This project aims to improve the quality of higher education in the field of Palliative Care nursing education by (a) producing a report of European common Core Competences Palliative Care, (b) developing innovative education ‘tools’ for Palliative Care education and (c) training educators in how to work with the European Matrix Palliative Care Core Competences (a toolkit for educators) to introduce these innovative tools into the curriculum. To reach this aim, Kajaani University of applied science (KAMK, Finland), HOWEST University of applied science (HOWEST, Belgium), the University Transylvania of Brasov (UTBV, Romania), Dr. Piret Paal (Paracelsus Medicinische Privatuniversität, PMU, Austria) and the European Association for Palliative Care (EAPC, Belgium) will join forces. Palliative care (PC) is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.The rate at which populations are aging and living with chronic ill health means that the need for experienced nurses is constantly increasing, but the possibilities for practical internship in Palliative Care are limited. There are few options for gaining bed-side practical experience with regard to supporting patients during the dying phase. Also international research shows that nurses lack Core Competences to deal with Palliative Care situations adequately, as do the educators who train them. An innovative, attractive way of training, with educators who have the right knowledge, skills and attitudes to deal with something as complex as Palliative Care, is needed. It is widely recognised that Palliative care is not included appropriately into most if not all undergraduate nursing curriculum, a fact also noted in research done by the participating project partners. The NursEduPal@Euro project wants to tackle gaps in Palliative Care knowledge, skills and behaviours by: 1. developing a report that detail the European Palliative Care Core Competences to be reached in bachelor degree nursing education2. developing innovative tools to teach the Core Competences in Palliative Care 3. developing a training for educators to use the European Matrix and pilot elements in their curriculumBased on the European Palliative Care Core Competences report and lessons learned from novel teaching tools piloted in the NursEduPal@Euro project, a European matrix of palliative nursing education will be built as a toolkit for educators. This will include innovative tools to teach and assess the Core Competences in PC. The project rewards excellence in skills development using new ways (blended teaching, e-learning courses, simulation and others) to provide education and the integration of innovative technology by teachers. By training teachers we make sure they feel comfortable introducing new techniques and methodologies both inside and outside their traditional classroom setting, and supporting core competence development needed in practice. This introduction of new methodologies, as an alternative to traditional bedside training, will create new learning opportunities, adapted to the needs of future nurses. This will lead to more attractive and tailored courses that will strengthen skills acquisition of the students. Over time the European Palliative Care Core Competences report and the European Matrix for Palliative Care education should strengthen educator competency ultimately impacting on the nursing care provided by nurses to their patients.In short: The NursEduPal@Euro project will develop a competence based European matrix for educating bachelor degree nurses, containing innovative blended training tools for educators. This enhanced training resource will enable students to acquire Core Competencies in Palliative Care so they are better equipped to deal with Palliative Care issues in practice.

"The rate of medical advance during 20th century was enormous, due to improvements of technology as well as new scientific discoveries. Modern palliative care, as part of the health system, has developed rapidly in western countries, then all over Europe in the last part of the twentieth century.In the process of developing palliative care, an important role is to educate professionals and that is a concern included in all partners’ organization activity.Although major steps in the process of integration and delivering palliative care trainings for graduated clinicians, designing competencies frames for PC professionals, introduce this clinical specialty in the university curricula, provide post university specialized programs, a SWOT analysis conducted by the consortium partners revealed low capacity to effectively read and understand research literature and few studies made in palliative care in an evidence-based clinical practice framework. As research skills are needed for lifelong learning and level of research in the formal education varies between countries and between different PC professionals/ educators the project RESPACC is aiming to include core research competences as part of the general education related to clinical practice of palliative care professionals.The project will address the following objectives:1: Designing effective education strategies for enhancing basic research competences acrossmembers of multidisciplinary teams in palliative care.2. Stimulating the development and use of innovative approaches to increase the effective uptakeevidence-based research in palliative care.3. Increase the research capacity for a number of 48 practitioners in palliative care.4. Raise awareness among PC clinicians regarding the importance research integration in clinicalpracticeThe project has an innovative approach in developing mixed intellectual outputs considering the