Evaluating an evidence-based curriculum in undergraduate palliative care education: piloting a phase II exploratory trial for a complex intervention

BMC Medical Education

Research Article

Mischa F Möller¹  Martin W Schnell¹  Daniel Seidler²  Christian Schulz³ 

[1] Institute for Ethics and Communication in Healthcare Systems, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, D-58448, Witten, Germany;University Dusseldorf, Medical Faculty, Clinical Institute for Psychosomatic Medicine and Psychotherapy, Moorenstraße 5, D-40225, Dusseldorf, Germany;University Dusseldorf, Medical Faculty, Interdisciplinary Centre for Palliative Medicine, Moorenstraße 5, D-40225, Dusseldorf, Germany;University Dusseldorf, Medical Faculty, Clinical Institute for Psychosomatic Medicine and Psychotherapy, Moorenstraße 5, D-40225, Dusseldorf, Germany;

关键词: Medical Student;    Palliative Care;    Medical Curriculum;    Palliative Care Patient;    Naturalistic Design;   

DOI  :  10.1186/1472-6920-13-1

 received in 2012-02-08, accepted in 2012-12-11,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundBy 2013 Palliative Care will become a mandatory examination subject in the medical curriculum in Germany. There is a pressing need for effective and well-designed curricula and assessment methods. Debates are on going as how Undergraduate Palliative Care Education (UPCE) should be taught and how knowledge and skills should be assessed. It is evident by this time that the development process of early curricula in the US and UK has led to a plethora of diverse curricula which seem to be partly ineffective in improving the care for the seriously ill and dying offered by newly qualified doctors, as is demonstrated in controlled evaluations. The goals of this study were to demonstrate an evidence-based approach towards developing UPCE curricula and investigate the change in medical students’ self-perceived readiness to deal with palliative care patients and their families.MethodsTo evaluate the effects of the UPCE curriculum we chose a prospective, controlled, quasi-experimental, pre, retrospective-pre, post study design. A total of n = 37 3rd and 4th –year medical students were assigned to the intervention group (n = 15; 4th -year) and to the control group (n = 22; 3rd-year). Resting on the self-efficacy concept of Bandura the measurement was conducted by a refined test-battery based on two independent measurements (the revised Collet-Lester-Fear-of-Death-Scale and the instrument of the “Program in Palliative Care Education and Practice” at Harvard Medical School) including 68 items altogether in a five-point Likert-scale. These items were designed to test elementary skills in caring for the dying and their relatives as perceived by medical undergraduates. Datasets from both groups were analysed by paired and independent two-sample t-test. The TREND statement for reporting non-randomized evaluations was applied for reporting on this quasi-experimental study.ResultsThree constructs showed statistically significant differences comparing the intervention group before and after. Willingness to accompany a dying patient increased from 21.40 to 37.30 (p < .001). Self-estimation of competence in communication with dying patients and their relatives increased from 12.00 to 23.60 (p = .001). Finally, self-estimation of knowledge and skills in Palliative Care increased from 8.30 to 13.20 (p = .001).ConclusionsThis study is a small but systematic step towards rigorous curricular development in palliative care. Our manualised curriculum is available for scrutiny and scientific feedback to support an open and constructive process of best-practice comparison in palliative care.

【 授权许可】

Unknown   
© Schulz et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.