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Toussaint V, Paal P, Simader R, Elsner F. The state of undergraduate palliative care education at Austrian medical schools - a mixed methods study. BMC Palliat Care 2023; 22:151. [PMID: 37814283 PMCID: PMC10563205 DOI: 10.1186/s12904-023-01255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/01/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND There is an increasing demand for universal, high-quality access to palliative care in Austria. To ensure this, the implementation of palliative care in the medical studies curriculum is essential. This is the first study to investigate the state of undergraduate palliative care education at Austrian medical schools. METHODS For this mixed-methods study with concurrent embedded design, expert interviews and online surveys were conducted between March and August 2022. The interviews were subjected to a thematic analysis according to Braun and Clarke, while the questionnaires were analysed descriptively-statistically. For the final integration, the results of both methods for each topic are presented and discussed complementarily. Both the primary qualitative and supportive quantitative data were collected to combine the advantages of the in-depth nature of the qualitative data and the consistent structure of the quantitative data to provide a more precise representation of the state of teaching. RESULTS Twenty-two persons participated in the study, of whom twenty-one participated in the interview and eight in the questionnaire. The participants were experts in palliative care teaching at Austrian medical schools. Currently, palliative care is taught at seven out of the eight universities. Large differences were found in the number of hours, organisation, teaching formats, and interprofessional education. At present, three universities have a chair for palliative care and at least five universities have access to a palliative care unit. CONCLUSION Undergraduate palliative care education in Austria is very heterogeneous and does not meet the minimum standards suggested by the European Association for Palliative Care (EAPC) curriculum recommendations. However, several universities are planning measures to expand palliative care teaching, such as the introduction of mandatory teaching or the establishment of new teaching formats. Better coordination and networking within and between universities would be beneficial for the expansion and quality of teaching.
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Affiliation(s)
- Véronique Toussaint
- Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany.
| | - Piret Paal
- Institute of Palliative Care, Paracelsus Medical University, Salzburg, Austria
| | - Rainer Simader
- Hospiz Österreich / Österreichische Palliativgesellschaft, Vienna, Österreich
| | - Frank Elsner
- Department of Palliative Medicine, Medical Faculty RWTH Aachen University, Aachen, Germany
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2
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End of Life Simulation in a Pediatric Cardiac Intensive Care Unit. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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3
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Ferri P, Di Lorenzo R, Stifani S, Morotti E, Vagnini M, Jiménez Herrera MF, Bonacaro A, Artioli G, Rubbi I, Palese A. Nursing student attitudes toward dying patient care: A European multicenter cross-sectional study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021018. [PMID: 33855982 PMCID: PMC8138802 DOI: 10.23750/abm.v92is2.11403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 12/02/2022]
Abstract
Background and aim of the work: Nursing education plays a key role in preparing future nurses to deal with dying patients, which represents one of the most emotionally involving aspect of nursing. The aims of the study were to explore nursing students’ attitudes towards care of dying patients in three different European contexts and to analyze the variables that can influence them. Methods: We conducted an international multicenter cross-sectional study. We administered the Frommelt Attitude Toward Care of the Dying Scale form B (FATCOD-B) and a demographic form to 569 students, enrolled in three Nursing Programmes in different countries (Italy, Spain and United Kingdom), who accepted to participate in the study. The data were analyzed using SPSS software version 26.0. Results: Median total FATCOD-B scores indicated intermediate levels of students’ attitudes towards care for dying patients, with a statistically significant difference among the three student groups. The median total FATCOD-B scores did not statistically significantly change in students with different age, gender, year of study, religious beliefs, nursing education on palliative care, previous experiences of dying patient care and personal grieving. Conclusions: In our study, nursing students feel partially prepared in caring for dying patients and their attitudes do not change as the course of study progresses. No selected variables had an impact on students’ attitudes towards palliative care. Since nurses play a vital role in ensuring the quality of care, education on end-of-life care should be offered as a core part of undergraduate nursing programs. (www.actabiomedica.it)
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Affiliation(s)
| | - Rosaria Di Lorenzo
- Psychiatric Intensive Treatment Facility, Mental Health and Drug Abuse Department of AUSL-Modena.
