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Qualitative study finds both self-directed and facilitated e-learning perceived effective for palliative care educationHow do doctors learn best? Two online teaching styles both help with palliative care

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Key Takeaway
Consider qualitative findings that both e-learning formats were perceived as effective for palliative care education.

This qualitative study, embedded within a cluster randomized controlled trial, explored primary care teams' perceptions of different e-learning modalities within the CAPACITI virtual palliative care education program. The study involved 63 focus groups representing 42 unique primary care teams, comparing a facilitated e-learning modality to a self-directed e-learning modality. The primary outcome was perceived differences between these modalities and how they contributed to changes in practice.

Participants reported that both learning modalities contributed to changes in thinking and changes in behavior, though specific effect sizes, absolute numbers, and statistical measures were not reported. Notably, the study found no overwhelming preference for either learning modality among participants. About a quarter of the teams had experienced both learning modalities, providing comparative insights.

Safety and tolerability data were not reported. The study has several important limitations: it is a qualitative analysis of perceptions and experiences rather than a quantitative assessment of outcomes, and findings are based on focus group themes. The practice relevance suggests that both self-directed and facilitated e-learning modalities were perceived as effective in promoting practice changes across diverse primary care settings, though these are associations based on participant perceptions rather than measured behavioral outcomes.

When it comes to teaching busy primary care teams about sensitive topics like palliative care, what's the best way to do it online? A new study listened to 42 different primary care teams who went through a virtual training program called CAPACITI. The teams took part in focus groups to talk about their experiences with two different learning styles: one where they worked through material on their own, and another where a facilitator guided them. The big takeaway? Both styles were seen as effective. Teams reported that the training led to changes in their thinking and their behavior when caring for patients. Interestingly, there wasn't a strong preference for one style over the other. This is important because it means training programs might have more flexibility in how they're designed. However, it's crucial to remember what this study is—and isn't. It's a qualitative look at people's perceptions. The results come from what teams said in conversations, not from tracking specific patient outcomes. Also, only about a quarter of the teams had tried both learning styles, so the comparison isn't complete. No safety issues with the training were reported. The findings offer a useful snapshot of what works for learners, but they don't tell us which method ultimately leads to better care for patients.

What this means for you:
For teaching palliative care online, both solo and guided learning can work, based on what doctors said.

Study Details

Study typeRct
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
ObjectiveCAPACITI (Community Access to PAlliative Care via Interprofessional Teams Improvement) is a virtual training program that teaches primary care providers how to incorporate an early palliative approach to care in practice. Building this capacity can help primary care providers better meet the needs of their seriously ill patients; however, there has been limited in-depth study as to the added benefits of active facilitation in on-line education. We completed a qualitative inquiry with CAPACITI participants to explore perceived differences in self-directed and facilitated e-learning to understand how these modalities contribute to change in practice.MethodsWe completed a qualitative analysis of semi-structured focus groups with primary care teams that participated in CAPACITI. This study was part of a cluster randomized controlled trial where teams were randomized to self-directed or facilitated modalities for each of the three CAPACITI modules. We followed a qualitative descriptive design, using a constant comparative approach to determine emergent themes to understand participant experience and preference in learning modality.ResultsWe conducted 63 focus groups throughout the trial, representing 42 unique teams, about a quarter of which had experienced both learning modalities at the time of the focus group. Qualitative analysis revealed three main themes: changes in thinking (ie identifying patients early in the illness trajectory), change in behavior (ie increased collaboration), and preference in learning modality and perceived benefits. Interestingly, we found no overwhelming preference in learning modality.ConclusionsSelf-directed and facilitated learning modalities were both perceived as effective in promoting changes in thinking and behavior among primary care providers across diverse care settings. Future studies should further explore the use of tailored facilitation such as simulated patient encounters and innovative coaching strategies to optimally promote behavior change in virtual palliative care education.
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