scholarly journals How effective is undergraduate palliative care teaching for medical students? A systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036458
Author(s):  
Jason W Boland ◽  
Megan E L Brown ◽  
Angelique Duenas ◽  
Gabrielle M Finn ◽  
Jane Gibbins

Palliative care is central to the role of all clinical doctors. There is variability in the amount and type of teaching about palliative care at undergraduate level. Time allocated for such teaching within the undergraduate medical curricula remains scarce. Given this, the effectiveness of palliative care teaching needs to be known.ObjectivesTo evaluate the effectiveness of palliative care teaching for undergraduate medical students.DesignA systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Screening, data extraction and quality assessment (mixed methods and Cochrane risk of bias tool) were performed in duplicate.Data sourcesEmbase, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov, Cochrane and grey literature in August 2019. Studies evaluating palliative care teaching interventions with medical students were included.Results1446 titles/abstracts and 122 full-text articles were screened. 19 studies were included with 3253 participants. 17 of the varied methods palliative care teaching interventions improved knowledge outcomes. The effect of teaching on clinical practice and patient outcomes was not evaluated in any study.ConclusionsThe majority of palliative care teaching interventions reviewed improved knowledge of medical students. The studies did not show one type of teaching method to be better than others, and thus no ‘best way’ to provide teaching about palliative care was identified. High quality, comparative research is needed to further understand effectiveness of palliative care teaching on patient care/clinical practice/outcomes in the short-term and longer-term.PROSPERO registration numberCRD42018115257.

2020 ◽  
Author(s):  
Ali Ardekani ◽  
Seyed Ali Hosseini ◽  
Parinaz Tabari ◽  
Zahra Rahimian ◽  
Afrooz Feili ◽  
...  

Abstract Background: The coronavirus disease 2019 (COVID-19) pandemic has boosted medical students' vulnerability to various problems. Given the stressful nature of medical disciplines, considerable attention must be paid to student support systems during pandemics. This study aimed to review the current literature regarding medical student support systems systematically.Methods: We performed a systematic review of six databases and grey literature sources in addition to a hand search in the references of the articles in July 2020. We included all studies about support for undergraduate medical students delivered in response to the COVID-19 pandemic. In conducting this review, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Results: A total of 5347 articles were retrieved from the databases, and 30 additional articles were extracted from other sources. After removing duplicates, we screened 3492 titles and abstracts according to our criteria. Among them, 51 full-text articles were assessed for eligibility, before seven studies were ultimately included for reviewal. We identified two major themes: (a) academic support and (b) mental health support.Conclusion: There are several methods of supporting medical students while they are experiencing unprecedented changes in their educational trajectory. This review showed that, given the novel circumstances after the outbreak of COVID-19, the use of online student support methods had received more attention. Implications for further developments in student support systems in the time of the present pandemic were also discussed.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Ardekani ◽  
Seyed Ali Hosseini ◽  
Parinaz Tabari ◽  
Zahra Rahimian ◽  
Afrooz Feili ◽  
...  

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has boosted medical students’ vulnerability to various problems. Given the stressful nature of medical disciplines, considerable attention must be paid to student support systems during pandemics. This study aimed to review the current literature regarding medical student support systems systematically. Methods We performed a systematic review of six databases and grey literature sources in addition to a hand search in the references of the articles on April 5, 2021. We included all studies about support for undergraduate medical students delivered in response to the COVID-19 pandemic. In conducting this review, we used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results A total of 3646 articles were retrieved from the databases, and 16 additional papers were extracted from other sources. After removing duplicates, we screened 2434 titles and abstracts according to our criteria. Among them, 32 full-text articles were assessed for eligibility. Ultimately, 10 studies were included for review. We identified two major themes: (a) academic support and (b) mental health support. All of the included studies utilized online methods whether for transitioning from previous support systems or developing novel approaches. Students and faculty members seemed to be receptive to these new systems. Despite indicating outstanding program outcomes, most studies merely described the positive effects of the program rather than providing a precise evaluation. Conclusion There are several methods of supporting medical students who are experiencing unprecedented changes in their educational trajectory. Due to substantial differences in undergraduate medical education in different regions of the world, cultural and contextual-oriented support is indispensable for developing a safe learning environment. Future research should investigate the question of the extent to which online support can supersede in-person strategies.


