Learning to care: medical students’ reported value and evaluation of palliative care teaching involving meeting patients and reflective writing

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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Twelve tips for developing palliative care teaching in an undergraduate curriculum for medical students

Medical Teacher ◽

10.1080/0142159x.2018.1533243 ◽

2019 ◽

Vol 41 (12) ◽

pp. 1359-1365 ◽

Cited By ~ 4

Author(s):

Jason W. Boland ◽

Stephen Barclay ◽

Jane Gibbins

Keyword(s):

Palliative Care ◽

Medical Students ◽

Undergraduate Curriculum ◽

Care Teaching

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Attitudes of preclinical medical students towards caring for chronically ill and dying patients: does palliative care teaching make a difference?

Postgraduate Medical Journal ◽

10.1136/pmj.2003.009571 ◽

2004 ◽

Vol 80 (939) ◽

pp. 31-34 ◽

Cited By ~ 20

Author(s):

M Lloyd-Williams

Keyword(s):

Palliative Care ◽

Medical Students ◽

Chronically Ill ◽

Care Teaching ◽

Dying Patients ◽

Preclinical Medical Students

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Student’s Inventory of Professionalism (SIP): A Tool to Assess Attitudes towards Professional Development Based on Palliative Care Undergraduate Education

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16244925 ◽

2019 ◽

Vol 16 (24) ◽

pp. 4925 ◽

Cited By ~ 2

Author(s):

Antonio Noguera ◽

María Arantzamendi ◽

Jesús López-Fidalgo ◽

Alfredo Gea ◽

Alberto Acitores ◽

...

Keyword(s):

Professional Development ◽

Palliative Care ◽

Factor Analysis ◽

Medical Students ◽

Confirmatory Factor Analysis ◽

Personal Growth ◽

Goodness Of Fit ◽

Self Report ◽

Care Teaching ◽

Confirmatory Factor

Introduction: Quality medical education, centered on a patient’s needs, is crucial to develop the health professionals that our society requires. Research suggests a strong contribution of palliative care education to professionalism. The aim of this study was to design and validate a self-report inventory to measure student’s professional development. Method: Sequential exploratory strategy mixed method. The inventory is built based on the themes that emerged from the analysis of four qualitative studies about nursing and medical students’ perceptions related to palliative care teaching interventions (see Ballesteros et al. 2014, Centeno et al. 2014 and 2017, Rojí et al. 2017). The structure and psychometrics of the inventory obtained is tested in two different surveys with two different groups of medical students. Inventory reliability and construct validity are tested in the first survey group. To verify the inventory structure, a confirmatory factor analysis is performed in a second survey group. Results: The inventory has 33 items and seven dimensions: a holistic approach, caring for and understanding the patient, personal growth, teamwork, decision-making, patient evaluation, and being a health care professional. Cronbach’s-alpha was 0.73–0.84 in all seven domains, ICC: 0.95. The confirmatory factor analysis comparative fit index (CFI) was 1 with a standardized root mean square Index 0.088 (SRMR) and obtained a 0.99 goodness-of-fit R-square coefficient. Conclusions: this new inventory is grounded on student’s palliative care teaching experiences and seems to be valid to assess student’s professional development.

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

BMJ Open ◽

10.1136/bmjopen-2019-036458 ◽

2020 ◽

Vol 10 (9) ◽

pp. e036458

Author(s):

Jason W Boland ◽

Megan E L Brown ◽

Angelique Duenas ◽

Gabrielle M Finn ◽

Jane Gibbins

Keyword(s):

Palliative Care ◽

Clinical Practice ◽

Medical Students ◽

Teaching Method ◽

Data Extraction ◽

Grey Literature ◽

Undergraduate Medical Students ◽

Care Teaching ◽

Teaching Interventions ◽

Meta Analyses

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.

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