Postgraduate Diploma in Palliative Medicine/Postgraduate Diploma in Palliative Care (Year 1)
The Postgraduate Diploma in Palliative Medicine/Care education programme at Cardiff University is designed for experienced professionals who wish to gain expertise in the practical management of patients with non-curable and terminal illness. The programme content is also designed to emphasise the unique contribution made by each discipline involved in palliative care. The programme is delivered over 2 academic years and aims to include learning about many aspects of palliative care practice. A holistic approach to patient care is adopted throughout with an emphasis on reflective practice where the student is encouraged to consider all aspects of their patients’ care. However the delivery of the Diploma is through a series of modules each focusing on a particular aspect of palliative care eg. Pain control, symptom control and ethics.
How is Year 1 delivered?
This Diploma is multi-professional with 2 slightly different pathways and takes advantage of home- and practice-based learning opportunities. It is, therefore, particularly suitable for palliative care practitioners in all regions of the world, irrespective of individual specialisations.
The educational resources are accessed through the password-secure personal web space allocated to you as a student at enrolment, supported by a 2-day residential teaching block. Students correspond with tutors by e-mail and submit their course work electronically.
Is there a qualification available at the end of Year 1?
Year 1 forms the first part of a pathway programme ultimately leading to the Masters in Science qualification (subject to eligibility). However students initially apply for and complete the Postgraduate Diploma in Palliative Medicine (for doctors) or Palliative Care (for nurses, pharmacists and allied health professionals). In exceptional circumstances, students accruing 60 credits who are unable to continue studying may exit with a Postgraduate Certificate.
Is the qualification suitable for all professions?
Yes. There are 2 qualification pathways: The Postgraduate Diploma/MSc in Palliative Medicine(for doctors) and the Postgraduate Diploma/MSc in Palliative Care (for non-medical healthcare professionals) The residential teaching is held as a multidisciplinary event and students largely undertake the same modules but approach them from their own unique professional perspective. Current and former students have backgrounds in medicine, nursing, pharmacy and professions allied to medicine. Doctors are from a range of specialties other than palliative care, including general practice, oncology, surgery and paediatrics.
The course previously had the option of a 1 year Postgraduate Certificate qualification open to all professions but the Diploma/MSc was open only to registered medical practitioners. However from September 2008 the Diploma and MSc opened to nurses and pharmacists and other healthcare professionals in 2009 i.e. all professions will be encouraged to progress to Diploma / MSc level.
The Diploma offers students the option to study palliative medicine in either adults or children. Students choosing the full paediatric option must be working in paediatrics and will be required to choose the 2 paediatric modules as their optional modules.
Is the programme based on clinical practice?
You will be asked to select patients from your own clinical practice for study in detail. This forms the basis of the written reflective work. You will also be asked to conduct other work-based reviews on aspects of palliative care that are of particular importance to you in your own clinical setting.
Year 1 equips you with a sound understanding of all aspects of palliative care and sufficient knowledge to competently and correctly manage many of the problems that will arise. The topics covered are therefore mainly problem-orientated, but are also linked to general scientific principles.
You should be capable of changing your own clinical practice to improve patient care and also positively influence behaviour throughout your working environment. Ideally, you should be able to act as a local facilitator for subsequent education and research developments in both palliative and general clinical care.
As palliative care involves a multi-disciplinary approach, you will have the opportunity to develop material that can be used in your own practice, so that other members of your team can understand the standards you set.
Are any exemptions available for Specialist Registrars in palliative medicine?
If you are a doctor working in the UK as a specialist registrar in palliative medicine, you may notice some similarity between the case reflections within this programme and those that are being recommended as part of your higher training appraisal process.
If this applies to you, please contact a tutor, as 1case reflection may be based upon cases already completed as part of your specialist training.
Do you recognise prior learning?
We have a procedure to accredit prior learning (APL) gained from other educational institutions, but we do not presently recognise experiential learning. If you believe that you have completed a recognised programme of learning equivalent to one or more modules of the Diploma and wish to apply for an APL exemption, please contact us prior to your application. There will be a cost of approximately £250 for the APL process.
Who is the educational programme run by?
Lecturers and tutors are drawn from different departments within the School of Medicine at Cardiff University and its distributed clinical schools, plus specialists in palliative care from throughout the UK. All are recognised by the University as “Honorary Teaching Associates”.
Who are the tutors on the programme?
Professor the Baroness Finlay of Llandaff FRCP FRCGP is the Programme Director. She is Professor of Palliative Medicine at Cardiff University and Consultant in Palliative Medicine at Velindre Cancer Centre in Cardiff.
The Postgraduate Diploma Tutors are:
Dr Nikki Pease. Nikki completed the Diploma in 2000 and the MSc in 2003. She is a Consultant in Palliative Medicine at Velindre Cancer Centre in Cardiff and an Honorary Senior Lecturer at Cardiff University
Dr Joanne Hayes. Jo completed the Diploma in 1999 and the MSc in 2003. She is a Consultant in Palliative Medicine, The Medical Director at Marie Curie Hospice, Holme Tower Penarth and an Honorary Lecturer at Cardiff University.
