Mora-Delgado Juan, Lojo-Cruz Cristina, Bández Manuel J, Rosety-Rodríguez Manuel, García Ángel Estella
Internal Medicine and Palliative Care Clinical Management Unit, Hospital Universitario de Jerez de La Frontera, Ronda de Circunvalación S/N, 11407 Jerez de La Frontera, Spain.
Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Cádiz, 11003 Cádiz, Spain.
Med Sci Educ. 2025 Jan 9;35(2):1001-1008. doi: 10.1007/s40670-024-02275-7. eCollection 2025 Apr.
End-of-life care training is a critical component of medical education, yet gaps remain in adequately preparing students for these complex interactions. Objective Structured Clinical Examinations (OSCEs) have emerged as a vital tool to assess clinical competence in real-world scenarios. This study aimed to evaluate medical students' competencies in palliative care using a specialized OSCE station focused on end-of-life skills. A cohort of 118 final-year medical students at the University of Cádiz completed an OSCE that tested abilities in diagnosis, communication, ethical decision-making, and professionalism. Students demonstrated high proficiency in diagnostic competencies, particularly in identifying underlying pathologies and managing refractory symptoms. However, significant variability emerged in skills related to communication, managing advance directives, and obtaining informed consent for palliative sedation. Statistical analyses revealed areas of both strength and challenge, with items related to ethical-legal considerations showing higher difficulty and variability among students. Our findings underscore the need for curricular enhancements that integrate technical training with ethical and communicative aspects of palliative care. Improving student preparation in these domains is essential to equip future physicians with the holistic skills necessary for compassionate end-of-life care.
临终关怀培训是医学教育的关键组成部分，但在让学生充分准备应对这些复杂互动方面仍存在差距。客观结构化临床考试（OSCEs）已成为评估现实场景中临床能力的重要工具。本研究旨在使用一个专注于临终技能的专门OSCE站点来评估医学生在姑息治疗方面的能力。加的斯大学的118名医学专业最后一年学生完成了一项OSCE，该考试测试了诊断、沟通、伦理决策和专业素养方面的能力。学生们在诊断能力方面表现出很高的熟练度，尤其是在识别潜在病理和管理难治性症状方面。然而，在沟通、管理预立医疗指示以及获得姑息性镇静的知情同意等技能方面出现了显著差异。统计分析揭示了优势和挑战领域，与伦理法律考量相关的项目在学生中显示出更高的难度和变异性。我们的研究结果强调了课程改进的必要性，即将技术培训与姑息治疗的伦理和沟通方面相结合。提高学生在这些领域的准备程度对于使未来的医生具备进行富有同情心的临终关怀所需的整体技能至关重要。
