Ross D D, Fraser H C, Kutner J S
Departments of Medicine and Pathology, University of Maryland School of Medicine, Program in Experimental Therapeutics, University of Maryland Greenebaum Cancer Center, Baltimore Veterans Medical Center, Baltimore, Maryland, USA.
J Palliat Med. 2001 Winter;4(4):512-8. doi: 10.1089/109662101753381683.
Stimulated by support from an R25 grant from the National Cancer Institute, we assembled a multidisciplinary team to design, implement, evaluate, and institutionalize in our medical school curriculum a training program to enable all students to graduate with basic competency in palliative and end-of-life care. In the fall of 1994, we reviewed the medical curriculum extensively to determine the need and optimal sites for integration of new educational modules. The freshman and junior years were found most suitable for our purposes; hence, behavioral objectives targeted at the freshman and junior medical student as learner were designed for the domain of palliative and end-of-life care. By 1996, negotiations with the medical school curriculum committee and with individual course masters secured permission and time allotments to include new coursework as required elements. We integrated approximately 20 hours of required training into the medical school curriculum, accomplished by modules that utilized small group learning, didactic presentations, out-of-classroom assignments, and practicum/experiential teaching methods. Freshman year curriculum consisted of a 3-hour module that considers the role of the physician in end-of-life care. Junior year training included a 1-hour module on advance directives and a 16-hour classroom and practicum course on hospice and end-of-life care. Performance-based assessment revealed that the students achieved the behavioral objectives. Furthermore, the students perceived benefit from the training and concluded that palliative care education should be a required part of their medical school experience. In September 2000, the medical school's Clinical Years Committee officially designated the palliative and end-of-life care training modules a mandatory part of the curriculum, with satisfactory completion a requirement for graduation.
在国立癌症研究所R25资助的支持下，我们组建了一个多学科团队，以设计、实施、评估并将一个培训项目纳入我们医学院的课程体系，使所有学生毕业时具备姑息治疗和临终关怀的基本能力。1994年秋季，我们广泛审查了医学课程，以确定整合新教育模块的必要性和最佳地点。结果发现大一和大三学年最适合我们的目标；因此，针对大一和大三医学生这一学习者群体，设计了姑息治疗和临终关怀领域的行为目标。到1996年，与医学院课程委员会和各课程负责人的谈判获得了许可和时间分配，以便将新的课程作业作为必修内容纳入。我们将大约20小时的必修培训融入医学院课程，通过利用小组学习、理论讲授、课外作业以及实习/体验式教学方法的模块来完成。大一学年的课程包括一个3小时的模块，探讨医生在临终关怀中的角色。大三学年的培训包括一个1小时的关于预立医疗指示的模块以及一个16小时的关于临终关怀和临终护理的课堂及实习课程。基于表现的评估显示，学生们实现了行为目标。此外，学生们认为培训有益，并得出结论，姑息治疗教育应该是他们医学院学习经历的必修部分。2000年9月，医学院临床学年委员会正式将姑息治疗和临终关怀培训模块指定为课程的必修部分，圆满完成是毕业的一项要求。
