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      Palliative care training in undergraduate medical, nursing and allied health: a survey

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          Abstract

          Objectives

          Impending death is poorly recognised. Many undergraduate healthcare professionals will not have experience of meeting or caring for someone who is dying. As death can occur in any setting, at any time, it is vital that all healthcare students, regardless of the setting they go on to work in, have end-of-life care (EOLC) training. The aim was to determine current palliative care training at the undergraduate level, in multiple professions, in recognising and communicating dying.

          Methods

          Current UK undergraduate courses in medicine, adult nursing, occupational therapy, social work and physiotherapy were included. All courses received an email asking what training is currently offered in the recognition and communication of dying, and what time was dedicated to this.

          Results

          A total of 73/198 (37%) courses responded to the request for information. 18/20 medical courses provided training in recognising when patients were dying (median 2 hours), and 17/20 provided training in the communication of dying (median 3 hours). 80% (43/54) of nursing and allied health professional courses provided some training in EOLC. Many of the course organisers expressed frustration at the lack of resources, funding and time to include more training. Those courses with more palliative care provision often had a ‘champion’ to advocate for it.

          Conclusions

          Training in EOLC was inconsistent across courses and professions. Further research is needed to understand how to remove the barriers identified and to improve the consistency of current training.

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          Most cited references9

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          Recognizing that it is part and parcel of what they do: teaching palliative care to medical students in the UK.

          In their first year of work, newly qualified doctors will care for patients who have palliative care needs or who are dying, and they will need the skills to do this throughout their medical career. The General Medical Council in the United Kingdom has given clear recommendations that all medical students should receive core teaching on relieving pain and distress together with caring for the terminally ill. However, medical schools provide variable amounts of this teaching; some are able to deliver comprehensive programmes whilst others deliver very little. This paper presents the results of a mixed methods study which explored the structure and content of palliative care teaching in different UK medical schools, and revealed what coordinators are trying to achieve with this teaching. Nationally, coordinators are aiming to help medical students overcome the same fears held by the lay public about death, dying and hospices, to convey that the palliative care approach is applicable to many patients and is part of every doctors' role, whatever their specialty. Although facts and knowledge were thought to be important, coordinators were more concerned with attitudes and helping individuals with the transition from medical student to foundation doctor, providing an awareness of palliative medicine as a specialty and how to access it for their future patients.
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            Student nurses’ experience of and attitudes towards care of the dying: A cross-sectional study

            Nurses are the professional group with the greatest contact with those at the end of life and their attitudes towards the care of the dying is important in care delivery.
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              Educational needs of foundation doctors caring for dying patients.

              The aim of this study was to identify the educational needs of year one North of Scotland foundation doctors caring for dying patients. A postal questionnaire approach was used. The results from the questionnaire (79/132 respondents) confirmed that year one foundation doctors are frequently exposed to patient death, with 61% finding their most memorable patient death to be emotionally distressing. A quarter (26% ) of respondents had recent experience of significant personal bereavement. Communicating with patients and relatives at the end of life, concerns about overtreatment and lack of senior support were highlighted as particularly difficult issues. Educational needs of the foundation doctors were identified, emphasising the importance of emotional, analytical and personal competencies.
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                Author and article information

                Journal
                BMJ Support Palliat Care
                BMJ Support Palliat Care
                bmjspcare
                bmjspcare
                BMJ Supportive & Palliative Care
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2045-435X
                2045-4368
                October 2022
                20 November 2019
                : 12
                : e4
                : e489-e492
                Affiliations
                [1 ] departmentMarie Curie Palliative Care Research Department , University College London , London, UK
                [2 ] departmentPalliative Medicine , Brighton and Sussex University Hospitals NHS Trust , Brighton, UK
                [3 ] departmentPalliative Medicine , Central and North West London NHS Foundation Trust , London, UK
                Author notes
                [Correspondence to ] Dr Nicola White, Marie Curie Palliative Care Research Department, University College London, London W1T 7NF, UK; n.g.white@ 123456ucl.ac.uk
                Author information
                http://orcid.org/0000-0002-7438-0072
                http://orcid.org/0000-0001-5544-2672
                http://orcid.org/0000-0002-4258-8995
                http://orcid.org/0000-0002-1645-642X
                http://orcid.org/0000-0002-5765-9047
                Article
                bmjspcare-2019-002025
                10.1136/bmjspcare-2019-002025
                9510433
                31748200
                0be985e4-e758-427c-a6de-ab6227f9f0d1
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 03 September 2019
                : 10 October 2019
                : 04 November 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000654, Marie Curie Cancer Care;
                Award ID: MCCC-FPO-16-U
                Categories
                Short Report
                1506
                Custom metadata
                unlocked

                palliative care,education,death
                palliative care, education, death

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