| | - Serena Stifani
- Nursing Degree Course of Modena, University of Modena and Reggio Emilia.
| | - Elena Morotti
- Nursing Degree Course of Modena, University of Modena and Reggio Emilia.
| | | | | | - Antonio Bonacaro
- Department of Adult and Mental Health Nursing, Anglia Ruskin University.
| | | | - Ivan Rubbi
- Nursing Degree Course of Faenza, University of Bologna.
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Thompson A, Shura I, Utz R. "Doing" healthcare at end-of-life: Identity tensions, negotiations, and conflicts. DEATH STUDIES 2021; 46:2134-2144. [PMID: 33685365 DOI: 10.1080/07481187.2021.1894512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Observing how healthcare providers deal with death and dying, in terms of "doing" identity, allows us to explore how they cope with patient end-of-life (EOL) and highlights how the professional identity breaks down while managing patient death and dying. We conducted a digital ethnography of a publicly-accessible online forum for healthcare professionals. Providers' personal experiences with patient death and dying were interpreted through internalized values associated with their professional identity, which when dealing with EOL are challenged and must be negotiated. Training and support are needed to better equip providers with the skills and tools needed at EOL.
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Affiliation(s)
- Amber Thompson
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
| | - Isha Shura
- Department of Biological Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Rebecca Utz
- Department of Sociology, University of Utah, Salt Lake City, Utah, USA
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Gocmen Baykara Z, Keles S, Demir Karabulut S, Gul S, Eren H, Durmus Iskender M, Yildiz A, Kavas MV, Yalim NY. The effect of professional education on medical and nursing students' attitudes toward death. DEATH STUDIES 2020; 46:1728-1740. [PMID: 33287666 DOI: 10.1080/07481187.2020.1850546] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This qualitative study aims to reveal the effect of professional education on medical and nursing students' attitudes toward death. The study was carried out with nursing and medical students (N = 197). Research data was collected through semi-structured interview questions and 23 focus group interviews. The data was assessed using thematic analysis method. The themes were evaluated within the context of perception of death, ethical dilemmas, and, death education. To achieve professional competency in attitudes toward death, it is imperative to form a common educational curriculum and practice that would help students develop a mutual language and value system about death.
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Affiliation(s)
| | - Sukru Keles
- Department of Medical Ethics and History, Karadeniz Technical University, Trabzon, Turkey
| | | | - Senay Gul
- Fundamentals of Nursing Department, Hacettepe University, Ankara, Turkey
| | - Handan Eren
- Department of Nursing, Yalova University, Yalova, Turkey
| | | | - Abdullah Yildiz
- Department of Medical Ethics and History, Ankara University, Ankara, Turkey
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Knowledge, Attitudes and Expectations of Physicians with Respect to Palliative Care in Ecuador: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113906. [PMID: 32486456 PMCID: PMC7312868 DOI: 10.3390/ijerph17113906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022]
Abstract
Background: The worldwide need for palliative care is high, especially in mid- income countries like Ecuador, where the percentage of patients receiving such care is very small due to the scarcity of infrastructure and specialized personnel and to the unequal distribution in the country. The objective of this study is to explore the knowledge, attitudes and expectations related to palliative care of the physicians in Ecuador. Methods: A qualitative study based on 28 semi-structured interviews, from March 2014 to November 2016, with physicians working in four cities in Ecuador recruited through the snowball technique. Thematic analysis was developed supported by the ATLAS.ti software. Results: Five core themes were identified: (1) training, (2) health policy, (3) professionals’ activities, (4) health services and (5) development of palliative care in Ecuador. Conclusions: Strategies are needed which intensify the training of medical professional in palliative care, as well as avail the human resources and materials for providing it.
