Palliative care: A proposal for undergraduate education in Medicine

Scientific production about palliative care and communication in online journals: a scoping review

OBJECTIVES

to characterize publications about palliative care and communication, with an emphasis on the approaches addressed, disseminated in online journals.

METHODS

it is a scope review, in which the mnemonic strategy Problem, Concept and Context was used, based on database research. The sample consisted of 86 publications.

RESULTS

most publications were written in the English language, published in the journal BMC Palliative Care, and with level of evidence IV. As for the approaches approached, the following stand out: Importance of communication in palliative care; Breaking the bad news in palliative care; Training professionals/staff to communicate in palliative care; and Communication strategies in palliative care.

FINAL CONSIDERATIONS

the review made it possible to map a significant number of publications on palliative care and communication. It is recommended to produce new studies with better scientific evidence that guide the assistance of health professionals.

Assessing palliative care education in undergraduate medical students: translation and validation of the Self-Efficacy in Palliative Care and Thanatophobia Scales for Brazilian Portuguese

BACKGROUND

As the global population ages, palliative care is ever more essential to provide care for patients with incurable chronic conditions. However, in many countries, doctors are not prepared to care for dying patients. Palliative care education should be an urgent concern for all medical schools all around the world, including Latin America and Brazil. Advances in palliative care education require robust assessment tools for constant evaluation and improvement of educational programmes. Bandura's social cognitive theory proposes that active learning processes are mediated by self-efficacy and associated outcome expectancies, both crucial elements of developing new behaviour. The Self-Efficacy in Palliative Care (SEPC) and Thanatophobia Scales were developed using Bandura's theory to assess the outcomes of palliative care training.

OBJECTIVES

We aimed to translate and validate these scales for Brazilian Portuguese to generate data on how well doctors are being prepared to meet the needs of their patients.

DESIGN

Cross-sectional study.

SETTING

One Brazilian medical school.

PARTICIPANTS

Third-year medical students.

METHODS

The authors translated the scales following the European Organisation for Research and Treatment of Cancer's recommendations and examined their psychometric properties using data collected from a sample of 111 students in a Brazilian medical school in 2017.

RESULTS

The Brazilian versions of SEPC and Thanatophobia Scales showed good psychometric properties, including confirmatory factor analysis, replicating the original factors (factor range: 0.51-0.90), and acceptable values of reliability (Cronbach's alpha: 0.82-0.97 and composite reliability: 0.82-0.96). Additionally, the Brazilian versions of the scales showed concurrent validity, demonstrated through a significant negative correlation.

CONCLUSIONS

The Brazilian version of the scales may be used to assess the impact of current undergraduate training and identify areas for improvement within palliative care educational programmes. The data generated allow Brazilian researchers to join international conversations on this topic and educators to develop tailored pedagogical approaches.

Death and End of Life: Perceptions Throughout The Career About Death, Palliative Care, and Educational Process

PURPOSE

To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula.

METHOD

Cross-sectional study of 12 attending physicians, residents, and undergraduate medical students randomly selected from a single teaching hospital in São Paulo, Brazil, 2018. Semi-structured interviews were conducted, transcripts were coded in depth, and categorizing analysis was carried out.

RESULTS

Three topical categories were recognized: Negative feelings about death and the EoL, importance of PC, and gaps in curricular structure hindering preparedness for PC and EoL communication. Besides differing perspectives depending on their years of experience, all participants strongly endorsed that the current medical school curriculum does not train and support physicians to handle EoL and PC.

CONCLUSIONS

Medical education plays a fundamental role in the development of knowledge and skills on death, dying, and PC. Such practices should extend throughout the course and be continuously improved after graduates move to clinical practice.

Médicos de Família e Cuidados Paliativos

O panorama epidemiológico atual mostra um aumento de doenças crônicas ameaçadoras à vida, tornando os Cuidados Paliativos essenciais à prática médica, em todos os níveis de atenção. O papel do médico de família na atenção primária à sáude motivou a Sociedade Brasileira de Medicina de Família e Comunidade a elaborar um currículo baseado em competências, que incluiu os Cuidados Paliativos. Ao analisar e discutir as competências em Cuidados Paliativos, os autores identificaram a necessidade de melhorias e propuseram competências novas e ampliadas. A revisão periódica do currículo deve contemplar as mudanças e avanços na prática do médico de família e atender às demandas de cuidado, incluindo levar Cuidados Paliativos a todos.