What indicators are measured by tools designed to address palliative care competence among 'generalist' palliative care providers? a critical literature review

Abstract

Background: There is growing evidence that generalists may lack skills and knowledge in palliative care provision. This has led to consideration of what the core competencies for palliative care provision among generalists should be. Aim: The objective of this review was to present the best available evidence related to indicators of competence in palliative care provision. Method: A systematic review of both qualitative and quantitative literature was undertaken. Medline, Medline in Progress, PubMed and CINAHL databases with additional hand searches of Journal of Palliative Care, Palliative Medicine, and the International Journal of Palliative Nursing were undertaken for the period 1990–2010. Hawker et al.’s checklist was utilized to select and assess data. Results: Nineteen of the 1361 articles met the inclusion criteria. The reviewed articles suggest a number of indicators of palliative care competence including: medical knowledge/skills, perceptions of knowledge/ skills, confidence in palliative care skills, attitudes/opinions towards palliative care, and experience in palliative care delivery. None of the reviewed research provided definitive evidence as to which indicators best reflect competency to practice. Conclusion: Multiple approaches, combined in a strategy of triangulation, must be incorporated in any appraisal in order to successfully measure palliative care competence.