Pediatric Project ECHO®: A Virtual Community of Practice to Improve Palliative Care Knowledge and Self-Efficacy among Interprofessional Health Care Providers


Background: Health care providers (HCPs) require ongoing training and mentorship to fully appreciate the
palliative care needs of children. Project ECHO (Extension for Community Healthcare Outcomes) is a model
for delivering technology-enabled interprofessional education and cultivating a community of practice among
HCPs who care for children with life-limiting illness.

Objectives: To develop, implement, and evaluate the Project ECHO model within the pediatric palliative care
(PPC) context. Specific objectives were to evaluate (1) participation levels, (2) program acceptability, (3) HCP
knowledge changes, (4) HCP self-efficacy changes, and (5) perceived practice changes after six months.

Intervention: An interprofessional PPC curriculum was informed by a needs assessment. The curriculum was
delivered through monthly virtual 90-minute TeleECHO sessions (didactic presentation and case-based learning)
from January 2018 to December 2019. The program was freely available to all HCPs wishing to participate.
Design: A mixed-methods design with repeat measures was used. Surveys were distributed at baseline and six
months to assess outcomes using 7-point Likert scales. Descriptive and inferential statistical analyses were
conducted. The study was approved by the Research Ethics Board at the Hospital for Sick Children.

Results: Twenty-four TeleECHO sessions were completed with a mean of 32 – 12.5 attendees. Acceptability
scores (n = 43) ranged from 5.1 – 1.1 to 6.5 – 0.6. HCPs reported improvements in knowledge and self-efficacy
across most topics (11 out of 12) and skills (8 out of 10) with demonstrated statistical significance ( p < 0.05).
Most participants reported positive practice impacts, including enhanced ability to provide PPC in their

Conclusion: Project ECHO is a feasible and impactful model for fostering a virtual PPC-focused community of
practice among interprofessional HCPs.

Area of Research: Pediatric palliative care

Lead Researchers

Link to Publication


  1. Christina Vadeboncoeur

    Investigator, CHEO Research Institute

    View Profile Email
  2. Stephanie Veldhuijzen van Zanten

    Investigator, CHEO Research Institute

    View Profile Email