A continuing medical education module on "The Last Hours of Living: Practical Advice for Clinicians," available on the Medscape Web site, has proven to be of enormous interest and benefit to health care professionals.

During the first 2 months of the program, more than 52,000 unique physicians, nurses, and other health care professionals read over 326,000 pages of content, averaging almost 6 pages per visitor. More than 10,000 individuals completed the program and received credit, including more than 6,000 nurses. Participants encompassed a wide range of specialties including oncology, cardiology, primary care, critical care, neurology, and surgery.

"We are extremely pleased with the high level of interest in this program," noted Dr. Susan B. Yox, Medscape editorial director. "Providing high-quality care at the end of life is vital, but many health professionals don't feel fully prepared to do this. Activities like 'Last Hours of Living' are a big step forward in increasing awareness and understanding."

The module is part of EPEC-O (Education in Palliative and End-of-Life Care in Oncology), a comprehensive train-the-trainer curriculum developed specifically for cancer care practitioners. The curriculum was developed, with funding from NCI's Office of Education and Special Initiatives (OESI), by the EPEC project team based at Northwestern University, with partnership support from the American Society for Clinical Oncology (ASCO) and the Lance Armstrong Foundation.

OESI and Medscape explored the feasibility of offering EPEC-O content at Medscape.com to reach a broad audience of health care practitioners, explained Dr. Cheryl Arenella with OESI's Professional Education and Research Dissemination Branch. "The first module to be piloted - 'The Last Hours of Living' - was selected after Medscape asked its audience to prioritize areas of need."

The initial response was "truly beyond our greatest expectations," said OESI Director Lenora Johnson. Some of the comments from Medscape users included: "I feel this will be a great education tool for the medical teams that do encounter a dying patient and help them to become more involved in the process" and "A very well-presented program that emphasizes the importance of including family/care givers."

OESI has two other dissemination projects centered around the EPEC-O curriculum. They are collaborating with the Indian Health Service (IHS) to present the curriculum throughout their medical care system using a combination of seminars and CD-ROM self-learning format. The first IHS seminar will be held in January 2007 and is approved for physician and nursing continuing education credit hours.

OESI is further exploring and evaluating dissemination channels for cancer care content. As such, OESI is partnering with ASCO to produce and publicize a CD-ROM-based training format for EPEC-O that will offer continuing education credits to clinicians inside and outside the oncology community. The target audiences include:

• Physicians, nurse practitioners, and physician assistants (particularly those working in oncology, hospice, palliative care, family medicine, general medicine, and geriatrics);
• Training program directors (including family practice residencies and oncology, palliative medicine, and geriatric fellowships);
• Oncology and palliative care nurses;
• Oncology social workers; and
• Therapists treating patients with cancer.