Impact of Palliative Care Educational Program on Knowledge and Attitude Regarding Pediatric Palliative Care Among Healthcare Professionals Working in Nepal

ABSTRACT There is a critical and persistent unmet need for pediatric palliative care (PPC) services in low‐ and middle‐income countries (LMICs), with the lack of specialized training among healthcare professionals (HCPs) identified as a major barrier. This study aimed to evaluate the impact of a structured educational intervention on the knowledge and attitudes of HCPs in Nepal toward PPC. We utilized the Project ECHO (Extension for Community Healthcare Outcomes) model, an interactive, technology‐enabled, flipped‐classroom approach designed to build capacity in resource‐limited settings. The program consisted of nine weekly 75‐min online sessions, incorporating expert‐led didactic lectures, breakout room discussions, and case‐based learning. Using a culturally and contextually adapted, validated questionnaire, we measured the changes in Likert scores before and after the educational intervention to assess changes in participants' PPC‐related knowledge and attitudes. Of the 55 HCPs who enrolled in the training, 40 completed both the course and the questionnaire. Among them, 19 (47.5%) were nurses, 17 (42.5%) physicians, 2 (5.0%) psychosocial counselors, and 1 (2.5%) a family support officer. Statistically significant improvements were observed in both knowledge and attitudes regarding PPC. All 40 participants (100.0%) reported that the training was valuable and would recommend it to peers. The most cited barriers to participation included time constraints (72.5%), and internet connectivity issues (40.0%). These findings suggest that virtual PPC education delivered through the Project ECHO model is a promising and effective strategy to enhance knowledge, attitudes, and confidence among HCPs in resource‐constrained settings. This study supports its potential to address the PPC education gap in LMICs like Nepal. Furthermore, the validated questionnaire developed through this initiative may serve as a useful tool for evaluating similar training initiatives.