Facilitating affective elements in learning - In a palliative care context (original) (raw)
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How Do Experienced Professors Teach Palliative Medicine in European Universities? A Cross-Case Analysis of Eight Undergraduate Educational Programs, 2018
Background: In Europe in recent decades, university teaching of palliative medicine (PM) has evolved. In some countries it has been introduced as a compulsory subject in all medical schools, but in a majority of countries it remains an isolated subject at few universities. Objective: To explore how PM has been introduced into the curricula and how it is currently being taught at different European universities. Method: Case study method using face-to-face semistructured interviews with experienced PM professors, comparing how they have developed PM undergraduate programs at their universities. Results: An intentional sample of eight university professors from Spain, France, UK, Italy, Hungary, Sweden, Germany, and Poland was chosen. The introduction of PM in the universities depends on the existence of a favorable social and political context in relation to palliative care and the initiative of pioneers, trusted by students, to push this education forward. A PM curriculum frequently starts as an optional subject and becomes mandatory in a short period. In the reported universities, PM uses a wide variety of teaching methods, such as lectures, workshops, role-plays, and discussions. PM assessment included tests, discussions, reflections, portfolios, and research works. According to respondents' opinions, lack of recognition, funding, and accredited teachers, along with competition from other curricula, are the main barriers for palliative medicine teaching development at universities. Conclusion: Diverse paths and tools have been identified for PM teaching in Europe. The described cases may shed light on other medical schools to develop PM curricula.
Psycho-oncology, 2021
Objective: Doctors working in palliative care services are exposed to challenging emotional environments almost daily. Strong-emotional reactions experienced in this setting have implications for patient care and doctor wellbeing. Existing research has not focused on doctors working in specialist palliative care. This study aimed to understand what strong emotional reactions are experienced by doctors working in specialist palliative care, the cause of these strong emotional reactions and the impact they have on the lives of palliative care doctors. Methods: Qualitative descriptive design included grounded theory techniques. Semistructured, audio-recorded individual interviews explored doctors' memories of strong emotional reactions and challenging aspects in palliative care work, how emotions were managed and affected doctors' lives. Setting/participants: Twenty doctors were recruited from a specialist palliative care service within a public health network in Melbourne, Australia, comprising of two inpatient units, a consult service and outpatient clinic. Results: Palliative care doctors experience a myriad of strong emotions in their line of work. Experiences found to elicit strong emotional reactions included patient, family and staff distress and organizational issues. Strong emotional reactions impacted clinical behaviours, patient care and doctors' personal lives. Strategies developed for managing strong emotional reactions included debrief, setting boundaries, avoidance and self-reflection, along with nonwork strategies such as time with family.
Swedish nursing students' reasoning about emotionally demanding issues in caring for dying patients
International Journal of Palliative Nursing, 2014
To describe nursing students' reasoning about emotionally demanding questions concerning the care of dying patients. Methods: The Frommelt Attitude Toward Care of the Dying (FATCOD) Scale was completed by students at the beginning of their education, and there was great variation in the responses to five items. At a follow-up measurement in the second year, an open-ended question, 'How did you reason when completing this question?', was added to each of the these five items. Qualitative content analysis was used to analyse the responses. Results: Of 140 students who completed the FATCOD, 111 provided free-text responses. The analysis of these responses revealed three themes: death perceptions, the students' understanding of their current situation, and the nurse's responsibility. Conclusion: This study provides useful information on students' reasoning about emotionally demanding questions relating to the care of dying patients. Such knowledge is valuable in helping students to overcome their fear and fulfil their expectations concerning their future proficiency.
Current Opinion in Supportive & Palliative Care, 2018
Purpose of review The aim of this review is to understand how palliative care teaching (PCT) as a patient-centered learning model, influences medical undergraduate students’ professional development. Recent findings To study PCT medical undergraduate students’ learning experiences, we have employed the medical teaching concept, ‘hidden curriculum,’ as a way of describing attitudes and behavior conveyed implicitly by palliative care educators. Fifteen studies were selected: ten of those studies used a qualitative approach; two are theoretical explanations of the topic explored, one guideline, one review and just one quantitative study, made up the review. Medical undergraduate students reported that after PCT, they felt they had acquired better attitudes for effective integration with the patient, such as empathy or holistic care; ethical principles, such as respect or humanization of their clinical practice; and commitment to an improvement in competences, such as self-awareness or ...
