Palliative care training in geriatrics residency: meanings and challenges in the development of competencies

Amaç: Bu araştırmada, jinekolojik onkoloji palyatif bakımda simülasyona dayalı mesleklerarası eğitime yönelik öğrencilerin görüş, düşünce ve önerilerinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Araştırmada nitel araştırma yöntemlerinden yorumlayıcı fenomenolojik yaklaşım kullanılmıştır. Araştırmanın uygulaması Nisan 2017 - Mayıs 2017 tarihleri arasında gerçekleştirilmiştir. Araştırmanın örneklemini 28 öğrenci (sekiz hemşirelik, sekiz beslenme ve diyetetik, sekiz sosyal hizmet ve dört tıp öğrencisi) oluşturmuştur. Araştırmanın verileri sosyo-demografik bilgi formu ve yarı yapılandırılmış odak grup görüşmesi soru yönergesi ile dört odak grup görüşmesi yapılarak toplanmıştır. Görüşmelerden elde edilen veriler tümevarım yaklaşımı ve içerik analizi yöntemi kullanılarak değerlendirilmiştir. Bulgular: Öğrenciler ile yapılan görüşmeler sonucunda ortaya çıkan temalar (1) “palyatif bakım hizmeti sunumunda ekip yaklaşımı” (2) “Mesleklerarası Jinekolojik Onkoloji Palyatif Bakım Eğitimi”; (3) “Simülasyona Dayalı Mesleklerarası Jinekolojik Onkoloji Palyatif Bakım Eğitimi” olarak sıralanmıştır. Araştırmada öğrenciler, palyatif bakımda ekip çalışması ve mesleklerarası eğitimin önemini daha iyi anladıklarını; diğer mesleklerin rol ve sorumluluklarını öğrenebilmek, ekip olarak çalışabilmek, hasta güvenliğini ve hasta merkezli bakımın sağlayabilmek için simülasyona dayalı mesleklerarası eğitimin gerekli olduğunu belirtmişlerdir. Öğrenciler lisans eğitim müfredatlarında simülasyona dayalı mesleklerarası eğitimin gerekliliğini vurgulamışlardır. Öğrencilerin simülasyon uygulamaları ile teorik eğitimde öğrendiklerini daha iyi pekiştirdikleri, yanlışlarını/hatalarını düzeltme fırsatı buldukları, mesleki profesyonelliklerinin farkına vardıkları belirlenmiştir. Sonuç: Sağlık profesyonellerinin eğitiminde mesleklerarası simülasyon uygulamalarının kullanımı için eğiticilerin ve öğrencilerin teşvik edilmesi ve lisans eğitim müfredatlarına entegre edilmesi önerilmektedir.

Accessible summary Palliative care is a holistic model of care that lessens suffering and improves quality of life for individuals who are very sick. As people with intellectual and developmental disabilities (PWIDD) get very sick, direct care workers (DCWs) are more likely to provide palliative care. Researchers need to know more about what palliative care training DCWs need. One hundred and forty‐nine (149) DCWs filled out surveys about their palliative care training needs. The research showed that DCWs need more training in certain areas, such as cultural competence, effective communication, post‐death logistics and legal matters. AbstractBackgroundDirect care workers (DCWs) caring for people with intellectual and developmental disabilities (PWIDD) provide palliative care, but research indicates DCWs are ill‐equipped to do so. This study aimed to assess DCWs’ palliative care experience and training and their perceived training needs.Materials and MethodsStaff trained as DCWs (n = 149) in organisations that serve PWIDD were surveyed in suburban and rural areas of a U.S. Midwestern state. Descriptive statistics were run, including t tests, analysis of variance, Scheffe's tests for pairwise comparison, Pearson's correlation, Fisher's exact tests and chi‐square tests.ResultsParticipants reported limited experience in legal matters, yet had substantial experience in assisting PWIDD with pain, distress and bereavement. Training was inadequate but desired for cultural competence, effective communication, post‐death logistics and legal matters. Rural DCWs reported less palliative care experience and training than suburban counterparts.ConclusionsThe results demonstrate the need for specific types of palliative care training among DCWs caring for PWIDD and that such training should be prioritised in rural agencies. Future research can explore ways to maximise training effectiveness.