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de Bruin J, Verhoef MJ, Slaets JPJ, van Bodegom D. End-of-life care in the Dutch medical curricula. PERSPECTIVES ON MEDICAL EDUCATION 2018; 7:325-331. [PMID: 30187388 PMCID: PMC6191393 DOI: 10.1007/s40037-018-0447-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Future doctors must be trained in giving appropriate care to terminal patients. In several countries, medical curricula have been reviewed for the attention devoted to end-of-life care (ELC). In the Netherlands, no formal review had been performed. Therefore, the aim of this study was to provide an overview of the Dutch medical curricula regarding ELC. METHODS We formed a checklist based on international standards consisting of five domains of ELC education that are considered essential. Firstly, we studied the Dutch national blueprint on medical education. Secondly, using a questionnaire based on the checklist we studied the curricula of the eight medical faculties. A questionnaire was sent to all Dutch medical faculties to study the compulsory courses of the curricula. To assess the elective courses, we consulted the study guides. RESULTS The national blueprint included four of the five domains of ELC. None of the eight medical faculties taught all domains specifically on ELC; they were taught within other courses. Most attention was given to the domains on psychological, sociological, cultural and spiritual aspects; communication and conversational techniques; and juridical and ethical aspects. One faculty taught an elective course that included all essential aspects of the international standards. DISCUSSION Our study shows that ELC is currently insufficiently mentioned in the national blueprint and that none of the faculties fully integrated ELC as a part of their compulsory medical curricula. To improve ELC education, we recommend the Dutch Federation of University Medical Centres to add the five ELC domains to the national blueprint and we recommend the medical faculties to review their curricula and offer a separate and compulsory course on ELC to prepare their students for their future medical practice.
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Affiliation(s)
| | - Mary-Joanne Verhoef
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
- Centre of Expertise Palliative Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
- University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - David van Bodegom
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
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Bassah N, Cox K, Seymour J. Preregistration nursing students' experiences of a palliative care course in a resource-poor setting. Int J Palliat Nurs 2018; 24:388-397. [DOI: 10.12968/ijpn.2018.24.8.388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Nahyeni Bassah
- Assistant Lecturer of Nursing, Department of Nursing, Faculty of Health Sciences, University of Buea, South-West Region, Cameroon
| | - Karen Cox
- Vice-Chancellor and President, University of Kent, Canterbury, Kent, UK
| | - Jane Seymour
- Professor of Palliative and End-of-life Care, School of Nursing and Midwifery, University of Sheffield, UK
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9
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Dowling TB. Reflection on curative treatment versus palliation of symptoms in end of life care. Nurs Stand 2018; 32:46-51. [PMID: 29341551 DOI: 10.7748/ns.2018.e10644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2016] [Indexed: 06/07/2023]
Abstract
The conflicting tasks of treating or managing disease and preparing patients and their families for the end of life are well documented in haematology and palliative care settings. This article is a reflection on practice by a nursing student who was in the fourth year of an internship, and discusses a case study involving a woman at the end of life. It considers the approach to palliative and end of life care adopted in an oncology and haematology ward where there was a reluctance to be realistic about the limitations of treatments among some healthcare practitioners, who did not want to dispel unrealistic expectations of the patient's recovery as a result of continuing treatment. This reflection focuses on the care of a patient at the end of life and the frustration experienced by the nursing student at their inability to alter the direction of treatment from curative treatment to the palliation of symptoms.
