Landers Amanda, Wilkinson Tim J
Department of Medicine, University of Otago, Christchurch, New Zealand.
Canterbury District Health Board, Christchurch, New Zealand.
Adv Med Educ Pract. 2021 Dec 30;12:1531-1538. doi: 10.2147/AMEP.S338697. eCollection 2021.
Despite recommendations that palliative care education should be in all health professional programmes, such education is ad-hoc and variable. To reduce variability, the European Association of Palliative Care (EAPC) published a comprehensive guideline for curricula development. This study evaluates a new palliative and end-of-life care course for medical undergraduates aligned with the EAPC guidelines, focusing on knowledge, skills and attitudes.
Final-year medical students were surveyed using two validated questionnaires: Self Efficacy in Palliative Care (SEP-C) and Thanatophobia scale (TS). We compared the intervention group, that were exposed to an integrated palliative medicine course throughout the three clinical years, with a control group that were not exposed to the new educational intervention.
For self-efficacy, the intervention group had statistically significantly higher scores than the control arm. The control group had high scores compared with international data. Positive attitudes to dying patients were low and did not differ between the two groups.
A well-designed palliative and end-of-life curriculum that is aligned to EAPC guidelines increases the self-efficacy of medical students in managing palliative patients but has little effect on attitudes to dying people. This is likely to be influenced by other factors such as the need for experiential learning.
尽管有建议称姑息治疗教育应纳入所有健康专业课程,但此类教育是临时安排且各不相同的。为减少差异,欧洲姑息治疗协会(EAPC)发布了一份课程开发综合指南。本研究评估了一门符合EAPC指南的针对医学本科生的姑息治疗与临终关怀新课程,重点关注知识、技能和态度。
使用两份经过验证的问卷对医学专业最后一年的学生进行调查:姑息治疗自我效能感量表(SEP-C)和死亡恐惧量表(TS)。我们将在三个临床学年中接受了综合姑息医学课程的干预组与未接受新教育干预的对照组进行了比较。
在自我效能感方面,干预组的得分在统计学上显著高于对照组。与国际数据相比,对照组得分较高。对临终患者的积极态度较低,两组之间没有差异。
一门精心设计且符合EAPC指南的姑息治疗与临终关怀课程提高了医学生管理姑息治疗患者的自我效能感,但对对待临终患者的态度影响不大。这可能受到其他因素的影响,如体验式学习的需求。