Integrating exposure to palliative care in an undergraduate medical curriculum: student per-spectives and strategies

Lee, Adrian Y S; Carlon, Brodie; Ramsay, Rosemary; Thirukkumaran, Thiru

doi:10.5116/ijme.58cc.500c

Cited by 10 publications

(10 citation statements)

References 11 publications

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“…Del mismo modo, la OMS urge a los Estados Miembros a integrar la educación básica en CP en el pregrado de todos los futuros profesionales de medicina y enfermería 11 . En otras palabras, las leyes internacionales estipulan que los gobiernos y universidades de los Estados Miembros provean formación adecuada a los trabajadores sanitarios con arreglo a los principios establecidos por la OMS 26 .…”

Section: Resultsunclassified

Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano

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Lima

et al. 2018

Journal of Palliative Medicine

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ResumenContexto: La Academia Pontificia de la Vida (PAV) es una institución académica de la Santa Sede (Vaticano) cuyo objetivo es promover una visión católica de la ética biomédica. La PAV invitó a una serie de expertos en Cuidados Paliativos (CP) de todo el mundo, de todas las creencias, a desarrollar recomendaciones estratégicas para el desarrollo global de CP (“Grupo PAL-LIFE”).Diseño: Trece expertos internacionales reconocidos por su actividad promotora global de CP participaron en un estudio Delphi on-line. En un proceso de cuatro rondas, se pidió a los participantes que identificasen los grupos de interés o instituciones claves para la promoción de CP y que propusieran, para cada uno de ellos, recomendaciones estratégicas para el desarrollo de CP. Cada ronda incorporaba los comentarios de las rondas previas hasta lograr el consenso en las recomendaciones más importantes. En una última fase, al grupo de expertos se le solicitó la jerarquización por importancia de los grupos clave en una escala de 1 a 13. También se solicitaron sugerencias concretas para la implementación de las recomendaciones. Mediante análisis clúster se ordenaron los grupos de interés en dos niveles de importancia para el desarrollo de CP.Resultados: Trece recomendaciones fueron seleccionadas como las más importantes (una por cada grupo clave). Las recomendaciones para los grupos mejor puntuados fueron: (1) Responsables Políticos: garantizar el acceso universal a los CP; (2) Academia: ofrecer cursos obligatorios de CP en el pregrado; (3) Profesionales sanitarios: promover una certificación adecuada; (4) Hospitales e Instituciones sanitarias: asegurar el acceso a medicamentos de CP; y (5) Asociaciones de CP: ser promotoras eficaces y trabajar con los gobiernos en la implementación de las recomendaciones internacionales sobre CP. También se presentan recomendaciones para los ocho grupos clave restantes.Discusión: Este documento representa la posición oficial de la PAV en lo que respecta a estrategias de promoción para el desarrollo de los CP en el mundo.

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Section: Resultsunclassified

Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano

Centeno

Sitte

Lima

et al. 2018

Journal of Palliative Medicine

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“…11 In other words, international law stipulates that governments and universities of Member States provide adequate training of healthcare workers pursuant to the principles laid out by the WHO. 26 …”

Section: Resultsmentioning

confidence: 99%

White Paper for Global Palliative Care Advocacy: Recommendations from a PAL-LIFE Expert Advisory Group of the Pontifical Academy for Life, Vatican City

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Sitte

Lima

et al. 2018

Journal of Palliative Medicine

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Background: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC (“PAL-LIFE group”).Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development.Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented.Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world.

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“…This echoes published reports, which demonstrate that lack of undergraduate exposure prevents students from realising personal learning needs, leaving them under-prepared for working with dying patients in the post-qualification setting. 5,11,12 Whilst some students felt the scenarios were realistic, others felt that in reality you would likely be much busier when working in an on-call situation. This may reflect the views of those students who have experienced on-call shifts as part of their clinical attachments.…”

Section: Qualitative Analysismentioning

confidence: 99%

Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study

Wells

Montgomery

Hiersche³

2019

BMJ Support Palliat Care

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BackgroundUndergraduate teaching currently fails to adequately prepare doctors to deliver ‘end-of-life’ care. Despite much evidence supporting simulation-based teaching, its use in medical undergraduate palliative and ‘end-of-life’ care curricula remain low.AimThis study assesses whether simulation can improve the confidence and preparedness of medical students to provide holistic care to dying patients and their families, from clinical assessment to symptom management, communication and care after death.MethodsSix fourth-year medical students undertook individual simulations involving a dying patient (high-fidelity simulator) and family member (actor). Intentional patient death occurred in four of the six scenarios (although unexpected by students). Pre-simulation/post-simulation thanatophobia questionnaires measured student attitudes towards providing care to dying patients. Thematic analysis of post-simulation focus group transcripts generated qualitative data regarding student preparedness, confidence and value of the simulations.ResultsThematic analysis revealed that students felt the simulations were realistic, and left them better prepared to care for dying patients. Students coveted the ‘safe’ exposure to dying patient scenarios afforded by the simulations. Observed post-simulation reduction in mean thanatophobia scores was not found to be statistically significant (p=0.07).ConclusionsResults suggest a feasible potential for simulations to influence undergraduate medical student teaching on the care of a dying patient and their family. We believe that this study adds to the limited body of literature exploring the value of simulation in improving the confidence and preparedness of medical students to provide ‘end-of-life’ care. Further research into the cost-effectiveness of simulation is required to further support its application in this setting.

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Integrating exposure to palliative care in an undergraduate medical curriculum: student per-spectives and strategies

Cited by 10 publications

References 11 publications

Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano

Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano

White Paper for Global Palliative Care Advocacy: Recommendations from a PAL-LIFE Expert Advisory Group of the Pontifical Academy for Life, Vatican City

Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study

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