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Palliative care in undergraduate medical education - consolidation of the learning contents of palliative care in the final academic year.

ABSTRACT: Background: Demographic change and the medical imperative to accompany patients at all times and also in the case of illness leading to death require good basic knowledge of palliative care in large parts of the medical profession. Palliative care has been introduced into undergraduate medical education as a compulsory subject: "interdisciplinary subject 13 palliative care" (Q13). While course concepts for Q13 have already been positively evaluated, assessment of the consolidation and practical relevance of the knowledge taught is lacking. Methods: Assessment of the consolidation of the learning content from Q13 after the practical year (the "practical year" is the sixth and final year of undergraduate medical education in Germany) by means of a survey with a proven questionnaire and integrated qualitative free-text analysis of a cohort of medical students (n=176) who had already participated in an evaluation before and after Q13. Results: The response rate was 96% after Q13 and 45% after the practical year (PY). Teaching was predominantly perceived as more helpful than the PY (p<0.001). Compared to the status after Q13, students rated themselves as less competent after the PY in all areas surveyed, including drug-based pain therapy (p=0.0386). The certainty in informing patients about the incurability of the disease also decreased significantly after the PY (p=0.0117), although the preparation in Q13 was positively highlighted. Conclusion: The knowledge acquired in Q13 could not be anchored in the PY. On the contrary, after initial practical experiences, the students found it challenging to conduct conversations in cases of serious illness and to deal with their own uncertainty in the care of seriously ill patients. Structural factors regarding palliative care in the PY, as well as intrinsic motives of students, such as prior knowledge or motivation to learn, should be analyzed to identify ways to close the gap between theoretical and practical training in general palliative care. To generate samples that are sufficiently representative, future studies on teaching should be easily accessible to students and consider attractive forms of evaluation including electronic methods and social media.

SUBMITTER: Gerlach C

PROVIDER: S-EPMC8493850 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundThere is an increasing demand for universal, high-quality access to palliative care in Austria. To ensure this, the implementation of palliative care in the medical studies curriculum is essential. This is the first study to investigate the state of undergraduate palliative care education at Austrian medical schools.MethodsFor this mixed-methods study with concurrent embedded design, expert interviews and online surveys were conducted between March and August 2022. The interviews were subjected to a thematic analysis according to Braun and Clarke, while the questionnaires were analysed descriptively-statistically. For the final integration, the results of both methods for each topic are presented and discussed complementarily. Both the primary qualitative and supportive quantitative data were collected to combine the advantages of the in-depth nature of the qualitative data and the consistent structure of the quantitative data to provide a more precise representation of the state of teaching.ResultsTwenty-two persons participated in the study, of whom twenty-one participated in the interview and eight in the questionnaire. The participants were experts in palliative care teaching at Austrian medical schools. Currently, palliative care is taught at seven out of the eight universities. Large differences were found in the number of hours, organisation, teaching formats, and interprofessional education. At present, three universities have a chair for palliative care and at least five universities have access to a palliative care unit.ConclusionUndergraduate palliative care education in Austria is very heterogeneous and does not meet the minimum standards suggested by the European Association for Palliative Care (EAPC) curriculum recommendations. However, several universities are planning measures to expand palliative care teaching, such as the introduction of mandatory teaching or the establishment of new teaching formats. Better coordination and networking within and between universities would be beneficial for the expansion and quality of teaching.

Project description:BackgroundAs the global population ages, palliative care is ever more essential to provide care for patients with incurable chronic conditions. However, in many countries, doctors are not prepared to care for dying patients. Palliative care education should be an urgent concern for all medical schools all around the world, including Latin America and Brazil. Advances in palliative care education require robust assessment tools for constant evaluation and improvement of educational programmes. Bandura's social cognitive theory proposes that active learning processes are mediated by self-efficacy and associated outcome expectancies, both crucial elements of developing new behaviour. The Self-Efficacy in Palliative Care (SEPC) and Thanatophobia Scales were developed using Bandura's theory to assess the outcomes of palliative care training.ObjectivesWe aimed to translate and validate these scales for Brazilian Portuguese to generate data on how well doctors are being prepared to meet the needs of their patients.DesignCross-sectional study.SettingOne Brazilian medical school.ParticipantsThird-year medical students.MethodsThe authors translated the scales following the European Organisation for Research and Treatment of Cancer's recommendations and examined their psychometric properties using data collected from a sample of 111 students in a Brazilian medical school in 2017.ResultsThe Brazilian versions of SEPC and Thanatophobia Scales showed good psychometric properties, including confirmatory factor analysis, replicating the original factors (factor range: 0.51-0.90), and acceptable values of reliability (Cronbach's alpha: 0.82-0.97 and composite reliability: 0.82-0.96). Additionally, the Brazilian versions of the scales showed concurrent validity, demonstrated through a significant negative correlation.ConclusionsThe Brazilian version of the scales may be used to assess the impact of current undergraduate training and identify areas for improvement within palliative care educational programmes. The data generated allow Brazilian researchers to join international conversations on this topic and educators to develop tailored pedagogical approaches.

Project description:BackgroundSince June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work.MethodsUsing a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures.ResultsData from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21); problem-based learning at 29% (n = 10), e-learning at 3% (n = 1), and internship in ambulance service is mandatory at 11% (n = 4). In terms of assessment methods, multiple-choice exams (15 to 70 questions) are favoured (89%, n = 31), partially supplemented by open questions (31%, n = 11). Some faculties also perform single practical tests (43%, n = 15), objective structured clinical examination (OSCE; 29%, n = 10) or oral examinations (17%, n = 6).ConclusionEmergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard level of education in emergency medical care.

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Palliative care in undergraduate medical education - consolidation of the learning contents of palliative care in the final academic year.

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