A UK Perspective on Worldwide Inadequacies in Palliative Care Training: A Short Postgraduate Course Is Proposed

Abstract

A chronological literature review illustrates how undergraduate and postgraduate education and training in the care of the dying and bereaved is inadequate worldwide. This is despite the foundation of the modern hospice movement in the United Kingdom in 1967 and its wider dissemination as a specialty in 1985. This situation has implications for those doctors working in both primary and secondary care, and this paper describes a 3-day course which has been successfully run in the West Midlands, UK, since 1997 for family physicians in training. A pre-course survey of 250, with a response rate of 54%, in 2003 revealed that 100% of respondents felt that they needed further training, and 51.5% said that they had had no previous training in palliative care.

Spiralled Palliative Care Curriculum Aligned with International Guidelines Improves Self-Efficacy but Not Attitudes: Education Intervention Study

“…Despite recommendations that palliative care education should be included in all health professional programmes, such education is often ad hoc and variable. 12–15 Our study has shown that a well-designed palliative and end-of-life curriculum aligned to EAPC guidelines increases the confidence and self-efficacy of medical students in managing palliative patients. 9 However, the curriculum appeared to have little effect on attitudes to dying people.…”

A poststructural glimpse at the World Health Organization's palliative care discourse in rural South Africa

“…The principles of palliative care are based on holistic care which implies that care providers aim to see the patient beyond a patient-identity and provide and/or coordinate caring which is humane, sensitive and necessary. Due to the positive outcomes and successes of early programs, palliative care services have grown throughout the world, and palliative care training is available in undergraduate and postgraduate medical and nursing training institutions 10 .…”

What does care mean? Perceptions of people approaching the end of life

“…Empathy and compassion are paramount and must shape the physician's actions and intentions. Medical education in palliative and end-of-life care has shown some much-needed improvements in recent years but this is not consistent across institutions (Charlton & Currie, 2008). Moreover, the need for ongoing evaluation and updating of existing education is often overlooked (Spruyt et al, 2007).…”

“…Moreover, the need for ongoing evaluation and updating of existing education is often overlooked (Spruyt et al, 2007). Despite progress and the development of guidelines and policy to improve such education, and the value students place on learning to care for dying patients (Mutto et al, 2009), evidence continues to show that in many institutions worldwide, it remains at best ill-timed and often substandard or nonexistent (Lloyd-Williams & MacLeod, 2004; Spruyt et al, 2007; Charlton & Currie, 2008; Pereira et al, 2008; Gibbons et al, 2009).…”