Implementing and Evaluating a Four-year Integrated Palliative Care Curriculum for Medical Students

2019 ◽  
Author(s):  
Matthew Ellman
Keyword(s):  
Palliative Care ◽  
Medical Students

Medical Students’ Professionalism Narratives Reveal That Experiences With Death, Dying, or Palliative Care Are More Positive Than Other Experiences During Their Internal Medicine Clerkship

2016 ◽  
Vol 34 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Larry D. Cripe ◽  
David G. Hedrick ◽  
Kevin L. Rand ◽  
Debra Burns ◽  
Daniella Banno ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Palliative Care ◽  
Medical Students ◽  
Educational Strategies ◽  
Barriers To Learning ◽  
Medicine Clerkship ◽  
Student Preparedness ◽  
Internal Medicine Clerkship ◽  
The Common ◽  
And Control

Purpose: More physicians need to acquire the skills of primary palliative care. Medical students’ clerkship experiences with death, dying, and palliative care (DDPC), however, may create barriers to learning such skills during residency. Whether professional development is differentially affected by DDPC is unknown. This knowledge gap potentially hinders the development of educational strategies to optimize students’ preparedness for primary palliative care. Method: Third-year students submitted professionalism narratives (N = 4062) during their internal medicine clerkship between 2004 and 2011. We identified DDPC-related narratives and then randomly selected control narratives. Narratives were compared by valence (positive or negative) and professionalism-related themes. Results and Conclusion: Less than 10% of the narratives were related to DDPC, but the majority was positive. There was a significant overlap in professionalism themes between DDPC and control narratives. The results suggest student preparedness for primary palliative care may be improved by addressing the common professionalism challenges of clinical clerkships.

scholarly journals Knowledge of medical students on the use of opioids in the management of pain in patients receiving palliative care

2020 ◽  
Vol 14 (4) ◽  
pp. 247-252
Author(s):  
Bogumił Olczak ◽  
Grzegorz Kowalski ◽  
Sylwia Kropińska ◽  
Wojciech Leppert ◽  
Katarzyna Wieczorowska-Tobis
Keyword(s):  
Palliative Care ◽  
Medical Students

11 Filling the void: preparing future junior doctors for challenging conversations

2018 ◽  
Vol 8 (3) ◽  
pp. 363.3-364
Author(s):  
Hannah Costelloe ◽  
Alice Copley ◽  
Andrew Greenhalgh ◽  
Andrew Foster ◽  
Pratik Solanki
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
Small Group ◽  
End Of Life ◽  
Communication Skills ◽  
Skills Training ◽  
Junior Doctors ◽  
List Type ◽  
The Impact

Evidence demonstrates that medical students have limited experience in developing ‘higher-order communication skills’ (Kaufman et al. 2000). Anecdotally many do not feel confident in their ability to conduct difficult conversations often due to a lack of exposure to such scenarios in practice or a pervasive notion that these scenarios are inappropriate for students and beyond the scope of a junior doctor’s role and thus not a focus of curriculums (Noble et al. 2007). There is however a correlation between level of clinical experience and improved confidence for medical students (Morgan and Cleave-Hogg 2002).We surveyed a group of final year medical students to assess their confidence using a 10-point Likert scale in tackling common palliative and end of life care scenarios. Our intervention comprised a study day of 10 practical small-group teaching simulation and OSCE-style stations designed to provide exposure to common experiences in a controlled setting. We reassessed the confidence of students after delivery and objectively explored the impact of the day by asking participants to complete a validated assessment before and after the course. All results showed significant improvement on t-testing: confidence in end of life communication in an OSCE setting improved by 42.2% and assessment marks improved by 24.7% (p=0.039).Palliative care is an area in which students approaching the end of undergraduate training feel underprepared. Our findings demonstrate that small group sessions improve confidence by facilitating communication practice in a controlled environment and providing crucial exposure to common palliative care scenarios they will face as doctors.References. Kaufman D, Laidlaw T, Macleod H. Communication skills in medical school: Exposure confidence and performance. Academic Medicine [online] 2000;75(10):S90–S92. Available at https://journals.lww.com/academicmedicine/Fulltext/2000/10001/Communication_Skills_in_Medical_School__Exposure.29.aspx [Accessed: 30 May 2018]. Morgan P, Cleave-Hogg D. Comparison between medical students’ experience confidence and competence. Medical Education [online] 2002;36(6):534–539. Available at https://doi.org/10.1046/j.1365-2923.2002.01228.x [Accessed: 30 May 2018]. Noble L, Kubacki A, Martin J, Lloyd M. The effect of professional skills training on patient-centredness and confidence in communicating with patients. Medical Education [online] 2007;41(5):432–440. Available at https://doi.org/10.1111/j.1365-2929.2007.02704.x [Accessed: 30 May 2018]

