Abstract
Abstract: Introduction: The palliative care (PC) approach is a care modality recommended by the World Health Organization. Suffering and the process of dying are present in everyday clinical practice, affecting people with life-threatening diseases. However, the predominant model of teaching in Brazilian medical schools does not include palliative care. Objectives: The aim of the study was to get to know the Brazilian medical schools that include PC in their curriculum, and how it has been taught. Methods: Descriptive and exploratory study, carried out by searching for medical schools with disciplines in PC, through the analysis of the course syllabi available in the curricular matrices on the official websites of higher education institutions from August to December 2018. They were analyzed considering the offered period of the PC content, workload, scenario, and type of discipline (elective or mandatory). Results: 315 schools registered with the Ministry of Education were found, and only 44 of them (14%) offer courses in PC. These schools are distributed throughout 11 Brazilian states, of which 52% are located in the Southeast region, 25% in the Northeast, 18% in the South, 5% in the Midwest, and none in the North region. The predominant modality of the type of discipline in PC was mandatory in 61% of schools. Most Brazilian medical schools are private entities (57%), a similar percentage to the total number of medical schools identified with the teaching of PC. This course takes place in the 3rd and 4th years of the course; in most schools, the workload was 46,9 hours. The predominant scenario is the classroom, while some institutions provide integration between teaching community service and medical practice. The program contents are diverse, including thanatology, geriatrics and finitude, humanization, bioethics, pain, oncology and chronic diseases. Conclusion: PC education in Brazil is insufficient, which represents a barrier to the training of doctors in line with the recommendations of international entities, the National Curriculum Guidelines and legal frameworks within the scope of SUS. Investments by medical entities and government agencies are necessary to increase teaching in PC and the consequent qualification of medical training.
Highlights
The palliative care (PC) approach is a care modality recommended by the World Health Organization
Brazilian medical schools are private entities (57%), a similar percentage to the total number of medical schools identified with the teaching of PC
PC education in Brazil is insufficient, which represents a barrier to the training of doctors in line with the recommendations of international entities, the National Curriculum Guidelines and legal frameworks within the scope of SUS
Summary
The palliative care (PC) approach is a care modality recommended by the World Health Organization. On the other hand, according to data from the World Health Organization (WHO), this reality brings up the importance of including in medical education topics related to end-of-life care and the process of dying. Emerging diseases, such as COVID19, combined with demographic and epidemiological transitions, require specific care processes during illness and death. The PC approach emerges from a historical and sociocultural process, with the medieval hospices, places of lodging destined to accommodate people who needed care due to illness or hunger, as examples of this modality It was only in the 1960s that modern palliative care emerged. Saunders in the United Kingdom and Elizabeth Kübler-Ross in Switzerland/USA promoted the teaching and research in PC, aiming at best practices for people who needed assistance in the finitude of life[5,6]
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