Palliative care: A proposal for undergraduate education in Medicine

Abstract

Objective: to propose essential competencies for the teaching of palliative care on undergraduate Medicine courses. Method: a documentary analysis of the literature on general competencies in palliative care was initially carried out, to construct a framework with suggestions of essential competencies for undergraduate education in Brazil. The elaborated material was then presented individually to eight professionals from a range of areas for analysis. All the professionals had specialized training in palliative care, and the material was accompanied by an interview with three open questions. The categorical thematic content analysis proposed by Bardin was used in the documentary analysis and the interviews with the professionals. Results: the initial documentary analysis resulted in five categories, eight subcategories and 96 units of analysis, based on which the researcher was able to construct the suggestions for competences, which were distributed with their respective contents in a framework with five modules. Six categories, 12 subcategories and 168 analysis units emerged from the interviews with the professionals following a reading of the material. From the discourse contained in the subcategories and units of analysis, suggestions emerged for a better distribution of the modules, resulting in the renaming of the same (Basic principles of palliative care, Symptom management, Teamwork, Ethical and legal issues, Care in the last moments of life). Conclusion: the discussion and improvement of the palliative care competencies suggested in this study will be essential at medical education forums, providing clarity about what is really required in general practitioner training.

Profissionais de enfermagem: compreensão sobre cuidados paliativos pediátricos

“…It is observed that Palliative Care began in Brazil only in the 80's, causing delay or even the inexistence of this issue in the curricular curricula of health care courses, which may justify the lack of knowledge presented in the speeches of the participants. 16 On the other hand, similar research was carried out with 159 Nursing professionals in a Spanish hospital of third level, pointing out, as a result, that the participants show a sufficient knowledge about the Palliative Care, a fact that can be justified by Spain include in the graduation, Palliative Care with a heterogeneous study plan on the subject, in addition to a postgraduate program. 17 It is understood, for many health professionals, the impossibility of cure as a justification for the execution of limited care, which confronts the principles of Palliative Care in which professionals must offer a support system that enables the patient to live as actively as possible, until the moment of his death, offering a support system to assist the family members.…”

“…The difficulty of health professionals in dealing with death in the current literature is highlighted, highlighting that it is associated to the traditional teaching method, centered on the cure and rehabilitation of the disease, in this way, often decontextualized from reality. 16 It is added that both the family members and the multiprofessional team suffer with the death of the child and, thus, seek to find mechanisms to face loss and mourning. 25 It is warned that in Palliative Care, understanding about the various forms of spirituality can be a positive strategy for English/Portuguese J Nurs UFPE online., Recife, 13(1):126-36, Jan., 2019 132…”

Validation of the Palliative Competency Tool: An Instrument To Qualify Medical Education (Validation of Palliative Competency Tool)

“…The inserted content should be based on consistent scienti c literature and demanded research time from the authors. However, the competencies required for basic palliative care are broad and numerous, and the degree of depth of the approach in medical training has rarely been described in the literature [24,25].…”

Médicos de Família e Cuidados Paliativos

“…Embora não tenhamos estabelecidas as competências em cuidados paliativos para a graduação médica, essa questão vem sendo discutida. 10,11 A seguir, consta a proposta dos autores em relação aos pré-requisitos:…”

“…Conhece os conceitos e princípios de CP: há inserção progressiva dos CP na graduação das escolas médicas. 10,12 Independentemente da especialização posterior, todo médico deve compreender os CP e como seus princípios se aplicam em diversos contextos da rede de atenção à saúde. É um tema que pode ser inserido a diversas disciplinas do curso médico: clínica, bioética, geriatria, cuidados intensivos, urgência e emergência, anestesiologia, oncologia, neurologia, pediatria, medicina de família, entre outros.…”