Palliative medicine

2019 ◽  
pp. 547-556
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Symptom Control ◽  
Occupational Therapists ◽  
Palliative Care Team ◽  
Care Team ◽  
Spiritual Needs ◽  
Patient Symptom ◽  
Inpatient Nursing ◽  
Medical Teams

The chapter underlines the importance of early involvement of the palliative care team to help patients to live better and longer. Palliative care is a multidisciplinary specialty and the role of community and inpatient nursing staff, physiotherapists, occupational therapists, psychologists, and the bereavement, chaplaincy, and medical teams are discussed. The chapter also covers where palliative care is delivered, which can be at home as well as in a hospice or a hospital. Advice is given on where and when medical students can learn the most from the palliative care team, from listening to one of the palliative care consultants take a history to observing the palliative care team prescribing anticipatory medications for the dying patient. Symptom control, including pain, nausea and vomiting, anorexia, constipation, diarrhoea, and breathlessness are also discussed. The chapter focuses not only on the patient and her/his psychological and spiritual needs but also on family members and carers who might also have their own needs. The chapter underlines the importance of communication skills in palliative care and how medical students should observe carefully in either the hospice or in hospital to learn from interactions that are difficult as well as the ones that go well.

35 Online randomised controlled trial to improve clinical estimates of survival (ORACLES): study design

2018 ◽  
Vol 8 (3) ◽  
pp. 373.1-373 ◽  
Author(s):  
Linda Oostendorp ◽  
Nicola White ◽  
Priscilla Harries ◽  
Sarah Yardley ◽  
Christopher Tomlinson ◽  
...  
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Randomised Controlled Trial ◽  
Care Pathway ◽  
Low Cost ◽  
Controlled Trial ◽  
Online Training ◽  
List Type ◽  
More Care ◽  
Randomised Controlled

IntroductionClinicians often struggle to recognise whether palliative care patients are imminently dying.1 2 A previous study identified the factors that expert palliative care doctors (with demonstrated prognostic skills) had used to judge the probability of patients dying within 72 hours.Aim and methodsTo evaluate whether an online training resource can teach medical students to formulate survival estimates for palliative care patients that are more similar to experts’ estimates. In this online randomised controlled trial we will recruit 128 students in the penultimate/final year of medical school. Participants are asked to review three series of vignettes describing patients referred to palliative care and provide estimates (0%–100%) about the probability that patients will die within 72 hours. After the first series of vignettes students in the intervention arm are given access to the training resource showing how experts weighted the various symptoms/signs. Participants are asked to complete a second series of vignettes and then a third series after two weeks to assess if any effect has been maintained.ResultsStudents’ survival estimates will be correlated with experts’ estimates to determine the baseline level of agreement and any changes following the intervention. The primary outcome will be the survival estimates provided in the second series of vignettes. Secondary outcomes include the estimates provided at the follow-up the weighting of symptoms/signs and levels of discrimination and consistency.ConclusionThis study will provide evidence about whether a brief low-cost online training resource can influence how medical students make prognostic decisions in an experimental setting.References. Neuberger J. More care less pathway: A review of the liverpool care pathway.Department of Health2013. Available from: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212450/Liverpool_Care_Pathway.pdf [Accessed: 30thMay 2018]. White N, Reid F, Harris A, Harries P, Stone P. A systematic review of predictions of survival in palliative care: How accurate are clinicians and who are the experts?PLoS One25 August 2016;11(8):e0161407. Available from: http://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0161407&type=printable [Accessed: 30th May 2018]

scholarly journals A brief home-based palliative care learning experience for medical students and resident doctors in Okinawa, Japan

PLoS ONE ◽  
2019 ◽  
Vol 14 (6) ◽  
pp. e0218780
Author(s):  
Hiroaki Nagano ◽  
Haruo Obara ◽  
Yoshihiro Takayama
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Learning Experience ◽  
Home Based

Exposure of Medical Students to Palliative Care

2019 ◽  
Vol 37 (3) ◽  
pp. 239-239
Author(s):  
Amrit Kaur Kooner ◽  
Abiya Amna Ahmed ◽  
Roshni Mitra
Keyword(s):  
Palliative Care ◽  
Medical Students
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