Use of e-learning in improving the knowledge, attitudes and confidence of rehabilitation therapists towards palliative care

Melissa Xin Yi Ng; Josiah Geng Xiang Koh; Qian Ci Tang; Halim Zul Fahmi; Xin Yi Lam; Wei Lin Teoh; Bernice Lip Lin Soon; Mona Oh Yak Mok; Xin Mei Ng; Chalani Udhyami Ubeynarayana; Laurence Lean Chin Tan; Melissa Xin Yi Ng; Josiah Geng Xiang Koh; Qian Ci Tang; Halim Zul Fahmi; Xin Yi Lam; Wei Lin Teoh; Bernice Lip Lin Soon; Mona Oh Yak Mok; Xin Mei Ng; Chalani Udhyami Ubeynarayana; Laurence Lean Chin Tan

doi:10.3934/medsci.2026017

AIMS Medical Science

2026, Volume 13, Issue 4: 238-250. doi: 10.3934/medsci.2026017

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Research article

Use of e-learning in improving the knowledge, attitudes and confidence of rehabilitation therapists towards palliative care

1.
Rehabilitation Services, Yishun Community Hospital, Singapore
2.
Rehabilitation Services, Khoo Teck Puat Hospital, Singapore
3.
Clinical Research Unit, Khoo Teck Puat Hospital, Singapore
4.
Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore

Received: 29 October 2025 Revised: 24 September 2026 Accepted: 19 October 2026 Published: 27 October 2026

Background
Rehabilitation therapists increasingly encounter patients with palliative care needs, yet structured palliative care training for this group remains limited. E-learning has demonstrated effectiveness in healthcare education, but evidence specific to rehabilitation therapists is scarce. This study examined the effectiveness of an animated e-learning intervention in improving therapists' knowledge, attitudes, and confidence toward palliative care.
Methods
A pre-post cohort study was used. Rehabilitation therapists from two hospitals completed an e-learning intervention consisting of a 12-part animated palliative care video series (Powerfacts). Knowledge (25-item quiz), attitudes (Frommelt Attitude Toward Care Of the Dying Scale), and confidence (single Likert item) were assessed before and after the intervention. Baseline differences and change scores were compared across experience and exposure. Paired and independent t-tests were conducted.
Results
Of 108 participants who started the intervention, 73 completed both assessments. Baseline scores indicated gaps in knowledge, attitudes, and confidence, with significantly higher knowledge (mean difference −2.37) and confidence (mean difference −0.79) among therapists with prior exposure to palliative care. Following the intervention, significant improvements were observed in knowledge (mean difference −3.92; p < 0.001), attitudes (mean difference −6.98; p = 0.004), and confidence (mean difference −0.90; p < 0.001). Change scores did not differ significantly across experience or exposure groups, indicating consistent benefits across demographic subgroups.
Conclusion
Animated e-learning significantly improved rehabilitation therapists' knowledge, attitudes, and confidence in palliative care, addressing foundational gaps identified at baseline. E-learning is well-suited for basic palliative care training and may complement blended approaches for more advanced competencies. Integrating digital modules within multimodal educational frameworks may enhance the preparedness of rehabilitation therapists to support patients with serious illness.
- education,
- palliative care,
- e-learning,
- knowledge,
- attitudes,
- rehabilitation therapists
Citation: Melissa Xin Yi Ng, Josiah Geng Xiang Koh, Qian Ci Tang, Halim Zul Fahmi, Xin Yi Lam, Wei Lin Teoh, Bernice Lip Lin Soon, Mona Oh Yak Mok, Xin Mei Ng, Chalani Udhyami Ubeynarayana, Laurence Lean Chin Tan. Use of e-learning in improving the knowledge, attitudes and confidence of rehabilitation therapists towards palliative care[J]. AIMS Medical Science, 2026, 13(4): 238-250. doi: 10.3934/medsci.2026017

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Abstract

Background

Rehabilitation therapists increasingly encounter patients with palliative care needs, yet structured palliative care training for this group remains limited. E-learning has demonstrated effectiveness in healthcare education, but evidence specific to rehabilitation therapists is scarce. This study examined the effectiveness of an animated e-learning intervention in improving therapists' knowledge, attitudes, and confidence toward palliative care.

Methods

A pre-post cohort study was used. Rehabilitation therapists from two hospitals completed an e-learning intervention consisting of a 12-part animated palliative care video series (Powerfacts). Knowledge (25-item quiz), attitudes (Frommelt Attitude Toward Care Of the Dying Scale), and confidence (single Likert item) were assessed before and after the intervention. Baseline differences and change scores were compared across experience and exposure. Paired and independent t-tests were conducted.

Results

Of 108 participants who started the intervention, 73 completed both assessments. Baseline scores indicated gaps in knowledge, attitudes, and confidence, with significantly higher knowledge (mean difference −2.37) and confidence (mean difference −0.79) among therapists with prior exposure to palliative care. Following the intervention, significant improvements were observed in knowledge (mean difference −3.92; p < 0.001), attitudes (mean difference −6.98; p = 0.004), and confidence (mean difference −0.90; p < 0.001). Change scores did not differ significantly across experience or exposure groups, indicating consistent benefits across demographic subgroups.

Conclusion

Animated e-learning significantly improved rehabilitation therapists' knowledge, attitudes, and confidence in palliative care, addressing foundational gaps identified at baseline. E-learning is well-suited for basic palliative care training and may complement blended approaches for more advanced competencies. Integrating digital modules within multimodal educational frameworks may enhance the preparedness of rehabilitation therapists to support patients with serious illness.

Ethics approval and consent to participate

The National Healthcare Group, Singapore, Domain Specific Review Board (DSRB) reviewed and approved this study protocol (Reference number: 2021/01185). Verbal informed consent forms were obtained from participants. Only de-identified data was analysed.

Conflict of interest

The author declares no conflict of interest.

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