claudia Gamondi, Philip Larkin and Sheila Payne in their White Paper (Gamondi et al, 2013). For this reason, an online survey has been launched to evaluate the core elements of palliative care.

We ask all EAPC members to contribute to this survey. In addition to evaluating the listed competencies, we are very interested in learning about your individual learning and teaching experiences. Can you share your most valuable lesson in palliative care or give good teaching examples? Irrespective of your level of experience or involvement in teaching or practising palliative care, your expertise will be much appreciated. We hope this survey will enable you to express what, in your opinion, lies at the heart of palliative care – that all healthcare professionals should be aware of and should form the basis of our teaching and learning strategies.

If you don’t have time to complete the survey but would like to share a story about palliative care education experiences, add your topic and email address and we will contact you.

We look forward to hearing from you and thank you for supporting this important European project.


More about the authors . . .
Prof. Dr. Frank Elsner, Associate Professor for Palliative Medicine at the RWTH Aachen University in Aachen will chair the newly proposed EAPC Reference Group on Palliative Care Education.
Prof. Dr. Phil Larkin, President, EAPC, Professor of Clinical Nursing (Palliative Care), University College Dublin and Our Lady’s Hospice and Care Services, Dublin, Visiting Professor, Paracelsus Medical University in Salzburg.
Prof. Dr. Stefan Lorenzl, Professor of Neurology (LMU) and Professor for Palliative Medicine at the Paracelsus Medical University Salzburg.
Dr. Piret Paal, Coordinator of the EAPC Spiritual Care Reference Group (Education), EPICC Participant, Researcher and coordinator at the WHO Collaborating Centre for Nursing Research and Education at the Paracelsus Medical University in Salzburg, Austria.


Elsner, F; Centeno, C; Ellershaw, J. PallMed 2016. Early integration needs early education, Palliative Medicine 2016, Vol. 30(9) 805–6.

Gamondi, C. Larkin, P., Payne, S. (2013). Core competencies in palliative care: an EAPC White Paper on palliative care education – part 1. European Journal of Palliative Care, 20(2), 86-145.

Hawley, P. (2017). Barriers to Access to Palliative Care. Palliative Care, 10, 1178224216688887. doi:10.1177/1178224216688887

World Health Organization (2014). Strengthening of Palliative Care as a Component of Integrated Treatment throughout the Life Course. Journal of Pain & Palliative Care Pharmacotherapy, 28(2), 130-134. doi:10.3109/15360288.2014.911801.

This entry was posted in EAPC Task Forces/Reference Groups, EDUCATION & TRAINING and tagged . Bookmark the permalink.

4 Responses to Breaking Barriers: Towards a WHO policy for strengthening palliative care education for all healthcare professionals

  1. seanog57 says:

    Can this survey link be shared beyond EAPC members?

    • Piret Paal says:

      Dear all, the online survey is open to anyone! Please, kindly distribute it among the HCP’s and educators, who believe that the ability to provide palliative care is an essential part of our healthcare services.

  2. Pingback: Invitation to participation in survey by EAPC – Research in Faith and Health

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