Palliative Care in Undergraduate Medical Education: Status Report and Future Directions
Billings, J. Andrew
JAMA. 1997 Sep 3; 278(9): 733-738.
OBJECTIVE: To describe the status of palliative care education in the undergraduate medical curriculum and to offer recommendations for improvement. DATA SOURCES: Review of literature on palliative care and of recently submitted grants on medical education for end-of-life care. STUDY SELECTION: English-language reports of educational programs targeted toward medical students were examined, as well as surveys of medical schools. DATA EXTRACTION: Studies were reviewed by the authors to assess the quality of the educational program, evaluation methodology, and conclusions. From over 9000 citations on palliative care and related topics that were retrieved from MEDLINE searches from 1980 through 1995, and from reviewing 14 palliative care journals published from 1985 through 1996, 310 articles were identified that addressed medical education for end-of-life care, and 180 were carefully examined. DATA SYNTHESIS: While nearly all medical schools offer some formal teaching about end-of-life care, there is considerable evidence that current training is inadequate, most strikingly in the clinical years. Teaching about palliative care is received favorably by students, positively influences student attitudes, and enhances communication skills. However, curricular offerings are not well integrated; the major teaching format is the lecture; formal teaching is predominantly preclinical; clinical experiences are mostly elective; there is little attention to home care, hospice, and nursing home care; role models are few; and students are not encouraged to examine their personal reactions to these clinical experiences. CONCLUSIONS: The increasing attention to palliative care education has created major opportunities for improving education about care at the end of life. Educational programs should be rigorously evaluated to identify best educational practices.
Attitudes; Attitudes to Death; Autonomy; Communication; Competence; Curriculum; Death; Decision Making; Education; Emotions; Empirical Research; Ethics; Evaluation; Faculty; Guidelines; Home Care; Hospices; Hospitals; Humanism; Internal Medicine; Internship and Residency; Life; Literature; Medical Education; Medical Ethics; Medical Schools; Medical Students; Medicine; Methods; Pain; Palliative Care; Patient Care; Patient Care Team; Physicians; Professional Competence; Research; Review; Residency; Schools; Standards; Statistics; Students; Surveys; Teaching Methods; Terminal Care; Terminally Ill; Terminology; Trends;
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Billings, J. Andrew; Block, Susan (1997-09-03)
Teaching and Learning End-of-Life Care: Evaluation of a Faculty Development Program in Palliative Care Sullivan, Amy M.; Lakoma, Matthew D.; Billings, J. Andrew; Peters, Antoinette S.; Block, Susan D. (2005-07)
Block, Susan; Billings, J. Andrew (1998-07)After many years of neglect by the medical establishment, the discipline of palliative medicine is finally moving into academic health centers (AHCs). While hospice programs have cared for dying patients in the community ...