Department of Applied Health Research,University College London,London,England.
Hospital Britanico,Docencia e Investigacion,Buenos Aires,Argentina.
Palliat Support Care. 2018 Feb;16(1):107-117. doi: 10.1017/S147895151700061X. Epub 2017 Jul 11.
The integration of palliative care (PC) education into medical and nursing curricula has been identified as an international priority. PC education has undergone significant development in Latin America, but gaps in the integration of PC courses into undergraduate and postgraduate curricula remain. The aim of our review was to systematically examine the delivery of PC education in Latin America in order to explore the content and method of delivery of current PC programs, identify gaps in the availability of education opportunities, and document common barriers encountered in the course of their implementation.
We carried out a systematic review of peer-reviewed academic articles and grey literature. Peer-reviewed articles were obtained from the following databases: CINAHL Plus, Embase, the Web of Science, and Medline. Grey literature was obtained from the following directories: the International Association for Hospice and Palliative Care's Global Directory of Education in Palliative Care, the Worldwide Hospice Palliative Care Alliance's lists of palliative care resources, the Latin American Association for Palliative Care's training resources, and the Latin American Atlas of Palliative Care. The inclusion criteria were that the work: (1) focused on describing PC courses; (2) was aimed at healthcare professionals; and (3) was implemented in Latin America. The PRISMA checklist was employed to guide the reporting of methods and findings.
We found 36 programs that were delivered in 8 countries. Most of the programs were composed of interdisciplinary teams, taught at a postgraduate level, focused on pain and symptom management, and utilized classroom-based methods. The tools for evaluating the courses were rarely reported. The main barriers during implementation included: a lack of recognition of the importance of PC education, a lack of funding, and the unavailability of trained teaching staff.
Considerable work needs to be done to improve the delivery of PC education programs in Latin American countries. Practice-based methods and exposure to clinical settings should be integrated into ongoing courses to facilitate learning. A regional platform needs to be created to share experiences of successful training programs and foster the development of PC education throughout Latin America.
将姑息治疗（PC）教育纳入医学和护理课程已被确定为国际优先事项。PC 教育在拉丁美洲得到了显著发展，但 PC 课程融入本科和研究生课程的情况仍存在差距。我们的综述旨在系统地考察拉丁美洲的 PC 教育实施情况，以探讨当前 PC 课程的教学内容和方法，确定教育机会的差距，并记录在实施过程中遇到的常见障碍。
我们对同行评议的学术文章和灰色文献进行了系统综述。从以下数据库中获取同行评议文章：CINAHL Plus、Embase、Web of Science 和 Medline。从以下目录中获取灰色文献：国际姑息治疗协会全球姑息治疗教育目录、世界临终关怀与姑息治疗联盟姑息治疗资源清单、拉丁美洲姑息治疗协会培训资源，以及拉丁美洲姑息治疗地图集。纳入标准为：（1）专注于描述 PC 课程；（2）针对医疗保健专业人员；（3）在拉丁美洲实施。采用 PRISMA 清单指导方法和结果的报告。
我们发现了在 8 个国家实施的 36 个项目。大多数项目由跨学科团队组成，在研究生阶段教授，侧重于疼痛和症状管理，并采用课堂教学方法。课程评估工具很少被报告。实施过程中的主要障碍包括：对 PC 教育重要性的认识不足、缺乏资金以及缺乏训练有素的教学人员。
拉丁美洲国家需要做大量工作来改进 PC 教育项目的实施。应将基于实践的方法和接触临床环境纳入现有课程，以促进学习。需要创建一个区域平台，以分享成功培训计划的经验，并促进拉丁美洲各地 PC 教育的发展。
