BMC Medical Education | |
Undergraduate education in palliative medicine in Germany: a longitudinal perspective on curricular and infrastructural development | |
Christine Schiessl3  Alexandra Scherg6  Alexander Laske5  Johanna Hildebrandt2  Frank Elsner7  Isabel Kiesewetter8  Bernd Alt-Epping4  Benjamin Ilse1  | |
[1] Department of Neurology, University Medical Center, Göttingen, Germany;Vestische Children’s Hospital, University of Witten/ Herdecke, Datteln, Germany;Algesiologikum - Pain Center, Munich, Germany;Department of Palliative Medicine, University Medical Center, Göttingen, Germany;Sana Arztpraxen Rügen, Bergen, Germany;Interdisciplinary Centre for Palliative Medicine, University Hospital Dusseldorf, Dusseldorf, Germany;Department of Palliative Medicine, Uniklinik RWTH Aachen University, Aachen, Germany;Department of Anesthesiology, Munich University Hospital, Munich, Germany | |
关键词: Undergraduate education; German medical faculties; Implementation process; Cross-sectional subject; Palliative medicine; | |
Others : 1225411 DOI : 10.1186/s12909-015-0439-6 |
|
received in 2015-03-16, accepted in 2015-09-11, 发布年份 2015 | |
【 摘 要 】
Background
In 2009, palliative medicine became an integrated and compulsory part of undergraduate training in Germany by legislation. After a transitional period, all medical faculties were required to provide adequate teaching with an according examination and certification procedure. In parallel, we conducted bi-annual surveys on all medical faculties in Germany to examine for potential discrepancies between the implementation process and their intended consequences on teaching time and content.
Methods
Four consecutive bi-annual surveys (2006, 2008, 2010, 2012) of all 36 medical faculties in Germany were performed, using purposively for this study developed questionnaires. Likert scales and closed questions were analyzed descriptively.
Results
Medical Faculty response rate increased from 50 % in 2006 to 88.9 % in 2012. Teaching coordinators in palliative medicine primarily had an anesthesiology or internal medicine background. There was a noted increase over time of the involvement of specialized palliative care units (PCUs) as providing the setting for education. The number of faculties that were able to offer a complete 16 weeks of training in palliative medicine during the “final year” rose steadily. In addition, increased patient-centered teaching formats have been implemented over time. The faculties which offered innovative teaching formats with actors as patients (standardized patient interaction) increased, as did the total number of mandatory examinations. The number of faculties that provided compulsory teaching in a condensed manner within a single academic year increased sharply from 3 of 31 responding faculties in 2010 to 19 of 32 responding faculties in 2012.
Conclusions
Until now, teaching conditions and structures in palliative medicine in Germany have proven to be extraordinarily heterogeneous. Although professorships (“Chairs”) in palliative medicine proved to be particularly beneficial and supportive in curricular and structural development, only a minority of faculties provide leading academic positions in palliative medicine.
【 授权许可】
2015 Ilse et al.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150920020039877.pdf | 381KB | download |
【 参考文献 】
- [1]Gamondi C, Larkin P, Payne S. Core competencies in palliative care: an EAPC white paper on palliative care education: part 1. Eur J Palliat Care. 2013; 20(2):86-91.
- [2]Gamondi C, Larkin P, Payne S. Core competencies in palliative care: an EAPC white paper on palliative care education: part 2. Eur J Palliat Care. 2013; 20(3):140-5.
- [3]Gibbins J, McCoubrie R, Forbes K. Why are newly qualified doctors unprepared to care for patients at the end of life? Med Educ. 2011; 45(4):389-99.
- [4]Weber M, Schmiedel S, Nauck F, Alt-Epping B. Knowledge and attitude of final - year medical students in Germany towards palliative care - an interinstitutional questionnaire-based study. BMC Palliat Care. 2011; 10:19. BioMed Central Full Text
- [5]Schiessl C, Walshe M, Wildfeuer S, Larkin P, Voltz R, Juenger J. Undergraduate curricula in palliative medicine: a systematic analysis based on the palliative education assessment tool. J Palliat Med. 2013; 16(1):20-30.
- [6]Laske A, Dietz I, Ilse B, Nauck F, Elsner F. Palliativmedizinische Lehre in Deutschland. Palliativmedizin. 2010; 11(01):18-25.