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10
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Garrino L, Contratto C, Massariello P, Dimonte V. Caring for Dying Patient and Their Families. J Palliat Care 2017; 32:127-133. [DOI: 10.1177/0825859717745169] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The literature from recent decades persistently suggests that nurses are not adequately trained in caring for the dying. Numerous studies call for enhanced education in end-of-life care. Objective: To explore student nurses’ experience of caring for dying persons and their families and how this experience was influenced by their undergraduate education, with a view to improving end-of-life training. Methods: Narrative interviews were administered to a purposive sample of 18 undergraduate students at Turin University’s School of Nursing and analyzed following Giorgi’s qualitative phenomenological methodology. Results: The students’ accounts featured 4 main themes: emotions and feelings, reactions and coping strategies, growth in personal and professional awareness, and the professional nursing model. Students reporting positive experience of end-of-life care in clinical settings displayed the expected learning outcomes for undergraduate nursing education. Conclusion: This study’s strength lies in the fact that it draws on student nurses’ lived experience to assess training in end-of-life care. It confirms the need to invest in targeted end-of-life education and support for nursing students.
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Affiliation(s)
- Lorenza Garrino
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Claudia Contratto
- Corso di Laurea in Infermieristica, A.S.L. “Città di Torino,” Turin, Italy
| | | | - Valerio Dimonte
- Department of Public Health and Paediatrics, University of Turin, Turin, Italy
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Lippe M, Jones T, Becker H, Carter P. Student Preparation to Care for Dying Patients: Assessing Outcomes Across a Curriculum. J Nurs Educ 2017; 56:633-637. [DOI: 10.3928/01484834-20170918-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/25/2017] [Indexed: 11/20/2022]
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12
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Lippe M, Carter P. Assessing student characteristics in palliative care education research: a literature review. Int J Palliat Nurs 2017; 23:402-408. [DOI: 10.12968/ijpn.2017.23.8.402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Megan Lippe
- Assistant Professor, University of Alabama Capstone College of Nursing Tuscaloosa, AL
| | - Patricia Carter
- Associate Professor, University of Texas at Austin School of Nursing Austin, TX
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13
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Factors Influencing Chinese Nursing Students’ Attitudes Toward the Care of Dying Patients. J Hosp Palliat Nurs 2017. [DOI: 10.1097/njh.0000000000000353] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Croxon L, Deravin L, Anderson J. Dealing with end of life-New graduated nurse experiences. J Clin Nurs 2017; 27:337-344. [DOI: 10.1111/jocn.13907] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Lyn Croxon
- School of Nursing; Midwifery & Indigenous Health; Charles Sturt University; Dubbo NSW Australia
| | - Linda Deravin
- School of Nursing; Midwifery and Indigenous Health; Charles Sturt University; Bathurst NSW Australia
| | - Judith Anderson
- School of Nursing; Midwifery and Indigenous Health; Charles Sturt University; Bathurst NSW Australia
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Spalding J, Yardley S. 'The nice thing about doctors is that you can sometimes get a day off school': an action research study to bring lived experiences from children, parents and hospice staff into medical students' preparation for practice. BMJ Support Palliat Care 2016; 6:459-464. [PMID: 27208813 DOI: 10.1136/bmjspcare-2015-001080] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/29/2016] [Accepted: 04/27/2016] [Indexed: 11/04/2022]
Abstract
Patient and public involvement in healthcare is important to ensure services meet their needs and priorities. Increasingly, patient experiences are being used to educate healthcare professionals. The potential contribution to medical education of children and parents using hospice services has not yet been fully explored. OBJECTIVES (1) To explore perceptions of what medical students must learn to become 'good doctors' among children, parents and staff in a hospice. (2) To collaborate with children/parents and staff to develop educational materials based on their lived experiences for medical students. (3) To assess feasibility of student-led action research in a children's hospice to develop research skills. METHODS Prospective ethical approval received. Volunteer children (n=7), parents (n=5) and staff (n=6) were recruited from a children's hospice. Data were generated in audio-recorded semistructured focus groups, individual interviews and/or activity workshops. Participants discussed what newly qualified doctors' needed to care for children with life-limiting conditions. Audio data were transcribed and combined with visual data for thematic analysis. Findings were refined by participant feedback. This paper presents thematic findings and educational material created from the project. RESULTS Thematic analysis identified six learning themes: (1) treat children as individuals; (2) act as a person before being a doctor; (3) interpersonal communication; (4) appreciate the clinical environment; (5) learn from children, parents and other staff; (6) how to be a doctor as part of a team. The student researcher successfully developed qualitative research skills, coproducing materials with participants for sharing learning derived from lived experiences. CONCLUSIONS All participants were willing and able to make valuable contributions, and believed that this was a worthwhile use of time and effort. Further work is required to understand how best to integrate the experiences of children in hospices into medical education.
