Palliative care education in Swiss undergraduate medical curricula: a case of too little, too early

Abstract

Palliative medicine education is an important strategy in ensuring that the needs of terminally ill patients are met. A review was conducted in 2007 of the undergraduate curricula of all five of Switzerland's medical schools to identify their palliative care-related content and characteristics. The average number of mandatory hours of palliative care education is 10.2 h (median 8 h; range 0-27 h), significantly short of the 40 h recommended by the European Palliative Care Association's Education Expert Group. The median time allocated to designated palliative care blocks is 3 h (range 0-8 h). Most of the education occurs before the clinical years, and there are no mandatory clinical rotations. Three schools offer optional clinical rotations but these are poorly attended (<10% of students). Although a number of domains are covered, ethics-related content predominates; 21 of a total of 51 obligatory hours (41%). Communication related to palliative care is largely limited to 'breaking bad news'. In two of the schools, the teaching is done primarily by palliative care physicians and nurses (70% or more of the teaching). In the others, it is done mostly by educators in other clinical specialties and ethics (approximately 90% of the teaching). These findings show significant deficiencies

The impact of a medical undergraduate student-selected module in palliative care

“…The suggestion that the module should be core curriculum is likely to reflect the relative lack of palliative care content in the core curriculum, but may also be influenced by the fact that this is a self-selected cohort of students. It has been previously reported that optional modules in palliative care have variable uptake 15. In this study, the module was found to be a popular choice, and those who took the module were very appreciative of the opportunity to obtain further education in this area.…”

Improving medical graduates&#39; training in palliative care: advancing education and practice

“…In addition to this study, Germany, Switzerland, and England have cataloged the current state of palliative care programs, including progress toward broader implementation. 7 – 11 Reports from Ireland, Spain, Italy, Switzerland, England, and Germany 7 , 8 , 12 – 14 demonstrate a broad recognition of the need for improved palliative care training. Studies conducted in Spain, Germany, and France reveal both a lack of sufficient knowledge and skills and a strong desire by medical trainees to get more palliative care education.…”

“…2013;10(2):22–31. 7 Kaufert J, R, Schwartz K,Labine L, Lutfiyya Z, Pearse C. End-of-life ethics and disability: differing perspectives on case-based learning. Med Health Care Philos .…”

Die Münchner Erklärung – Eckpunkte zur Etablierung der Lehre im neuen Querschnittsbereich 13: Palliativmedizin an deutschen Fakultäten

“…Even if our goal is to teach 40 hours of palliative content in total in accordance with the requirements of the European Association for Palliative Care (EAPC), one must be aware, however, that this goal has not been achieved in neighbouring European countries either [13], [14]. This should not lead to flagging efforts but rather serve as an incentive to achieve the common goal step by step through comparison and exchange with our neighbours.…”