BMJ supportive & palliative care, 2014
Palliative care (PC) education has become a priority in many European countries where PC is quickly developing. There remains, however, a lack of information on acceptability and medical students' experiences in PC education. This kind of information is important because it could encourage universities to adapt their curricula appropriately to the demographic and societal necessity. To explore medical students' reactions to an optional PC course using their reflective written comments. 316 medical students at the University of Navarra, over a period of 4 years, wrote evaluative comments regarding their experience and what they perceived as the course's contribution to their education. With these comments, a qualitative thematic analysis was carried out. With a response ratio of 90%, five main themes were identified: (1) The course helped medical students to become and act as doctors, (2) The benefits of having a holistic view of the patient and taking the family into acc...
Incorporating palliative care into undergraduate curricula: lessons for curriculum development
Medical Education, 2009
CONTEXT It is well recognised that teaching about palliative care, death and dying should begin at undergraduate level. The General Medical Council in the UK has issued clear recommendations for core teaching on the relieving of pain and distress, and care for the terminally ill. However, whereas some medical schools have incorporated comprehensive teaching programmes, others provide very little. The reasons underpinning such variability are unknown. OBJECTIVES The aim of this study was to explore the factors that help or hinder the incorporation of palliative care teaching at undergraduate level in the UK. METHODS Semi-structured interviews were carried out with a purposive sample of coordinators of palliative care teaching in 14 medical schools in the UK. Transcribed interviews were analysed using principles of grounded theory and respondent validation. RESULTS There are several factors promoting or inhibiting palliative care teaching at undergraduate level that are common to the development of teaching about any specialty. However, this study also revealed several factors that are distinctive to palliative care. Emergent themes were 'need for an individual lead or champion', 'the curriculum', 'patient characteristics and exposure', 'local colleagues and setup of service', 'university support' and 'the influence of students'. CONCLUSIONS The incorporation of palliative care into the medical undergraduate curriculum involves a complex process of individual, institutional, clinical, patient and curricular factors. These new findings could help medical schools to incorporate or improve such teaching.
Palliative care teaching, what can we learn
Psycho-oncology, 1995
Lack of palliative care education is being identified by many universities as a deficiency in their undergraduate medical teaching programme which requires urgent implementation into the undergraduate curriculum.A comprehensive teaching programme in palliative care was devised and commenced at our institution at the beginning of 1991. This consists of seven one and half hour modules given to students in the last years of their course. The modules cover the broad range of aims of the course (as outlined) by using a diverse range of educational principles and methods and only a minimum of traditional non-interactive didactic teaching.Students complete anonymous evaluation form at the completion of the course and responses from the medical students have been overwhelmingly positive. 89 percent of students rated the course ‘very useful’ or ‘extremely useful’. The students' rating placed this course above all other components of their undergraduate teaching programme.However, written comments from students have provided us with even more significant insights into the importance of the programme, such as ‘why weren't we taught this before’ and ‘I would like to see more space given to discussion on how to cope with the stress of the medical profession.’The skills involved in palliative care are basic to good doctoring generally and we believe that this teaching programme could help form the basis for future medical undergraduate teaching programmes in palliative care.
Journal of Palliative Medicine, 2013
Background: To date there has been a paucity of research examining whether a course in palliative care influences the clinical work. Therefore a half-day course was started for different professionals. Objectives: The aims of this study were to quantitatively and qualitatively explore professionals' experience of the usefulness and importance of such a course. Design: An evaluation study was used with two measurement points in the quantitative part; qualitative focus group interviews were conducted three times. Setting and Subjects: Data was collected in Sweden through structured and open-ended questions (n = 355) and in focus group discussions (n = 40). Results: The majority of participants were allied professionals (86%). Course evaluation immediately after the intervention showed high scores. At three months, 78% of the 86 participants who had cared for a dying patient since the course claimed that the course had been useful in their work. In addition, there were improvements regarding symptom management (37%), support to family members (36%), more frequent break point conversations (31%), and improved cooperation in the teams (26%). The qualitative analysis showed that the course made participants start to compare their own working experiences with the new knowledge. When returning to work, the participants feel strengthened by the the newly acquired knowledge, but the will to improve the care also led to frustration, as some of the participants described that they wanted to change routines in the care of the dying, but felt hindered. Conclusion: The course was appreciated and useful in the professionals' work, but it also created problems.