Abstract
BackgroundWith increased demand for palliative care (PC), the World Health Organisation (WHO) have called for PC teaching to be made routine. However, medical students report feeling unprepared in dealing with end-of-life care. Necessary benchmarking of the preparedness of clinicians to provide PC is required to identify where current training is sub-optimal and ensure future doctors are equipped to meet the needs of their patients. The aim of this study is to assess the utility of an electronic International Medical Education in Palliative Care (IMEP-e) assessment tool that examines the preparedness of clinicians to provide PC.MethodsA multi-phase pilot study.Phase 1: To transpose the Self-Efficacy Palliative Care Scale (SEPCs) and the Thanatophobia Scale (TS) to an electronic format and evaluate its utility.Phase 2: To assess the effects of PC teaching by comparing data from year three (Y3) and year five (Y5 - who have participated in PC placement) medical students.Scales: The 23 item SEPC and 7 item TS assess attitudes towards caring for dying patients.ResultsTotal questionnaires sent =360 (280 Y3, 80 Y5). Total response rate = 46.39%, n = 167 (127 Y3, 40 Y5). Completed data: n = 125 (95 Y3, 30 Y5). Analysis identified statistically significant differences (p < 0.001) between year groups across all subscales of the SEPC; communication skills (t = − 13.52), Pain and Treatment management (t = − 14.25) and multidisciplinary management (t = − 7.89). The TS shows a statistically significant increased positive attitudes (z = − 2.85 p < 0.005). From the focus group, three themes were identified from the qualitative feedback including university based teaching, hospice based teaching and utility of IMEP-e tool.ConclusionThe IMEP-e tool is a viable and comparable method for collecting data on the preparedness to practice PC. A larger scale study is needed to determine and evaluate if, and how, preparing clinicians to work in PC has been adapted in to routine training.
Highlights
With increased demand for palliative care (PC), the World Health Organisation (WHO) have called for PC teaching to be made routine
Further analysis using the data provided indicates a large effect size, which is portrayed as a high Percentage (e.g. 70%) of Non-Overlap, indicating an educationally meaningful difference between the cohorts, in addition to statistical difference
The results presented and the comments from the focus group, suggest that the Electronic International Medical Education in Palliative Care (IMEP-e) is appropriate in its use, understood and is a suitable reflection of PC teaching in the undergraduate curriculum
Summary
With increased demand for palliative care (PC), the World Health Organisation (WHO) have called for PC teaching to be made routine. As the mean population age continues to rise, medical professionals of all grades and specialisations, will be required to provide palliative care (PC) for patients [3] with incurable chronic disease These patients will increasingly present with multiple complex comorbidities and many will continue to die in hospital [4]. The recent Lancet Commission report identified that half of all deaths in 2015 involved serious health-related suffering, equating to 6 billion hours of serious health related suffering across the globe each year [5] To address these challenges, the World Health Organisation (WHO) have called for training in PC to be “integrated as a routine element” for all undergraduates in health related disciplines [6]
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