wide access to internet, most of educational materials being available in digital format:- research/ study report on specific palliative care competences to address the necessities of population cared- the analysis will be the main point for a whitepaper paper disseminated to stakeholders by EAPC- developing a handbook for introducing palliative care clinicians to critical reading and academic writing mixed with webinars – the curriculum developed will be presented in a short term learning event attended by 26 palliative care professionals- a toolkit for guidance the palliative care professionals in developing their own research proposal – this will include videos that will provide the mentoring process with real cases;- handbook and guidance materials for understanding qualitative and quantitative research – the curriculum will be presented in a short term face to face event and eLearning material, attended by 22 palliative care professionalsEducational materials are in English and national languages, practice based and easy to connect with daily clinical experience.- Education and project website- where all elearning materials will be uploaded will be promoted and disseminated.- a whitepaper with recommendations of inclusion of core research competencies into the training of Palliative Care cliniciansSpecifically, the project expects the following number of direct participants from the partner countries to be attracted in the project the various activities and short-term training events:48 trainees attending the 2 Short-term joint staff training events (“Introducing palliative care clinicians to critical reading and academic writing"" and "" Translating clinical issues into research projects”; 245 participants in 4 Multiplier events. Invitations to the multiplier events may be include interested practitioners from other countries listed under Participant and Partner countries in the Erasmus+.The long-term cooperation between partners’ organizations and their experience covering the fields of palliative care services, education and research will ensure the quality of intellectual outputs produced within the project. Regarding impact on European and international levels, a strong asset on this matter is the presence of EAPC in the RESPACC partnership. All the results will be disseminated at national level and by EAPC to the 56 member associations out of 32 countries, being applicable and transferable to other countries (through European conference, website, taskforce)."

Patients living with cancer and other non-oncological diseases require palliative care (PC) for uncontrolled symptoms, for their social, psycho-emotional and spiritual suffering to improve their quality of life. Across Europe, the provision of PC training for medical undergraduates is rather inconsistent and newly qualified physicians are entering practice with variable skill sets and may be unprepared to meet the needs of PC for an increasing number of patients and their families. In Romania, the country were the project lead is coming from, a recent quality insurance framework for higher education is requesting that all medical and nursing schools include Palliative care as a compulsory discipline in their curricula. At the beginning of the project only 2 out of the 12 universities were complying with this regulation The aim of the project was to produce and test a complex European PC undergraduate Program for medical students by - developing a model blended undergraduate PC curriculum based on the European Association for Palliative Care (EAPC) recommendations for undergraduate training available in RO, GE, EN and credited with 3 ECET points and - to produces adjacent training material in RO and EN for face to face and online training format. - to increase capacity of trainers to incorporate modern teaching and assessment techniques and technology in their teaching and improve their capacity as mentors. Online courses or materials were produce regarding interactive teaching methods, use of technology, mentoring of students and innovative assessment methods ( both in RO and EN) To be able to implement this program academic trainers received tuition through 3 short term trainings. CONCRETE RESULTS and PARTICIPANTS Reviewed EAPC recommendation for undergraduate training available on the EAPC website European Model Palliative Care Curriculum for undergraduate medical training with 3ECTS available in English, Romanian and German 10 updated online courses covering topics on symptom control, psychosocial issues, available in English and Romanian and 9 new developed online courses on topics like basic palliative care, symptom management, psychosocial issues, nursing available in Romanian with free registration https://learningplatform.thepalliativehub.com/login/index.php; https://edu.unitbv.ro/login/index.phpTrainers toolkit including - 31 lesson plans for all topics in the curriculum available in Romanian and English- 14 power point presentations for all theoretical courses available in Romanian and partially English - 28 organizers of seminars with case studies, exercises, role plays etc available and Romanian and partially English Online platform available in Romanian and English with free access concerning - Use of technology to support the innovate delivery of undergraduate education- Technology in teaching and in learningOpen online course on mentoring available in Romanian and English and online Mentoring manual for academic trainers, freely available in Romanian and English Open Online Resource Interactive teaching and novel assessment methods in Romanian and English Objectives based assessment for medical students for trainers use in