DeCoste-Lopez Jennifer, Madhok Jai, Harman Stephanie
1 Department of Medicine, Stanford University School of Medicine , Stanford, California.
J Palliat Med. 2015 Apr;18(4):338-49. doi: 10.1089/jpm.2014.0270. Epub 2014 Dec 30.
Recent focus on palliative and end-of-life care has led medical schools worldwide to enhance their palliative care curricula.
The objective of the study was to describe recent curricular innovations in palliative care for medical students, evaluate the quality of studies in the field, and inform future research and curricular design.
The authors searched Medline, Scopus, and Educational Resource Information Center (ERIC) for English-language articles published between 2007 and 2013 describing a palliative care curriculum for medical students. Characteristics of the curricula were extracted, and methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI).
The sample described 48 curricula in 12 countries. Faculty were usually interdisciplinary. Palliative care topics included patient assessment, communication, pain and symptom management, psychosocial and spiritual needs, bioethics and the law, role in the health care system, interdisciplinary teamwork, and self-care. Thirty-nine articles included quantitative evaluation, with a mean MERSQI score of 9.9 (on a scale of 5 to 18). The domain most likely to receive a high score was data analysis (mean 2.51 out of 3), while the domains most likely to receive low scores were validity of instrument (mean 1.05) and outcomes (mean 1.31).
Recent innovations in palliative care education for medical students represent varied settings, learner levels, instructors, educational modalities, and palliative care topics. Future curricula should continue to incorporate interdisciplinary faculty. Studies could be improved by integrating longitudinal curricula and longer-term outcomes; collaborating across institutions; using validated measures; and assessing higher-level outcomes including skills, behaviors, and impact on patient care.
近期对姑息治疗和临终关怀的关注促使全球医学院校加强其姑息治疗课程。
本研究的目的是描述医学院学生姑息治疗课程的近期创新，评估该领域研究的质量，并为未来的研究和课程设计提供信息。
作者检索了Medline、Scopus和教育资源信息中心（ERIC），以查找2007年至2013年间发表的描述医学院学生姑息治疗课程的英文文章。提取课程的特征，并使用医学教育研究质量工具（MERSQI）评估方法学质量。
样本描述了12个国家的48门课程。教员通常是跨学科的。姑息治疗主题包括患者评估、沟通、疼痛和症状管理、心理社会和精神需求、生物伦理与法律、在医疗保健系统中的作用、跨学科团队合作和自我护理。39篇文章包括定量评估，MERSQI平均得分为9.9（满分5至18分）。最有可能获得高分的领域是数据分析（平均3分中得2.51分），而最有可能获得低分的领域是工具的有效性（平均1.05分）和结果（平均1.31分）。
医学院学生姑息治疗教育的近期创新代表了不同的环境、学习者水平范围、教员、教育方式和姑息治疗主题。未来的课程应继续纳入跨学科教员。可以通过整合纵向课程和长期结果；跨机构合作；使用经过验证的测量方法；以及评估包括技能、行为和对患者护理的影响在内的更高层次结果来改进研究。