2020 ◽  
pp. 082585972092343
Author(s):  
Maria Luiza Galoro Corradi ◽  
Etienne Duim ◽  
Cibele Isaac Saad Rodrigues

Purpose: To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula. Method: Cross-sectional study of 12 attending physicians, residents, and undergraduate medical students randomly selected from a single teaching hospital in São Paulo, Brazil, 2018. Semi-structured interviews were conducted, transcripts were coded in depth, and categorizing analysis was carried out. Results: Three topical categories were recognized: Negative feelings about death and the EoL, importance of PC, and gaps in curricular structure hindering preparedness for PC and EoL communication. Besides differing perspectives depending on their years of experience, all participants strongly endorsed that the current medical school curriculum does not train and support physicians to handle EoL and PC. Conclusions: Medical education plays a fundamental role in the development of knowledge and skills on death, dying, and PC. Such practices should extend throughout the course and be continuously improved after graduates move to clinical practice.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e042653
Author(s):  
Isobel Marion Harris ◽  
Heather McNeilly ◽  
Hani Benamer ◽  
Derek J Ward ◽  
Alice J Sitch ◽  
...  

ObjectiveThis systematic review aimed to explore consultant attitudes towards teaching undergraduate medical students in the UK.DesignSystematic review.MethodologyStandard systematic review methodology was followed. MEDLINE, EMBASE and OpenGrey were searched from inception to August 2019 to identify studies exploring senior doctors’ attitudes towards teaching undergraduate medical students. Two reviewers independently carried out key methodological steps including study screening/selection, quality assessment and data extraction. A narrative synthesis was undertaken.ResultsFive studies were included in the review dating 2003–2015. Two studies used questionnaires, and three used focus groups/semistructured interviews. Key findings identified across all studies were consultants generally found teaching undergraduate medical students enjoyable, and consultants identified time constraints as a barrier to teaching. Other findings were consultants feeling there was a lack of recognition for time spent teaching, and a lack of training/guidance regarding teaching students.ConclusionsThis is the first systematic review to explore senior hospital doctors’ attitudes towards teaching undergraduate medical students. Despite these five studies spanning 12 years, the same attitudes and issues regarding teaching are identified by all, suggesting lack of time particularly is a persistent problem regarding consultant-based teaching. An anecdotal impression is that consultants are no longer as enthusiastic about teaching as they once were, but it is evident over the 12 years of these studies that enjoyment levels, and presumably enthusiasm, have not changed significantly.


2015 ◽  
Vol 9 (2) ◽  
pp. 98-104
Author(s):  
Kushani Rasangika Atukorala ◽  
Piyusha Atapattu

Background: Preclinical teaching of basic sciences provides the basis for the development of clinical reasoning skills and the ability to make management decisions. However, many senior undergraduates, pre-interns and doctors indicate that basic sciences knowledge is poorly recalled and has little relevance to their clinical practice. Objectives: To explore the perceptions of medical students in their clinical years, and pre-interns about the basic sciences courses taught to them in the preclinical years, and to assess how each group rates the applicability of these courses to current clinical training. Methods: A descriptive cross-sectional study was conducted among 118 pre-interns and 146 undergraduate medical students using a self-administered questionnaire, regarding their perceptions on preclinical basic sciences teaching. For statistical analysis chi square test was applied. Results: More than 75% both pre-interns and undergraduates agreed that preclinical teaching was useful and relevant for future clinical work. 50-75% frequently revisited preclinical subjects despite unapparent clinical significance. 55% couldn’t remember most of preclinical content. Physiology was the most retained (76%) and most clinically relevant subject (80%). Majority of (>60%) both the groups suggested more teaching time and >75% suggested concurrent clinical exposure for preclinical teaching. Undergraduates and preinterns differed in that 56% of undergraduates and 37% of pre-interns had studied pre clinical subjects just to pass examinations (p<0.01) Conclusions: Majority of undergraduates and pre-interns felt that preclinical teaching is interesting and relevant for future clinical practice, though recall and clinical significance were suboptimal. Revising teaching methods with interdisciplinary integration, early clinical exposure showing relevance of basic sciences and allocating more teaching time utilizing clinicians should be considered. DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22806 Bangladesh Soc Physiol. 2014, December; 9(2): 98-104


2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 66-66
Author(s):  
Sarina Isenberg ◽  
Rebecca Aslakson ◽  
Sydney Morss Dy ◽  
Renee Wilson ◽  
Julie Waldfogel ◽  
...  