Mrs Julie Rowlands. Julie completed her BSc in Palliative Care in 2003 and her MSc in advanced nursing practice in 2009. She works as Macmillan Palliative Care Lead Nurse for Velindre Cancer Centre in Cardiff and is an Honorary Lecturer at Cardiff University.
Helen Way. Helen completed her BSc in specialist palliative care nursing and is currently completing her MSc in advanced nursing practice in palliative care and applied education. She also holds a Postgraduate Certificate in teaching and learning in higher education. She works as an Advanced Practitioner in palliative care for Velindre Cancer Centre in Cardiff and is an Honorary Lecturer at Cardiff University
Dr Margred Capel. Margred completed the Diploma in 2004 and the MSc in 2006. She is a Consultant in Palliative Medicine at George Thomas Hospice Care in Cardiff.
Dr Dylan Harris. Dylan completed the Diploma in 2007 and completed his MSc in 2010. He works as a Consultant in Cwm Taf NHS trust and Hospice of the Valleys.
The Paediatric Diploma Tutor is:
Dr Joanne Griffiths. Jo completed her Diploma in 2003 (paediatric option) and is a Consultant in Paediatrics in Swansea.
The MSc Tutors are;
Dr Emma Mason. Emma is a Consultant in Acute & General Medicine at Bridgend hospital. She is an Honorary Senior Lecturer at Cardiff University.
Who are the external examiners?
The external examiners hold their post for a 3 year session. They are currently: -
Dr Miriam Johnson MB ChB (Hons) MRCGP, FRCP, MD.
Senior Lecturer in Palliative Medicine, Hull York Medical School. Honorary Consultant St Catherine’s Hospice, Scarborough and Acute NHS Trust, Scarborough, UK
Dr James Gilbert MB ChB FRCP ILTM.
Consultant in Palliative Medicine, Royal Devon and Exeter Healthcare Trust and Medical Director, Hospiscare, Exeter and District Hospice, UK
Dr Paul Keely MB ChB MRCGP
Honorary Senior Lecturer Glasgow University, UK. Consultant Palliative Physician, Glasgow Royal Infirmary UK.
Dr. Dilini Rajapakse MBBS, MRCP CH, Dip Pall Med (paeds)
Consultant in Paediatric Palliative Medicine, Great Ormond Street Hospital, London.
Ms Helen Walsh RGN, RM, RHV, MSc
Tutor in Nursing at Swansea University.
Dr Rob George BA, MB, BCHIR, MA, MRCP MD, FRCP
Consultant in Palliative Medicine at Guys and St Thomas' NHS Foundation Trust.
What is the residential teaching block for?
The residential study period gives students an opportunity to meet others on the course and form support groups locally or on-line, introduces the virtual learning environment (VLE), gives an overview of the course and allows topical issues to be discussed in small
groups. The communication skills session, facilitated by experienced tutors,
operates in small groups and provides a chance to practice some key communication
skills. During group work you are expected to actively contribute to the group
The study block offers a valuable chance for you to meet others from different palliative care backgrounds and to compare notes on how palliative care may be applied in different clinical settings.
The residential teaching block for each year is held in Wales (and in other centres across world, when the geographical distribution and numbers of students permit). It is a compulsory component of each Diploma year and students may not graduate until this component has been satisfactorily completed.
3 days need to be attended in year 1 in order to demonstrate a satisfactory level of active participation. You will be expected to have undertaken prior tasks, as notified, to gain the maximum benefit from your participation. Prior to each study block, you will be sent information regarding the timetable and topics to be discussed.
The next scheduled residential teaching block dates can be found on the home page.
What communication skills are involved?
Communication skills are an essential part of palliative medicine and palliative care. A large part of each residential study block is devoted to workshops on key communication skills. You will receive teaching on the Cardiff communication skills 6 point toolkit and then have time to practice its use: You will join a small group, supported by an experienced facilitator, to role play typical scenarios, using other students acting as “patients”. When attending the residential study block you need to be prepared to:-
• participate and observe in role plays
• contribute appropriately with constructive feedback
• be prepared to accept and reflect on feedback on your performance by other group members
All sessions will adhere strictly to rules of role play, which will be set out at the start. There will be opportunity during these sessions for you to share clinical examples that you feel would benefit the group work. The scenarios used for role play will concentrate on issues highlighted by participating students, yet are adaptable and appropriate to your own clinical setting. A core set of skills will be taught (The Cardiff 6 point toolkit) and then practised in the role play scenarios. Typically scenarios have focussed on:
• psychological impact of illness
• anxiety and depression
• communication strategies
• Handling uncertainty
• Inter-professional relations
Formal assessment of communication skills for successful completion of the course is subsequently undertaken and we will provide comprehensive guidance on how you should prepare this. This will include submission of a recorded consultation with a real patient.
What are the overall aims of Year 1?
A major aim in our teaching programme is to encourage thought and discussion as we equip you with practical and factual knowledge, and also provide an evidence-based approach to problems in palliative care. The attitudes and abilities acquired should be of lasting value long beyond specific advances in therapy and management.
How much work is involved in completing Year 1?