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Affiliation(s)
| | - Sarah Yardley
- Keele University Medical School, Keele, Staffordshire, UK.,Camden, Islington, UCLH & HCA Palliative Care Service, Central and North West London NHS Foundation Trust, Staffordshire, UK
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Chan ZCY. A systematic review on critical thinking in medical education. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2015-0117/ijamh-2015-0117.xml. [PMID: 27089400 DOI: 10.1515/ijamh-2015-0117] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/13/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Critical thinking is the ability to raise discriminating questions in an attempt to search for better ideas, a deeper understanding and better solutions relating to a given issue. OBJECTIVE This systematic review provides a summary of efforts that have been made to enhance and assess critical thinking in medical education. DESIGN Nine databases [Ovid MEDLINE(R), AMED, Academic Search Premier, ERIC, CINAHL, Web of Science, JSTOR, SCOPUS and PsycINFO] were searched to identify journal articles published from the start of each database to October 2012. RESULTS A total of 41 articles published from 1981 to 2012 were categorised into two main themes: (i) evaluation of current education on critical thinking and (ii) development of new strategies about critical thinking. Under each theme, the teaching strategies, assessment tools, uses of multimedia and stakeholders were analysed. DISCUSSION While a majority of studies developed teaching strategies and multimedia tools, a further examination of their quality and variety could yield some insights. The articles on assessment placed a greater focus on learning outcomes than on learning processes. It is expected that more research will be conducted on teacher development and students' voices.
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Affiliation(s)
- Zenobia C Y Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Phone: +852 2766 6426, Fax: +852 2364 9663
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van der Wath AE, du Toit PH. Learning end-of-life care within a constructivist model: Undergraduate nursing students' experiences. Curationis 2015; 38:1537. [PMID: 26842079 PMCID: PMC6091757 DOI: 10.4102/curationis.v38i2.1537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 10/09/2015] [Accepted: 09/10/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Although nursing education aims to equip nursing students to provide care to dying patients and their families, nurses often feel ill-prepared to cope with the emotional labour involved in end-of-life care. OBJECTIVES The aim of the study was to explore and describe nursing students' experiences of end-of-life care through experiential learning within a constructivist educational model. METHOD A qualitative, descriptive design was used. As part of introducing experiential learning, innovative educational practices were initiated during a second year level undergraduate nursing module on end-of-life care. Qualitative data on second-year nursing students' experiences were collected through written reflections and analysed using open coding. RESULTS The themes that emerged revealed participants' sensory and emotional experiences during the learning opportunities. Participants reflected on what they learnt and clarified their values related to death and dying. They indicated how they would apply the new meanings constructed in clinical practice. CONCLUSION A constructivist educational model of experiential learning holds potential to enhance value clarification and nursing students' sensory and emotional awareness of death and dying. Experiential learning is recommended to develop nursing students' competency inproviding end-of-life care.