66 Background: Recent reviews have not comprehensively addressed palliative care (PC) assessment tools. This project summarizes the extent of evidence about PC assessment tools for patients and families, and how tools have been used for clinical care, quality indicators, and evaluation of interventions. Methods: We searched MEDLINE, CINAHL, and Cochrane Database of Systematic Reviews for systematic reviews of assessment tools for PC, from January 2007 to March 2016. We searched the grey literature for domains without systematic reviews, and for domains with systematic reviews > three years old. Paired investigators independently screened search results and grey literature to determine eligibility, and assessed risk of bias of systematic reviews. The team selected the most recent and highest-quality systematic reviews for each domain. One investigator abstracted information, and a second investigator checked the information. Results: Using the National Consensus Project Palliative Care Guidelines domains, we included nine systematic reviews with 167 tools, and six tools from grey literature. Most tools were in physical, psychological, psychiatric, and social aspects of care, care at the end of life, and tools that cross domains (quality of life and caregiver-reported experience). Only two tools directly addressed spiritual aspects and none addressed cultural or patient-reported experience. Internal consistency reliability was evaluated for almost all tools; most reported construct validity; and few reported responsiveness (sensitivity to change). Few studies evaluated the use of assessment tools in quality indicators or clinical practice. A systematic review of 38 PC interventions and the assessment tools used found that at least 25 interventions included physical, psychosocial and psychiatric, and quality of life tools, but the tools varied extensively, and only nine included patient experience tools. Conclusions: Although assessment tools exist in many PC domains, tools are needed to assess spiritual and cultural aspects of care, and patient-reported experience. Research is needed concerning: tools in clinical practice and quality of care; comparison of existing tools; and evaluation and dissemination tools with evidence of responsiveness.


2021 ◽  
Vol 17 (2) ◽  
pp. 101-108
Author(s):  
Pratibha Manandhar ◽  
Naresh Manandhar ◽  
Sunil Kumar Joshi

Background and Objectives: Due to Covid-19 lockdown period undergraduate medical institutions across the country are moving towards e-learning for continuity of education. The purpose of this study is to determine the perceptions of students towards e-learning and to analyze medical students’ perception on e-learning vs. conventional learning. Materials and Method: This was a descriptive cross sectional study conducted by distributing an online semi-structured questionnaire consisting Likert scale to undergraduate medical students of Kathmandu Medical College. Data assembled from the survey were analyzed and Statistical package for social sciences (SPSS) 24 version software was used for data analysis. Result: A total of 273 students were enrolled in this study. Most of the students, 83.9% (229) had the perception that conventional teaching method was the best method for learning as compared to e-learning method 16.1% (44). The students mentioned that conventional method of learning is more effective to increase knowledge than e -learning (M= 3.87, M= 2.80) which was statistically significant (p=0.000). Conclusion: E-learning was the only option for students to study during lockdown period. But students preferred conventional method of learning as compared to e-learning. It might be due to some disadvantages of e-learning, eg. Technical difficulties, lack of interaction with teacher  and patients, etc. So, these measures have to be addressed for improving e-learning for betterment of teaching-learning activity during these types of circumstances in future.


2021 ◽  
Author(s):  
Sarah Pauline Bowers ◽  
Philip J Dickson ◽  
Katharine Thompson

Abstract Background COVID-19 led to global disruption of both healthcare delivery and undergraduate medical education with suspension of clinical placements in alignment with government and university guidelines. To facilitate ongoing palliative care education, we aimed to develop a model for delivering virtual palliative care teaching and to assess the suitability of this as an alternative to in-person teaching. Method Basic technology (iPad and linked computer) were used to facilitate video conferencing, via the secure platform Microsoft Teams, between a consultant-led ward round in a specialist palliative care unit and fourth year medical students located in the education department of the unit. This was evaluated using electronic survey responses from patients, medical students and medical staff with generation of quantitative and qualitative data.Results Medical students greatly appreciated the opportunity to maintain attendance at clinical sessions during COVID-19. Quantitative and qualitative feedback demonstrated that the virtual ward round model effectively met medical students’ educational needs, particularly in relation to holistic assessment, pain management and communication skills. Only minor technological difficulties were noted. Feedback indicated that the use of technology to allow medical education was acceptable to patients, who were open and willing to adapt. Patients acknowledged that without medical students’ physical presence on ward rounds, there was an element of discretion; clinicians also found this to be beneficial. Conclusion COVID-19 has forced changes in the delivery of medical education. Virtual ward rounds are an effective method for delivering high quality palliative care teaching and are acceptable to patients, medical students and clinicians alike. Additional benefits beyond COVID-19 included allowing students to be present discretely during sensitive conversations whilst still meeting their learning outcomes.


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