Martucci Gianfranco, Pereira Jose, Busa Csilla, Centeno Carlos, Csikos Agnes, Franchini Luca, Elsner Frank, Raccichini Melania, Mihailescu-Marin Maria-Mirabela, Mosoiu Daniela, Rubio Bernabé Sandra, Scherg Alexandra, Consorti Fabrizio
Local Network of Palliative Care, Department of Primary Care, Azienda USL di Modena, Via S. Giovanni del cantone, 23, Modena 41121, Italy.
Department of Family Medicine, McMaster University, Hamilton, ON, Canada.
Palliat Care Soc Pract. 2023 Dec 25;17:26323524231218279. doi: 10.1177/26323524231218279. eCollection 2023.
Although training in palliative care (PC) is increasingly frequent in medical schools, some barriers still hamper the design and implementation of effective educational programs. Information Technology-based distance learning (IT-DL) might contribute to the development of appropriate knowledge on PC in students, but it is still not clear how to best develop such curricula and how to deliver methodologically sound learning activities, allowing students to work on the complex skills required in PC.
To describe how internet-based education can be used in undergraduate medical PC education, in terms of realist theorization.
A realist review was carried out, producing a framework - or, in the terms of a realist review, a theory - focusing on finding out what might work, for whom, and in which circumstances, describing these variables in terms of Contexts, Mechanism, and Outcomes.
An international group of experts of PC education assessed the relevance and pertinence of 256 articles resulting from systematic retrieval of literature and expert suggestions.
The final synthesis, mainly informed by the 43 articles rated as most relevant, is presented in propositions regarding three groups: (1) Educational theory, where (a) Cognitivism (learning as an increase in knowledge); (b) Constructivism (learning as a social, cultural, and negotiated process); and (c) Behaviorism (learning as an observable modification of behaviors) appear to be consistent with the learning outcome of PC. (2) Desired effect of the technology, suggesting the simple use of IT-DL is not an additional value , as it should overcome objective limits set for face-to-face activities. (3) Contextualization and duration of the curricular activity, suggesting PC training activities should be included in an organic and legitimate way in the overall curriculum.
This field is expected to experience huge growth soon, and present and future research could use a realist approach like the one here presented to make sense of all the different variables involved.
尽管医学院校中姑息治疗（PC）培训日益频繁，但一些障碍仍阻碍着有效教育项目的设计与实施。基于信息技术的远程学习（IT-DL）可能有助于学生掌握有关PC的适当知识，但如何最好地开发此类课程以及如何提供方法合理的学习活动，使学生能够掌握PC所需的复杂技能，目前仍不清楚。
从现实主义理论的角度描述基于互联网的教育如何应用于本科医学PC教育。
进行了一项现实主义综述，得出一个框架——或者按照现实主义综述的说法，一种理论——重点是找出什么可能有效、对谁有效以及在何种情况下有效，并根据背景、机制和结果来描述这些变量。
一个国际PC教育专家小组评估了通过系统检索文献和专家建议得到的256篇文章的相关性和针对性。
最终综合分析主要基于被评为最相关的43篇文章，以关于三组的命题形式呈现：（1）教育理论，其中（a）认知主义（学习是知识的增加）；（b）建构主义（学习是一个社会、文化和协商的过程）；以及（c）行为主义（学习是行为的可观察到的改变）似乎与PC的学习成果一致。（2）技术的预期效果，表明单纯使用IT-DL并无额外价值，因为它应克服为面对面活动设定的客观限制。（3）课程活动的情境化和持续时间，表明PC培训活动应以有机且合理的方式纳入整体课程。
预计该领域很快将经历巨大发展，当前和未来的研究可以采用本文提出的现实主义方法来理解所有涉及的不同变量。
