# End-of-Life Care Training for Patients with Traumatic Brain Injury in Ghana: A Novel Curriculum and Its Initial Implementation

## TL;DR

A new palliative care training program for traumatic brain injury patients in Ghana improved healthcare providers' knowledge and long-term use of the material.

## Contribution

A novel palliative care curriculum tailored for low- and middle-income countries and traumatic brain injury patients is introduced and evaluated.

## Key findings

- Participants scored significantly higher on post-course tests compared to pre-course tests.
- Healthcare providers reported long-term use of the course material in their practice.
- Small group discussions confirmed strong comprehension and applicability of the curriculum.

## Abstract

The implementation and practice of palliative medicine have numerous boundaries in low- and middle-income countries (LMICs), stemming from various cultural, legal, and religious concerns. Additionally, professional education in palliative care medicine in these countries is severely lacking, especially when compared with developed countries. Background/Objectives: To enhance and demystify palliative medicine practice to health care providers in LMICs. Methods: We developed a novel and comprehensive course in palliative care medicine and end-of-life (EOL) care, specifically within the context of management of patients with traumatic brain injury (TBI). We performed both immediate pre-course and post-course analysis of course participant comprehension and feedback, as well as a one-year post-course analysis and small group discussion. Results: The comprehension of the course material was strong, as participants scored an average of 13.9 points better on the post-test compared to the pre-test (49.6% vs. 35.7%, p < 0.001). Participants in the one-year follow-up session reported long-term applicability of the course material in their respective practice settings, with all participants reporting that they utilize the course material often. Small group discussion responses indicated a strong level of comprehension of the course material. Conclusions: Providing education in palliative medicine to health care professionals in LMICs is feasible, and likely to be both well-received and strongly influential to local medical practice. Local cultural and religious practices may be less of a barrier to the provision of palliative medicine than previously considered. Practicing palliative medicine, particularly at EOL, may strengthen patient–provider relationships, improve job satisfaction among health care providers, and improve the perception of medical care provided in LMIC medical settings.