To assess the educational needs, role and perceptions in palliative care issues of radiation oncologists (ROs) and trainees. 1/3 of radiotherapy patients are treated with palliative intent. Conversely, education and role that ROs have in the palliative care process are not well established, neither in terms of how they perceive their competence nor whether it is important to improve training, research and attention in palliative care issues at radiotherapy congresses. Literature systematic review in National Library of Medicine and Cochrane databases with 11 relevant issues to be identified. One doctor made first selection of articles, a second one confirmed their eligibility. 722 articles reviewed, 19 selected. 100% recognize the importance of palliative care in radiotherapy, 89.4% the need of training in palliative care for ROs, 68.4% the necessity of improving the resident programs, 63.1% the importance of skilled ROs in palliative care, 63.1% the need of better communication skills and pain management (47.3%), 52.6%, the perception of inadequate training in palliative care, 36.8% the lack of research and palliative care topics in radiotherapy meetings, 21% the absence of adequate guidelines regarding palliative care approaches, 42.1% the importance of the ROs in palliative care teams and 26.3% the lack of their involvement. Palliative care has an important role in radiotherapy but it seems ROs still need more training. It is necessary to improve training programs, increment palliative care research in radiotherapy, giving more attention to palliative care themes at radiotherapy congresses. This could lead to a better integration of radiotherapists in multidisciplinary palliative care teams in the future.

BackgroundPalliative care is an integral approach to enhancing patients’ overall quality of life by taking into account their entire lives and addressing any suffering they may be experiencing. Thus, palliative care education and training should be advanced. However, palliative care training and education in Liberia have just started, and their development warrants further investigation.ObjectiveThis research aimed to explore the state of palliative care education in Liberia and highlight its barriers and challenges.MethodsA descriptive qualitative exploratory study design was adopted in this study. Semi-structured interviews were conducted with ten male lecturers and four female nurses to gain in‐depth insight into their perspectives on palliative care education. Thematic analysis with NVivo 12 plus was used for data analysis.ResultsFour themes emerged from the data: 1) the need for palliative education (lack of healthcare professionals, government support, regular workshops, integration, and interprofessional education on palliative care), 2) palliative care barriers (lack of curriculum implementation, lack of experience, lack of government actions, and poor infrastructures), 3) the level of student knowledge (senior and junior level, same educational level, and regular teaching materials), and 4) the roles of health care professionals (attention on palliative care, providing education on pain, and public awareness).ConclusionThe study findings may serve as input to develop palliative care education and training in Liberia. The identified gaps must be filled, and critical barriers must be overcome if the area of palliative care needs to be advanced. However, the comprehensive knowledge gathered in this study can be used by nurses, lecturers, and multidisciplinary teams to achieve the effectiveness of palliative care for patients.

Palliative Care in Nephrology: The Work and the Workforce.

Specialized palliative care (PC) services have emerged to address symptoms and provide end-of-life management for patients with brain tumors. The utilization patterns of PC in neuro-oncology are unknown. A 22-question survey was distributed to participants of the society for neuro-oncology annual meeting 2012 (n = 4487). Nonparametric methods including Wilcoxon two-sample and Kruskal-Wallis tests were used to assess differences in responses. 239 (5.3 %) evaluable responses were received; 79 % of respondents were physicians, and 17 % were nurses or midlevel providers. Forty-seven percent were medical or neuro-oncologists, 31 % neurosurgeons and 11 % radiation oncologists. Forty percent had no formal training in PC, 57 % had some formal training and 3 % completed a PC fellowship. Seventy-nine percent practiced in an academic setting. Of the respondents, 57 % referred patients to PC when symptoms required treatment and 18 % at end of life. Only 51 % of all providers felt comfortable dealing with end-of-life issues and symptoms, while 33 % did not. Fifty-one percent preferred a service named "Supportive Care" rather than "Palliative Care" (MDs > midlevel providers, p < 0.001), and 32 % felt that patient expectations for ongoing therapy hindered their ability to make PC referrals. Female gender, formal training in neuro-oncology and PC, and medical versus surgical neuro-oncology training were significantly associated with hospice referral, comfort in dealing with end-of-life issues, and ease of access to PC services. Provider level, specialty, gender, training in PC and neuro-oncology have significant impact on the utilization of PC and hospice in neuro-oncology.

