Milestones for the Final Mile: Interspecialty Distinctions in Primary Palliative Care Skills Training

Harris, John A.; Herrel, Lindsey A.; Healy, Mark A.; Wancata, Lauren M.; Perumalswami, Chithra R.

doi:10.1016/j.jpainsymman.2016.03.007

Cited by 14 publications

(15 citation statements)

References 20 publications

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“…This could reflect the role of surgeons and critical care physicians as gatekeepers of particular intense or aggressive interventions, including surgery and advanced life support, that drive them to operate as more “classical paternalists” (Falkum and Førde 2001). This finding should be tested with larger samples, but is consistent with prior work calling to decrease interspecialty variation in both ethical deliberation and training in primary palliative care skills (Harris et al 2016). Among nonclinicians, younger age and female gender were associated with a decreased acceptance of paternalistic decision making.…”

Section: Discussionsupporting

confidence: 85%

How acceptable is paternalism? A survey-based study of clinician and nonclinician opinions on paternalistic decision making

Bailoor

Valley

Perumalswami

et al. 2018

AJOB Empirical Bioethics

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We conducted an empirical study to explore clinician and lay opinions on the acceptability of physician paternalism. Respondents read a vignette describing a patient with brain hemorrhage facing urgent surgery that would be lifesaving but would result in long-term severe disability. Cases were randomized to show either low or high surrogate distress and certain or uncertain prognosis, with respondents rating the acceptability of not offering brain surgery. Clinicians (N = 169) were more likely than nonclinicians (N = 649) to find the doctor withholding surgery acceptable (30.2% vs. 11.4%, p ≤ 0.001). Among clinicians, the doctor withholding surgery was more acceptable when prognosis was certain to be poor (odds ratio [OR] 2.04, 95% confidence interval [CI] 1.04, 4.01). There was no effect of surrogate distress on clinician ratings. Responses among lay public were more variable. Given the differences in attitudes across clinicians and lay public, there is an ongoing need to engage stakeholders in the process of end-of-life decision making.

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Section: Discussionsupporting

confidence: 85%

How acceptable is paternalism? A survey-based study of clinician and nonclinician opinions on paternalistic decision making

Bailoor

Valley

Perumalswami

et al. 2018

AJOB Empirical Bioethics

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“…7 Discrepancies in the recognition of the need for palliative care education among residents and their program directors has improved, 6 with a recent national survey of pediatric program directors concluding that 81% of all respondents and 96% of general pediatrics program directors felt palliative care education would be beneficial. 20 Pediatic residency programs are also among the training programs which include the highest number of pallaitive care skills in their milestones, 21 suggesting that key stakeholers in pediatric residency education recognize that competency in palliative care skills is valuable.…”

Section: Introductionmentioning

confidence: 99%

Development and Implementation of an End-of-Life Curriculum for Pediatric Residents

Wilson

Herbst

Gonzalez-del-Rey

2018

Am J Hosp Palliat Care

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“…As the student answered the degree of agreement with each item, allowing a neutral response, the authors believe that the items that may have generated doubts had a response tending to neutral. It is known that the competencies used in this research have been described for several professions, including medicine [8,9], and in this way, some competencies had greater depth than others [26]. The researchers were careful to take these characteristics into the development, as well as the experts in the content validation were oriented to this fact.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Palliative Competency Tool: An Instrument To Qualify Medical Education (Validation of Palliative Competency Tool)

Guirro

Corradi-Perini

Siqueira

2020

Preprint

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Introduction: It is necessary to determine which competencies in Palliative Care (PC) have been acquired and which ones need to be improved. The aim was to develop and validate an instrument to assess the acquisition of competencies in PC care among medical students denominated Palliative Competency Tool (Pallicomp).Materials and methods: It were consisted of developing statements based on the competencies as described by the European Association for Palliative Care. The content was validated by experts, respecting the Delphi methodology. The instrument was applied to a group of medical students (n=71) enrolled at the final of 8th semester and statically validated.Results: Of the 30 questions developed, 24 were refined and approved by experts. The tool was applied to 71 medical students, only 12.7% had excellent performance and four out of ten competencies were underperformed. The statistical validation consisted of Bartlett's sphericity test, which showed adequate correlation for factor analysis (p <0.001); the Kaiser-Meyer-Olkin test for sample adequacy (0.7), and Conbach's alpha coefficient for the internal consistency (α = 0.7).Conclusions: Can be concluded that it was possible to construct and validate Palliative Competency Tool (PalliComp), an instrument of qualification of competencies acquisition of PC.

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Milestones for the Final Mile: Interspecialty Distinctions in Primary Palliative Care Skills Training

Abstract: Future revisions of specialty-specific ACGME milestone documents should focus on currently underrepresented, but important PPC skills.

Cited by 14 publications

References 20 publications

How acceptable is paternalism? A survey-based study of clinician and nonclinician opinions on paternalistic decision making

How acceptable is paternalism? A survey-based study of clinician and nonclinician opinions on paternalistic decision making

Development and Implementation of an End-of-Life Curriculum for Pediatric Residents

Validation of the Palliative Competency Tool: An Instrument To Qualify Medical Education (Validation of Palliative Competency Tool)

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