Designing whole-task learning opportunities for integrated end-of-life care: a practitioner-derived enquiry

Abstract

Knowledge and skills to contribute to high-quality patient-centred end-of-life care are essential for newly qualified doctors. End-of-life care is a multifaceted complex task but learning opportunities are often fragmented in undergraduate curricula. Wholetask models provide a framework for delivery of learning activities which equips students to function in variable complex contexts. To create learning experiences that would help students to integrate the knowledge, skills and behaviours needed when encountering patients near the end-of-life, including during transitions between primary and secondary care settings. We describe the development, implementation, content and evaluation of an educational intervention for undergraduate medical students. This comprised a study day offering whole-task learning opportunities for integrated end-of-life care combined with a longitudinal placement. Our research drew on two data sources: reflective summaries and end-of-semester, online, anonymous student questionnaires. Thematic analysis of student reflective writing demonstrated learning in multiple domains. Our intervention formed an important link between classroom learning and clinical practice due to its design according to whole-task models: learners were engaged in solving real-world problems, new knowledge was applied and integrated in practice, students built on existing knowledge longitudinally, and experienced professionals supported putting knowledge into action. Although set in the UK the issues we address are of relevance worldwide.