Palliative and end of life care communication as emerging priorities in postgraduate medical education
Roze des Ordons, Amanda, Ajjawi, Rola, Macdonald, John, Sarti, Aimee, Lockyer, Jocelyn and Hartwick, Michael 2016, Palliative and end of life care communication as emerging priorities in postgraduate medical education, Canadian medical education journal, vol. 7, no. 1, pp. e4-e21.
BACKGROUND: Reliance on surveys and qualitative studies of trainees to guide postgraduate education about palliative and end of life (EOL) communication may lead to gaps in the curriculum. We aimed to develop a deeper understanding of internal medicine trainees' educational needs for a palliative and EOL communication curriculum and how these needs could be met.
METHODS: Mixed methods, including a survey and focus groups with trainees, and interviews with clinical faculty and medical educators, were applied to develop a broader perspective on current experiences and needs for further education. Quantitative descriptive and thematic analyses were conducted.
RESULTS: Surveyed trainees were least confident and least satisfied with teaching in counseling about the emotional impact of emergencies and discussing organ donation. Direct observation with feedback, small group discussion, and viewing videos of personal consultations were perceived as effective, yet infrequently identified as instructional methods. Focus groups and interviews identified goals of care conversations as the highest educational priority, with education adapted to learner needs and accompanied by feedback and concurrent clinical and organizational support.
CONCLUSIONS: Our work expands on previous research describing needs for postgraduate education in palliative and EOL communication to include the importance of support, culture change, and faculty development, and provides insight into why such needs exist.
Field of Research
130209 Medicine, Nursing and Health Curriculum and Pedagogy 130202 Curriculum and Pedagogy Theory and Development
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