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Carrasco JM, Lynch TJ, Garralda E, Woitha K, Elsner F, Filbet M, Ellershaw JE, Clark D, Centeno C. Palliative Care Medical Education in European Universities: A Descriptive Study and Numerical Scoring System Proposal for Assessing Educational Development. J Pain Symptom Manage 2015; 50:516-23.e2. [PMID: 26025273 DOI: 10.1016/j.jpainsymman.2015.04.019] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT The lack of palliative medicine (PM) education has been identified as a barrier to the development of the discipline. A number of international institutions have called for its implementation within undergraduate medical curricula. OBJECTIVES The objectives are to describe the situation of undergraduate PM education in Europe and to propose a scoring system to evaluate its status. METHODS This descriptive study was conducted with data provided by key experts from countries of the World Health Organization European Region (n = 53). A numerical scoring system was developed through consensus techniques. RESULTS Forty-three countries (81%) provided the requested information. In 13 countries (30%), a PM course is taught in all medical schools, being compulsory in six of them (14%). In 15 countries (35%), PM is taught in at least one university. In 14 countries (33%), PM is not taught within medical curricula. A full professor of PM was identified in 40% of countries. Three indicators were developed to construct a scale (rank 0-100) of educational development: 1) proportion of medical schools that teach PM (weight = 32%); 2) proportion of medical schools that offer PM as a compulsory subject (weight = 40%); 3) total number of PM professors (weight = 28%). The highest level of PM educational development was found in Israel, Norway, the U.K., Belgium, France, Austria, Germany, and Ireland. CONCLUSION PM is taught in a substantial number of undergraduate medical programs at European universities, and a qualified teaching structure is emerging; however, there is a wide variation in the level of PM educational development between individual countries.
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Affiliation(s)
- José Miguel Carrasco
- ATLANTES Research Programme, Institute for Culture and Society at the University of Navarra, Pamplona, Spain.
| | - Thomas J Lynch
- Department of Anaesthesiology and Critical Care Medicine & Palliative Care Program, Kimmel Cancer Center, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Eduardo Garralda
- ATLANTES Research Programme, Institute for Culture and Society at the University of Navarra, Pamplona, Spain
| | - Kathrin Woitha
- ATLANTES Research Programme, Institute for Culture and Society at the University of Navarra, Pamplona, Spain
| | - Frank Elsner
- Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany
| | - Marilène Filbet
- Palliative Care Department, Academic University Hospital Lyon Sud HCL, Lyon, France
| | - John E Ellershaw
- Marie Curie Palliative Care Institute, University of Liverpool, Liverpool, United Kingdom
| | - David Clark
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, United Kingdom
| | - Carlos Centeno
- ATLANTES Research Programme, Institute for Culture and Society at the University of Navarra, Pamplona, Spain
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19
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Jafari M, Rafiei H, Nassehi A, Soleimani F, Arab M, Noormohammadi MR. Caring for dying patients: attitude of nursing students and effects of education. Indian J Palliat Care 2015; 21:192-7. [PMID: 26009673 PMCID: PMC4441181 DOI: 10.4103/0973-1075.156497] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Background: Education about caring for dying patients could be effective in changing nursing students’ attitude toward caring for dying patients. Aim: The aim of the present study was to examine the nursing students’ attitude toward caring for dying patients and effects of education on their attitude. Materials and Methods: The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD) scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS) 18 software. Results: Of 32 students, 30 participated in this study (response rate of 94%). Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students’ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33) (P < 0.001). Conclusion: Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students’ knowledge about caring for dying patients and the effect of education on their knowledge.