Romanian Two articles published in ISI journals in 2020Resolution on palliative care education in undergraduate training in Romanian and agreements signed with 2 other Romanian medical schools ) to transfer the curriculum and the teaching materials. As result 7 Medical schools increased their educational offer and adapted it to actual demographic and health problems, including pandemic context Blended curriculum tested on around 1521 medical students in Romania and Ireland EDUPALL online courses and trainers toolkit used in postgraduate training on 220 doctors Three short -term trainings with 89 participants from partners and associated partners, Three multiplier events: two for English speakers and one for Romania and Republic of Moldavia totaling over 350 participants . Project’s implementation had a main impact over the teachers, mentors and students involved in creating/ teaching/ learning palliative care new curriculum. New and innovative approach of teaching methods that teachers used during implementation of curriculum lead to an increased efficiency of teaching/learning process. On medium and long term, the impact of the project will be seen at doctor’s and patient’s level, by increased level of quality of care. In the same time, on short term, the impact of the project was perceived on indirect beneficiaries (teachers, mentors, students) that had access to the intellectual outputs resulted from the team-work of the partners, by posting them on project and coordinator website access free. The results are reflected in: -new competencies of future doctors ; good practices (89 academic staff participated in short-term trainings, over 4500 participants to other indirect dissemination events)

Chronic Obstructive Pulmonary Disease (COPD) is a devastating life-limiting lung disease with a high personal and societal burden. Worldwide, COPD is the third leading cause of death. The symptom burden of people with COPD is as severe and burdensome as the symptom burden of people with lung COPD. While palliative care in many countries is available for people with lung COPD, palliative care and good end-of-life care for people with COPD are not well integrated into their treatment by respiratory hospital teams in Europe. The EU PAL-COPD project is a multidisciplinary, interprofessional, international and intersectoral project aiming at evaluating the clinical and cost-effectiveness of the ICLEAR-EU intervention for people with advanced COPD in different healthcare systems in Europe. ICLEAR-EU is a person-centred and family-centred non-pharmacological service intervention in which respiratory teams in the hospital collaborate with interdisciplinary palliative care teams and with primary care to promote shared decision-making and advance care planning, improve symptom treatment and comfort care, and prevent re-hospitalization after an exacerbation. ICLEAR-EU is based on an existing intervention developed and pilot tested in the UK. In EU PAL-COPD, the effectiveness of ICLEAR-EU will be assessed with a stepped wedge cluster RCT in 1,224 people with advanced COPD in 18 hospitals across six European countries. It is hence the first large-scale international trial on systematic integration of palliative care in respiratory care for people with advanced COPD. Cost-effectiveness, robust mixed methods subgroup analyses and in-depth process and implementation evaluations are also included. EU PAL-COPD will improve the well-being and empowerment of people with COPD and their families and advance the state of the art by providing an innovative service model to the complex palliative and end-of-life care needs. User and stakeholder involvement is crucial throughout the project.

Challenge: many patients with advanced cancer in the final phase of life leave the hospital without continuity of information, and certainty about further treatment and care provision. Often, communication between healthcare providers in different settings is suboptimal and this leads to poor continuity and coordination of care, negatively impacting the quality of life and increasing preventable hospital admissions. Solution: the PAL-CYCLES programme: a transitional palliative care programme for patients with advanced cancer, adaptable to local cultures and healthcare systems. The programme contains an intervention aiming for a smooth transition from hospital care to community care, consisting of five cornerstone components: (1) identification of a patient with palliative and supportive care needs in collaboration with the oncologist and the hospital palliative care team; (2) compassionate communication towards the patient and their family; (3) a collaborative multidimensional care plan and follow-up in the home care setting; (4) periodic evaluation of the care plan with patients and relatives; (5) identification of the terminal phase (if there) based on the periodic evaluations, with appropriate intensification of care and end-of-life talks depending on local possibilities and habits, including consultation with patient and families about ethically and legally sensitive issues. Plan: we intend to develop, adapt, implement, and evaluate the PAL-CYCLES programme in seven European countries using a stepped wedge randomized controlled trial design. Patient, relatives, and health care provider experiences, as well as ethical and equity issues will be addressed with qualitative methods. Impact: the PAL-CYCLES programme will facilitate patient-centred communication and continuity of palliative cancer care in the community care setting, reducing unplanned hospital admissions and improving quality of life for patients with advanced cancer at the end of life.