- [7]Deutsche Krebshilfe e.V. http://www.krebshilfe.de/nc/startseite.html. Accessed (Last accessed February 5, 2015).
- [8]Ilse B, Hildebrandt J, Posselt J, Laske A, Dietz I, Borasio GD et al.. Palliative care teaching in Germany - concepts and future developments. GMS Z Med Ausbild. 2012; 29(3):Doc47.
- [9]Schiessl C, Ilse B, Hildebrandt J, Scherg A, Giegerich A, Alt-Epping B. Implementation of intersectional field 13: a survey of medical faculties in Germany. Schmerz. 2013; 27(3):275-88.
- [10]2. Dozentenworkshop Q13 – Querschnittsbereich 13 Palliativmedizin: Pflichtlehre im Medizinstudium. Palliativmedizin. 2011;12(04):139. doi:10.1055/s-0031-1284758.
- [11]Cheng DR, Teh A. Palliative care in Australian medical student education. Med Teach. 2014; 36(1):82-3.
- [12]Horowitz R, Gramling R, Quill T. Palliative care education in U.S. medical schools. Med Educ. 2014; 48(1):59-66.
- [13]Oneschuk D, Moloughney B, Jones-McLean E, Challis A. The status of undergraduate palliative medicine education in Canada: a 2001 survey. J Palliat Care. 2004; 20(1):32-7.
- [14]Gibbins J, McCoubrie R, Maher J, Wee B, Forbes K. Recognizing that it is part and parcel of what they do: teaching palliative care to medical students in the UK. Palliat Med. 2010; 24(3):299-305.
- [15]Jeffrey EJ, Goddard J, Jeffrey D. Performance and palliative care: a drama module for medical students. Med Humanit. 2012; 38(2):110-4.
- [16]Anneser J, Kunath N, Krautheim V, Borasio GD. Needs, expectations, and concerns of medical students regarding end-of-life issues before the introduction of a mandatory undergraduate palliative care curriculum. Journal of palliative medicine. 2014.
- [17]Tai V, Cameron-Taylor E, Clark K. A mixed methodology retrospective analysis of the learning experience of final year medical students attached to a 1-week intensive palliative care course based at an Australian University. Am J Hosp Palliat Care. 2013; 31(6):636-40.
- [18]Billings JA, Block S. Palliative care in undergraduate medical education. Status report and future directions. JAMA. 1997; 278(9):733-8.
- [19]Pohl G, Marosi C, Dieckmann K, Goldner G, Elandt K, Hassler M, Ludwig H, Watzke H. Survey of palliative care concepts among medical students and interns in Austria: a comparison of the old and the new curriculum of the Medical University of Vienna. Palliat Care: Res Treat. 2008; 2:1-7.
- [20]Hildebrandt J, Ilse B, Schiessl C. “Traumcurriculum” - Wünsche Medizinstudierender an die Ausbildung in Palliativmedizin. Palliativmedizin. 2013; 14(02):80-4.
- [21]Schulz C, Moller MF, Seidler D, Schnell MW. Evaluating an evidence-based curriculum in undergraduate palliative care education: piloting a phase II exploratory trial for a complex intervention. BMC Med Educ. 2013; 13:1. BioMed Central Full Text
- [22]Becker G, Momm F, Gigl A, Wagner B, Baumgartner J. Competency and educational needs in palliative care. Wien Klin Wochenschr. 2007; 119(3–4):112-6.
- [23]Centeno C, Ballesteros M, Carrasco JM, Arantzamendi M. Does palliative care education matter to medical students? The experience of attending an undergraduate course in palliative care. BMJ Support Palliat Care. 2014. doi:10.1136/bmjspcare-2014-000646.
- [24]Sweeney C, Lynch G, Khashan A, Maher B, Murphy M, O’Brien T. The impact of a medical undergraduate student-selected module in palliative care. BMJ Support Palliat Care. 2014; 4(1):92-7.
- [25]Ostgathe C, Voltz R, Nauck F, Klaschik E. Undergraduate training in palliative medicine in Germany: what effect does a curriculum without compulsory palliative care have on medical students’ knowledge, skills and attitudes? Palliat Med. 2007; 21(2):155-6.