Palliative care and the arts: vehicles to introduce medical students to patient-centred decision-making and the art of caring

Carlos Centeno,Fernando Echarri,Carole Robinson,José Pereira,Antonio Noguera-Tejedor,María Arantzamendi

doi:10.1186/s12909-017-1098-6

Abstract

BackgroundMedical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. This paper describes the curriculum and evaluation results of a unique course centred on palliative care decision-making but aimed at introducing these other important competencies as well.MethodsThe 20 h-long optional course, presented in an art museum, combined different learning methods, including reflections on art, case studies, didactic sessions, personal experiences of faculty, reflective trigger videos and group discussions. A mixed methods approach was used to evaluate the course, including a) a post-course reflective exercise; b) a standardized evaluation form used by the University for all courses; and c) a focus group.ResultsTwenty students (2nd to 6th years) participated. The course was rated highly by the students. Their understanding of palliative care changed and misconceptions were dispelled. They came to appreciate the multifaceted nature of decision-making in the palliative care setting and the need to individualize care plans. Moreover, the course resulted in a re-conceptualization of relationships with patients and families, as well as their role as future physicians.ConclusionsPalliative care decision-making therefore, augmented by the visual arts, can serve as a vehicle to address several competencies, including the introduction of competencies related to being patient-centred and empathic.

Highlights

Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care
This paper describes a pilot course that used palliative care, end-of-life decision-making and the arts to introduce medical students earlier to wholistic patient care
Their understanding of palliative care changed and misconceptions were dispelled. They came to understand that palliative care is not restricted to the end-of-life phase of illness, that it represents active care and that it can be done alongside treatments to control or cure the disease. They came to appreciate the multifaceted nature of decision-making in the palliative care setting and the need to individualize care plans

Summary

Introduction

Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. The practice of medicine requires more than interviewing and examining a patient, ordering appropriate investigations, making the right diagnosis and initiating a treatment plan. While these skills are essential as is knowledge of sciences such as anatomy, pharmacology, and biochemistry, they are insufficient to make an excellent clinician. Medical Schools are challenged to find ways to catalyze and nurture these attributes and behaviours. Increasing cynicism and detachment may partly account for this and hidden curricula that do not make these attributes

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Results

Discussion

Conclusion