BackgroundThe prevalence of children with life-limiting conditions is rising, and since the amendment of the social insurance code in Germany, palliative home care teams have treated an increasing number of children. These teams provide 24/7 readiness, yet some parents still call the general emergency medical service (EMS) for various reasons. EMS is exposed to complex medical problems in rare diseases. Questions arose about the experiences of EMS and whether they felt prepared for emergencies involving children treated by a palliative care team.MethodsThis study used a mixed methods approach to focus on the interface between palliative care and EMS. First, open interviews were conducted, and a questionnaire was developed based on the results. The variables included demographic items and individual experiences with patients. Second, a case report of a child with respiratory insufficiency was presented to assess the spontaneous treatment intentions of EMS providers. Finally, the need, relevant topics, and duration of specific training in palliative care for EMS providers were evaluated.ResultsIn total, 1,005 EMS providers responded to the questionnaire. The average age was 34.5 years (±10.94SD), 74.6% were male. The average work experience was 11.8 years (±9.7), 21.4% were medical doctors. Experience with a call of a life-threatening emergency involving a child was reported by 61.5% and severe psychological distress during such a call was reported by 60.4%. The equivalent distress frequency for adult patient calls was 38.3%. (p < 0.001). After review of the case report, the EMS respondents suggested invasive treatment options and rapid transport to the hospital. Most (93.7%) respondents welcomed the consideration of special training in pediatric palliative care. This training should include basic information about palliative care, an analysis of cases involving palliatively treated children, an ethical perspective, practical recommendations, and available (24/7) local contact for further guidance and support.ConclusionEmergencies in pediatric palliatively treated patients were more common than expected. EMS providers perceived the situations as stressful, and there is a need for specific training with practical aspects.

Children with cancer experience suffering, particularly at the end of life. Pediatric hematology/oncology (PHO) fellows need dedicated palliative care (PC) training in order to adequately manage this suffering. Our objectives wereto understand (1) the PC training needs of Canadian PHO fellows and (2) experiences in providing PC, from the perspectives of fellows and their training program directors (PDs) and to describe (1)our experience in enhancing our institutional PC curriculum and (2)the preliminary evaluation of this curriculum. Electronic surveys were sent to all Canadian PHO fellows and PDs. Fellows participating in our curriculum were also sent post-course surveys. All 9/9 of the PDs and 63% (29/46) of the fellows completed our pre-course surveys. The majority of survey participants agreed that PHO fellows require dedicated PC training. All programs provided some PC education, but 45% of programs offered 3 or fewer hours of training per year. Only 55% (5/9) of the PDs believed that their trainees had adequate PC skills on completion of training. Fellows perceived a range of PC skills to be important but expressed low levels of comfort across these skills. Many fellows had experienced distress as a result of managing PC clinical situations, and many cited a lack of training as contributing to their distress. Despite increasing awareness of the importance of PC education for PHO fellows, this subject does not receive adequate attention in training curricula. The introduction of a Canadian national curriculum may improve the provision of PC training in education programs.

Abstract: The nursing staff is in permanent contact with death throughout their working life. In addition, attention in the process of dying, to family members and to the patient, is considered part of the nursing role. Patient care at the end of life generates in the nursing professionals feelings and an attitude to death, as well as a stage of coping with the fact of losing a patient, that are very different among professionals. Objective: To evaluate how a good training in palliative care and teaching techniques of coping with death to nurses, can help these health professionals to cope better with the death of patients and to have a healthier attitude to the patient dying process. Material and Methods: this bibliographical review was achieved through the search of scientific evidence in the Pubmed, google academic, LILACs and Cochrane Library databases of articles in the last five years and the critical reading of them. Results: The number of articles that relate training in palliative care and coping with death is insufficient to establish scientific evidence. However, articles found that the attitude and feelings to death by nurses are often negative or indifferent.Furthermore, the nurses participating in these studies state that the teaching of coping techniques and training in care palliatives could improve these results. Conclusion: Training in palliative care for nurses during their university period as well as training throughout their professional career should be greater, so that nurses face better the death of patients and have an attitude that favors better care at the end of life.

