<< Background >>Palliative care (PC) “is fundamental to human dignity and a component of the human right to health” (Resolution 2249 – 2018 of the European Parliamentary Assembly) and this is why education and training on PC are essential components of undergraduate medical education. Nevertheless, PC is not yet fully developed in the EU and the lack of services and teachers with a specific expertise in the PC domain also hamper the design and implementation of effective educational programs on PC for undergraduate students. Worldwide, many countries developed a core competencies catalog for PC at the undergraduate level and, in Europe, the European Association for Palliative Care (EAPC) issued a White Paper listing and discussing the core competencies on PC education.The various forms of technology-enhanced learning and – more in particular – synchronous and asynchronous online learning are promising pedagogies to foster effective teaching of the PC core competencies, overcoming the constraints of resources, at least for most of the cognitive and technical- manual learning outcomes and for the basic relational skills.<< Objectives >>The main goal of the ELPIS project is to enhance the quality of PC in the EU through a better and more uniform education at the undergraduate level. This goal is relevant not only because of the already mentioned importance of PC, as stated by the European Parliament but also because of the increasing cross-border mobility of medical graduates across the Union, seeking both post-graduate education and occupation. To achieve this goal, the ELPIS project has five intertwined objectives:1. to promote the design of internally coherent and comparable online undergraduate medical education programs on PC, through the development of a theoretical educational framework2. to promote effective implementation of online programs on PC, through the development of practice guidelines that are flexible enough to be- suitable for the local organizational context of higher education and PC- fit for the local cultural approach to palliative care and other end-of-life issues, including the students’ point of view3. to broadcast sharable educational resources, in different European languages4. to validate the theoretical framework and guidelines through testing and comparing the effectiveness of some local implementations of an online program on PC5. to design and implement faculty development programs to sustain the design of curricula in PC and the use of the educational resources<< Implementation >>The ELPIS project has four Work PackagesWP 1: DEFINITION OF THE THEORETICAL FRAMEWORK AND DRAFTING OF THE COURSE ON PCThis WP will define a theoretical educational framework to design an online undergraduate course on Palliative Care (PC). We chose the realist synthesis method to develop the theoretical framework from international literature. The final result of a realist review is a “final program theory”. The final output of WP1 will be the template of a course, ready to be reviewed by the experts of each partner institution. The structure of the template will be: according to the program theory, for this type of educational outcome, in this type of context, this type of structure of the course, use of technology, teaching, learning and assessment activities is likely to be the best choice.The theoretical framework and the draft design of an online course on PC are valuable products in themselves, addressed to all teachers in the field of PC education.WP2: EDUCATIONAL DESIGN AND IMPLEMENTATION OF THE LOCAL COURSESThe aim of WP2 is to develop and implement the local online courses on PC of the seven participating partners. The courses will be comparable, because they are based on the same template, but also adapted to the local organizational and curricular context. WP2 will also account for the production of the contents (text, exercises, tests of assessment) of the course both in English and in each partner’s language. The WP has three steps.1. The structure of each local training course will be designed, according to the general template developed in WP1. The course will aim to achieve two learning outcomes: a cognitive outcome of high taxonomic level (prescribing, planning, managing) and a relational-communication outcome. 2. The contents of the courses will be developed. The contents of all six courses will be translated into English language, to have an English version of every course, which will act as a template for possible further national translations in the future. Every single course will be delivered in the national local language (Italian, German, Hungarian, Romanian, Spanish) for local use. 3. Six partners will implement the course for delivery, according to the resources and rules of the local level, ready to be offered to the students in the experimental phase.WP3: PILOT & TESTING OF THE LOCAL COURSESThe aim of the WP3 is to empirically validate the theoretical framework through testing and comparing the effectiveness of the local implementations of the online courses on PC.The partners will run a quasi-experimental trial with a group of students attending the online course and a control group attending face-to-face teaching. The educational outcomes and the course contents will be the same, the two courses will differ only for the method of delivery and the implicated differences in the activities. WP4: QUALITY ASSURANCE OF DATA, STATISTICS AND ELECTRONIC REPOSITORY OF CONTENTSThis WP is aimed to assure the quality of experimental data and to gather the data and all the produced electronic contents (texts, exercises, tests).validation of the instruments for the assessment of learning outcomes. creation and delivery of a survey on students’ satisfaction of the course (both online and face-to-face), perception of relevance, utility, difficulty, self-confidence about the outcome.design and creation of an electronic repository for all the produced and tested contents. The repository will have a web interface and will be accessible to all academic centers and palliative care facilities involved in training, upon free registration. design of Faculty development programs for the design and implementation of online courses<< Results >>The results of the ELPIS project will be:-a theoretical framework to describe elements and methods for an effective design of online PC courses.-practice guidelines for the implementation and assessment of PC courses at the undergraduate level.-a core of multilingual educational resources in an open access repository-new knowledge and perspectives about the feasibility and comparative effectiveness of different forms of online learning vs in face-to-face learningThe outcome will be the impact of the ELPIS project on the target categories: undergraduate medical students and teachers at medical schools. We shall also consider the impact on the other relevant stakeholders: the national academic and scientific community, political decision-makers, the resonance of the information media. We expect an increase in knowledge and clinical skill in students participating in both online and face-to-face courses. We also expect a high level of student's satisfaction with the online course. If a substantial equivalence is demonstrated, this will increase the propensity of teachers to use online teaching to overcome the lack of resources (few hospices) and the ethical problems of exposing end-of-life patients to a large number of students.The multiplier events that will run during the project will raise the awareness of the academic community and local political stakeholders on the importance of education and policies for end-of-life.