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Affiliation(s)
- Mojtaba Jafari
- Department of Medical and Surgical Nursing, Faculty of Nursing and Midwifery, Bam University of Medical Sciences, Bam, Iran
| | - Hossein Rafiei
- School of Nursing and Midwifery, Qazvin University of Medical Science, Qazvin, Iran
| | - Asra Nassehi
- Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mansuor Arab
- Department of Medical and Surgical Nursing, Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Bassah N, Seymour J, Cox K. A modified systematic review of research evidence about education for pre-registration nurses in palliative care. BMC Palliat Care 2014; 13:56. [PMID: 25859159 PMCID: PMC4391725 DOI: 10.1186/1472-684x-13-56] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 11/19/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND We undertook a modified systematic review of research regarding educational approaches to and effectiveness of pre-registration palliative care nursing, to inform the development of a short course in palliative care for pre-registration nursing students in Cameroon. The aim of this review was to examine educational approaches applied to pre-registration palliative care nursing education and their effectiveness, and to discuss implications for the development of palliative care curricula in resource-poor countries. METHOD A modified systematic review of research on palliative care educational interventions, conducted with pre-registration student nurses was undertaken. Relevant literature was gathered from CINAHL, EMBASE, MEDLINE and PsychINFO databases for the period 2000-2013. Inclusion was limited to studies of educational interventions evaluating the effectiveness and outcomes of palliative and end of life care education with pre-registration student nurses. RESULTS 17 studies were found, all of which were conducted in resource-rich countries: United States of America, Canada, Australia, and United Kingdom. Palliative care nursing education at pre-registration level is either delivered as a discrete course within the curriculum or palliative care content is embedded into other nursing specialty courses throughout the wider curriculum. Palliative care education is delivered to students at a variety of stages in their nursing program, using a mix of both didactic and experiential educational strategies. Course facilitators span palliative care specialists, educators who have attended 'train-the-trainer' courses in palliative care, and nurses with hospice experience. Education is underpinned by transformative and experiential learning theories and reported as effective in improving students' attitudes towards care of the dying. CONCLUSION The educational strategies identified in this review may be applicable to resource-poor countries. However, there are challenges in transferability because of the lack of availability of specialist palliative care practitioners who can serve as educators, specialist palliative care units/institutions for experiential learning, funds to design and use high fidelity simulations, and palliative care textbooks and other educational materials. There is thus a need for innovative educational strategies that can bridge these barriers in resource-poor countries. There is also a need for further research into how palliative care education impacts on pre-registration student nurses' knowledge and practice.
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Affiliation(s)
- Nahyeni Bassah
- School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Jane Seymour
- School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
| | - Karen Cox
- School of Health Sciences, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
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Cavaye J, Watts JH. Student Nurses Learning about Death, Dying, and Loss: Too Little, Too Late? ACTA ACUST UNITED AC 2014. [DOI: 10.2190/il.22.4.c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Concerns about the care provided to people dying from life-threatening illness have prompted a number of international reforms to improve the quality of palliative and end-of-life (EOL) care. The majority of this care is provided by nurses. They spend more time with dying patients than any other health professionals and therefore, need specific clinical skills and knowledge. Palliative and EOL care education is increasingly being positioned as a specialism, available only to a small number of registered nurses as part of continuing professional development. However, increasing numbers of patients with life-threatening illness are being treated in non-specialist settings by nurses with a generalist education. Furthermore, undergraduate nurse education has traditionally had a limited focus on palliative and EOL care, hence claims that undergraduate nursing curricula are inadequate. Drawing on an international literature, this review explores the evidence about the adequacy of undergraduate curricula in this area. It considers the extent to which palliative and EOL curriculum is included in undergraduate nurse education and draws upon evidence from students and registered nurses, who as consumers of education, report feeling unprepared to care for and communicate with, dying patients.
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Mutto EM, Bunge S, Vignaroli E, Bertolino M, Villar MJ, Wenk R. Medical Students' Palliative Care Education in a Latin American University: A Three-Year Experience at Austral University in Buenos Aires, Argentina. J Palliat Med 2014; 17:1137-42. [DOI: 10.1089/jpm.2013.0673] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Eduardo Mario Mutto
- Department of Palliative Medicine, Universidad Austral, Buenos Aires, Argentina
| | - Sofía Bunge
- Fundación FEMEBA (PAMP), Buenos Aires, Argentina
| | | | | | | | - Roberto Wenk
- Fundación FEMEBA (PAMP), Buenos Aires, Argentina
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Ballesteros M, Centeno C, Arantzamendi M. A qualitative exploratory study of nursing students' assessment of the contribution of palliative care learning. NURSE EDUCATION TODAY 2014; 34:e1-e6. [PMID: 24461389 DOI: 10.1016/j.nedt.2013.12.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 11/20/2013] [Accepted: 12/26/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVE We explored the contribution of optional palliative care (PC) learning to the training of undergraduate nursing students. DESIGN This is a qualitative, exploratory study. PARTICIPANTS PC students from two universities (n=236) responded to the open question: What was the contribution of the PC course to your training? METHODS A thematic analysis of the respondents' answers was performed with investigator triangulation. FINDINGS Four themes were identified. Firstly, the PC course provided a comprehensive view of the nursing discipline. Secondly, the course helped the students to know how to interact with, communicate with and better understand patients. Thirdly, the contribution of the course to the students' personal growth prompted them to reflect personally on death, thus promoting self-awareness. Finally, the students considered the PC course to be of great importance in the nursing curriculum. CONCLUSION Nursing students believed that a PC course was an essential component in their training, which contributed favourably to their personal and professional development.