To complete this year, students must demonstrate regular detailed study throughout. As this is a postgraduate programme, students are expected to reach a high standard of knowledge, understanding and practical clinical expertise. Each year of the Diploma is based on 60 credits at M (Masters) level, which is the equivalent of 600 hours of study/practice. Please note the 600 hours includes clinical practice and is not simply 600 hours of book work.
A commitment to regular study at home is essential to your success. It has been estimated that the 'core' component of study amounts to around 200 hours across the whole year. However, your informal learning from your patients, colleagues, case discussions and your everyday clinical practice makes the 'effective' learning time much greater.
Most of your core study time will be from your home or work base, but three compulsory residential days are also involved. Careful planning is required as your study demands will have to be accommodated within your other professional and family commitments.
How is Year 1 structured?
Year 1 is comprised of 5 modules. Each module is allocated a number of M level credits which together form 60 credits.
Symptom control 1
Palliative care service organisation and special groups or Advanced practice for nurses and pharmacists and their contribution to palliative care service organisation.
OPTIONAL MODULES (Doctors to choose 1)
Principles of paediatric palliative care
Cancer specific palliative care
End stage cardiac disease
End stage renal disease
HIV and AIDS
End stage respiratory disease
You will be required to successfully complete one or more summative assessments for each module to gain the related credits. There is also a formative practical communication skills assessment, which occurs at the residential teaching block.
Different topics in palliative care are studied through a series of relevant articles, available through the Internet, which are categorised as "recommended reading" as well as additional "themed reading". You will be asked to identify key areas for your own learning from this resource and select the themed reading material that meets your learning needs as well as identifying your own resources.
The end of module assessments include extended match questions completed on line through the electronic learning portal, short reflective written assignments, communication skills assessments and some longer written assignments which are outlined below.
You will write a critique of out-of-hours palliative care and perform an audit of palliative care that is appropriate to your particular clinical setting. Additionally, you will be required to submit a case reflection which is a detailed case commentary arising from your own clinical practice and a research based project.
What are the contents of the modules?
The outline curriculum has been planned to provide a framework that mirrors actual clinical practice. Examples of module content are: -
Symptom control 1
• Pain; statistics, definitions, history, diagnosis, management, therapeutics
• Last days of life; symptom control, ethical considerations, care planning
• Nutrition, common gastro-intestinal symptoms
• Respiratory symptoms, uro-genital symptoms
• Skin care; wounds, fistulae, pressure awareness
• Mouth care
• Brain metastases; recognition and management, chronic cognitive impairment
• Metabolic complications of cancer, steroids, acute confusion
Cancer-specific palliative care
• Oncology language, clinical trials, genetics, performance status
• Chemotherapy; actions, aims, patient selection, monitoring
• Out-patient oncology treatments, common side effects of active treatments, the clinical support team, follow-up
• Radiotherapy; actions, aims, practical aspects, side effects
• Oncology emergencies, indication for urgent review
Care of the dying patient with chronic disease
• Special needs groups
• Caring for the elderly
• Palliative care for the non-cancer patient – the issues and debates
• The professional in a health care role
Understanding the Evidence
• Literature searching
• Interpreting the evidence
• Understanding how information is presented
• Levels of evidence, numbers needed to treat, numbers needed to harm
• Audit and its usefulness in identifying and managing change
What are the End of Module Assessments (EOMA)?
The End of Module Assessments take the form of either extended match questions, (where candidates are required to match a given question to the most appropriate answer of the list of answers given) or Short (approx.1000 word) reflective accounts of their learning from that module.
What is the critique of out-of-hours care?
The critique gives you an opportunity to put this particular aspect of care under some scrutiny. The objective here is to look at your own practice and environment with a critical eye.
It is not essential for you to participate in out-of hours-care arrangements. The intention is to critique the care that your palliative care patients receive, outside of normal working hours, from whichever agencies are involved in their care.
What is the audit project?
The audit project spans into year 2 and will allow you to investigate an aspect of care in your clinical area. You will be supported to set a quantified and qualified standard then undertake an audit to measure compliance with the standard. You will then complete the audit cycle by introducing any education/changes necessary to improve practice then re-auditing to compare results and measure any improvements.
The project is clinically based so allows you to investigate actual practice and make changes that wuill directly benefit patients and/or services.
Is study recognised for Continuing Professional Development?
We have obtained information from the RCP which suggests that Doctors no longer need to apply for accreditation for post graduate qualifications. Doctors should enter the course in the 'MSc and equivalents' section of their CPD diary and can claim / be awarded a maximum of 50 external CPD points for the whole MSc.
Nurses can record the course in their professional profile. All study and assessment is at Master's level which is becoming increasingly important for nurses working in advanced practice and specialist roles. The course has been mapped against the KSF framework and will allow nurses and allied healthcare professionals the opportunity to demonstrate competence within several of the KSF domains.
When does the programme start?
All students commence the Diploma in September annually.
What further information is available?
Registered students may login via www.mwe.cf.ac.uk to access the following documentation: -
• Programme regulations;
• Schedule of assessment; and
• Annual programme handbook