How We Do It

Providing Pain and Palliative Care Education Internationally


The Journal of Supportive Oncology
Volume 9, Issue 4, July-August 2011, Pages 129-133

How we do it

Providing Pain and Palliative Care Education Internationally

Judith A. Paice PhD, RN

, Carma Erickson-Hurt MSN, APRN, ACHPN, Betty Ferrell PhD, MA, FAAN, FPCN, CPCN, Nessa Coyle PhD, ACHPN, FAAN, Patrick J. Coyne MSN, APRN, FAAN, Carol O. Long PhD, RN, FPCN, Polly Mazanec PhD, ACNP, AOCN, FPCN, Pam Malloy RN, MN, OCN, FPCN and Thomas J. Smith MD, FACP

Received 21 December 2010;
accepted 8 April 2011.

Available online 2 July 2011.

Article Outline

Do Your Homework
Health-Care Structure
Available Medications
Education of Health-Care Professionals
Plan the Curriculum and the Program
Personal Considerations
During the Experience

For many clinicians in oncology, educating other health-care professionals about cancer pain and palliative care is part of their professional life. The need for education exists across clinical settings around the world. Improved education is an urgent need as the prevalence of cancer is increasing. This burden is largely carried by the developing world, where resources are often limited.[1] Global educational efforts, including managing common symptoms, communication, care at the time of death, grief, and other topics, are imperative to reduce pain and suffering.[2] International training efforts require additional expertise and preparation beyond the standard teaching skills needed for all professional education.

The goal of international training efforts in pain and palliative care is to provide useful, culturally relevant programs while empowering participants to sustain these efforts in the long term. Global efforts in palliative care have demonstrated that sharing educational materials, resources, support and encouragement with our international colleagues can provide mentorship to go beyond simply attending a course to developing and expanding their own programs of palliative care in oncology.[3] and [4] To do this well, the following provides specific suggestions for before, during, and after international palliative care training experiences.

Do Your Homework

Before a course, it is essential to learn as much as possible about the region, the culture(s), and the health-care system. Several resources for this information are listed in Table 1. Additionally, speaking with colleagues who have traveled to the country or to those who have emigrated from the country can provide valuable insight. These individuals can provide a wealth of information to assist in developing an appropriate curriculum and specific presentations. As demographics vary, it is important to know the common cancers and other leading causes of death in the region. Issues that may be seen as “competing” issues HIV/AIDS, malaria, immunizations, lack of clean water, or maternal–infant mortality.[5] and [6] Literature, including fiction and nonfiction, as well as movies and other media, can enlighten the traveler regarding life in the region. Local consulates offer opportunities for learning, as do organizations such as the Council on Global Relations. There are rapid changes in global politics, health-care systems, and governments, so it is also vital to have current information.

Table 1. Resources for International Educational Efforts
American Society for Clinical Oncology (ASCO)Offers international cancer courses as well as fellowships and other awards.
Centers for Disease Control and Prevention (CDC), information regarding common infectious illnesses, traveler's alerts.
Central Intelligence Agency (CIA), The World Factbook, review of a country's political, demographic, geographic, and other attributes.
City of Hope Pain & Palliative Care Resource Center, a clearinghouse that includes a wide array of resources and references to enhance pain and palliative care education and research.
End of Life Nursing Education Consortium (ELNEC), relevant articles, resources, and a summary of current international ELNEC training programs.
International Association for Hospice and Palliative Care (IAHPC), global palliative care resources, including List of Essential Medicines, Global Directory of Educational Programs in Palliative Care, Global Directory of Palliative Care Providers/Services/Organizations, as well as Palliative Care in the Developing World: Principles and Practice.
International Association for the Study of Pain (IASP), emphasis on support of developing countries with research and educational grants; publishes a Guide to Pain Management in Low-Resource Settings offered without cost.
Open Society Institute–International Palliative Care Initiative, support for training, clinical care, and research in palliative care, alone and in collaboration with other organizations.
Pain & Policy Studies Group, resource for information regarding opioid consumption by country as well as guidelines for policies that allow access to necessary medications.
U.S. Department of State, Bureau of Consular Affairs, lists of US embassies, consulates, and diplomatic missions; information to assist travelers from the United States to other countries, including visa requirements and safety alerts.
World Health Organization, http://www.who.intMany useful resources, including Access to Analgesics and to other Controlled Medicines, as well as statistics regarding common illnesses by country.


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