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Affiliation(s)
- Montserrat Ballesteros
- University of Navarra, Institute for Culture and Society (ICS), ATLANTES Research Program, Pamplona, Spain; Nursing Department of the University of Valladolid, Spain.
| | - Carlos Centeno
- University of Navarra, Institute for Culture and Society (ICS), ATLANTES Research Program, Pamplona, Spain; University of Navarra, Clínica Universidad de Navarra, Department of Palliative Medicine and Symptom Management, Pamplona, Spain.
| | - Maria Arantzamendi
- University of Navarra, Institute for Culture and Society (ICS), ATLANTES Research Program, Pamplona, Spain; Faculty of Nursing, Pamplona, Spain.
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An Integrated Literature Review of Death Education in Pre-Registration Nursing Curricula: Key Themes. ACTA ACUST UNITED AC 2014. [DOI: 10.1155/2014/564619] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recent policy has raised the profile of end-of-life care internationally, with the aim of increasing access to quality care for everyone experiencing life-limiting illness. This reflects an international shift in the provision of palliative care to encompass chronic conditions other than cancer. Nurses have an important role in delivering this care and need to be equipped with particular knowledge and skills. However, pre-registration nursing curricula have traditionally had a limited emphasis on death and dying and nurses report feeling unprepared to care for dying patients. This has led to claims that death education in pre-registration curricula is inadequate. This integrated review explores the published literature that reports on death education within pre-registration nurse education. Presenting an international overview, the aim of the review is to contribute to knowledge about the nature and extent of death education in pre-registration curricula. In the context of this paper, death education encompasses both palliative and end-of-life care. Electronic searches of major bibliographic databases found inconsistencies across educational provision with variations in quantity, content, and approach. Despite an increasing amount of death education in pre-registration curricula, there remains a deficit in key areas such as knowledge, skills, organisation of care, and teamwork.
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Wechter E, O'Gorman DC, Singh MK, Spanos P, Daly BJ. The Effects of an Early Observational Experience on Medical Students’ Attitudes Toward End-of-Life Care. Am J Hosp Palliat Care 2013; 32:52-60. [DOI: 10.1177/1049909113505760] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
End-of-life care is paramount in maintaining the quality of life of the terminally ill, protecting them from unnecessary treatment, and controlling costs incurred in their care. Training doctors to be effective end-of-life caregivers begins in medical school. A survey design was used to collect data from 166 first-year medical students before and after exposure to hospice or palliative care through an early clinical exposure program. Data demonstrated that students had a significant change in attitude scores after the observational experience ( P < .05). Providing students with the opportunity to observe and participate in end-of-life care has a positive effect on attitudes toward the care of dying persons. We recommend that direct exposure to end-of-life care practices be incorporated early in the medical school curriculum.
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Affiliation(s)
- Elizabeth Wechter
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | | | - Pete Spanos
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Barbara J. Daly
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Current World Literature. Curr Opin Support Palliat Care 2012; 6:402-16. [DOI: 10.1097/spc.0b013e3283573126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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