Impact of a Curriculum Reform in Graduate Students Self-Reported Palliative Care Competencies.

Radiation oncology resident palliative education

BackgroundAlthough palliative care has been advocated in the care of patients with chronic diseases such as parkinson's disease (PD) they do not always receive it in a timely fashion.AimThe authors...

PurposeTo improve cancer patient management, international recommendations underline the importance of integrating palliative care (PC) into oncology, and education of future oncologists is key to achieving this. In France, no study has evaluated PC training for oncology residents. This study aims to identify educational needs in PC among French oncology residents and to assess the acceptability of changing their medical training.MethodsA nationwide, descriptive, mixed-methods study was performed between 2021 and 2023. The first qualitative phase used semi-structured interviews with oncology residents to identify their training needs in PC. The second quantitative phase performed a nationwide online survey among all French oncology residents.ResultsThe least trained residents were the least keen to receive training, expressing a reductive definition of PC to the end of life, as well as a non-collaborative and integrated vision between PC and oncology. The questionnaire had a participation rate of 24%; 95% (n = 126) were in favour of modifying their PC training. Of these, 98% (n = 123) were strongly in favour of integrating PC training into the national oncology residency programme, and 91.3% (n = 115) were in favour of practical experience in a PC unit during their residency.ConclusionThis study highlights a need to improve the delivery of PC training both in theory and practice in France. This study corroborates previous reports of inadequate PC training, its heterogeneity, and the benefits to be yielded from improving it. To enable early integrated PC, improving training of oncology residents in PC is an attractive target.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00520-025-09749-3.

Due to the advancements in medicine coupled with the aging population, palliative care has become widely needed. In many countries, medical students are trained in palliative care in their postgraduate courses. However, palliative care education is not available as an independent course or standardized training for residents in China. This parallel randomized controlled trial was conducted in the Department of Internal Medicine, Beijing Chao-yang Hospital, Capital Medical University, between June 2016 and August 2017. The aim of the study was to explore the impact of the palliative care education and training program on 72 residents who were trained in standardization and were randomly divided into experimental and control groups at the ratio 1:1. The experimental group received resident physician standardized training and palliative care training program, while the control group received only standardized training. Standardized training included training in humanistic medical skills. The two groups were tested after training. A questionnaire survey was carried out to analyze the effect of palliative care education in humanistic medical skills. The total score of humanistic medical skills assessment of residents in the experimental group was higher compared to the control group (82.92±8.39 vs. 77.36±7.41, t =2.978, P=0.004). The experimental group performed better in terms of medical skills and the ability to care for dying patients. Palliative care education and training program should be required for residents as it is very useful. The purpose of palliative care education is to translate the knowledge in practice, truly implement the idea of palliative care, and relieve patients of terminal discomfort. The educational promotion of palliative care is of great value in China.

Features| November 2020 Palliative Care Training in Residency Mgbechi U. Erondu, MD, MFA Mgbechi U. Erondu, MD, MFA Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor November 2020, Vol. 84, 29. https://doi.org/10.1097/01.ASM.0000722140.82851.5e Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Mgbechi U. Erondu; Palliative Care Training in Residency. ASA Monitor 2020; 84:29 doi: https://doi.org/10.1097/01.ASM.0000722140.82851.5e Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search After my 11-month experience with the Botswana-Baylor International Pediatric HIV initiative (BIPAI), I published a short story titled “Rabid Morula Seed” about a young mother coming to terms with her 3-year-old daughter's diagnosis of rhabdomyosarcoma (The Examined Life. 1:2, 2011). As a student of anthropology, I have always been interested in the illness experience. Nowhere was this more evident than in my observation of children suffering from chronic conditions like cancer and HIV, and yet who shared hospital quarters with other children who had TB and measles. The program at the Botswana Baylor Children's Clinical Centre of Excellence in Gaborone is revolutionary among international programs for its emphasis on encouraging happiness and wellness for children outside of their medical diagnoses. In some ways, this was my first encounter with pediatric palliative care and it has motivated me to address disparities in hospice and palliative care in the U.S. and abroad.... You do not currently have access to this content.