Dataset Information

Examining the effect of non-specialised clinical rotations upon medical students' Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools.

ABSTRACT:

Introduction

Including palliative care (PC) in overloaded medical curricula is a challenge, especially where there is a lack of PC specialists. We hypothesised that non-specialised rotations could provide meaningful PC learning when there are enough clinical experiences, with adequate feedback.

Objective

Observe the effects of including PC topics in non-specialised placements for undergraduate medical students in two different medical schools.

Design

Observational prospective study.

Setting

Medical schools in Brazil.

Participants

134 sixth-year medical students of two medical schools.

Methods

This was a longitudinal study that observed the development of Self-efficacy in Palliative Care (SEPC) and Thanatophobia (TS) in sixth-year medical students in different non-specialised clinical rotations in two Brazilian medical schools (MS1 and MS2). We enrolled 78 students in MS1 during the Emergency and Critical Care rotation and 56 students in MS2 during the rotation in Anaesthesiology. Both schools provide PC discussions with different learning environment and approaches.

Primary outcomes

SEPC and TS Scales were used to assess students at the beginning and the end of the rotations.

Results

In both schools' students had an increase in SEPC and a decrease in TS scores.

Conclusion

Non-specialised rotations that consider PC competencies as core aspects of being a doctor can be effective to develop SEPC and decrease TS levels.

SUBMITTER: Gryschek G

PROVIDER: S-EPMC7677329 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Examining the effect of non-specialised clinical rotations upon medical students' Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools.

Gryschek Guilherme G Cecilio-Fernandes Dario D Barros Guilherme Antonio Moreira de GAM Mason Stephen S de Carvalho-Filho Marco Antonio MA

BMJ open 20201118 11

<h4>Introduction</h4>Including palliative care (PC) in overloaded medical curricula is a challenge, especially where there is a lack of PC specialists. We hypothesised that non-specialised rotations could provide meaningful PC learning when there are enough clinical experiences, with adequate feedback.<h4>Objective</h4>Observe the effects of including PC topics in non-specialised placements for undergraduate medical students in two different medical schools.<h4>Design</h4>Observational prospecti ...[more]

PMID: 33208334

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Project description:BackgroundSeveral lines of evidence indicate that medical schools have been failing to adequately nurture empathy and the ethical dimension in their graduates, the lack of which may play a central role in the genesis of medical errors, itself a major source of avoidable deaths, incapacity and wasted resources. It has been widely proposed that medical schools should adopt evaluation strategies as a means to promote a culture of respectful relationships. However, it is not clear if evaluation strategies in medical schools have addressed key domains related to that aim, such as ethics, through the perspective of their students. Hence, we conducted a national survey of instruments used by Brazilian medical schools to assess clerkship rotations from the perspective of students, with a main focus on the ethical domain.MethodsThe authors invited 121 randomly selected institutions to participate in the study. Key informants answered a questionnaire about clerkship rotations and sent copies of any instrument used to assess the quality of clerkship rotations according to the students' perspectives.ResultsTwenty-six (53%) of 49 participating schools used an instrument to assess the quality of clerkship rotations according to the perspective of students. Just 13 (27%) schools had instruments containing at least one question encompassing the ethical domain. Only 2 (4%) schools asked students specifically about the occurrence of any negative experience concerning the ethical domain during rotations. Merely 1 (2%) school asked students about having witnessed patient mistreatment and none asked about mistreatment against students themselves.ConclusionsThere are several missed opportunities in the way medical schools assess the quality of clerkship rotations regarding the ethical domain. Closing the gap between usual institutional discourses regarding ethics and how that dimension is assessed within clerkship rotations might represent an important step towards the improvement of medical education and healthcare systems.

Project description:BACKGROUND:Empathy is paramount in the doctor-patient relationship being a comprehensive and multidimensional concept. Self-ratings of empathy change across the years of medical education only when the Jefferson Scale of Physicians Empathy is used, with a worrying decrease being found throughout the years in Medicine Schools. As there are only few studies on the factors influencing medical student's empathy, particularly of the curricular model, this study aimed to compare the levels of empathy of medicine students of two Schools with different curricular models in central Portugal, the Faculty of Medicine - University of Coimbra (FMUC) and the Faculty of Health Sciences - University of Beira Interior (FCS-UBI). METHODS:Cross-sectional observational study with the Jefferson Scale of Physician Empathy - students' Portuguese version (JSPE - spv) to 1st, 3rd and 6th year students of the 2017/2018 academic year with descriptive and inferential statistical analysis (p?<?0.05). RESULTS:Size representative sample of 795 students. Higher total empathy score (TES) (p?=?0.008) and "Perspective taking" (p?=?0.001) in FCS-UBI were found. JSPE-TES was higher in FCS-UBI, 3rd year (p?=?0.038). Higher FCS-UBI "Perspective taking" in the 1st year (p?=?0.030) and 6th year (p?=?0.044), for "Compassionate care" in the 3rd (p?=?0.019) and for "Standing in the patient's shoes" in the 1st year (p?=?0.018) and in FMUC for "Compassionate care" in the 1st year (p?=?0.037) and the "Standing in the patient's shoes" in year 3 (p?=?0.002) were found. Higher levels of empathy were found in FCS-UBI female students, for JSPE-TES (p?=?0.045) and "Perspective taking" (p?=?0.001). CONCLUSION:Higher empathy levels in FCS-UBI were found, with different results in the third year suggesting influence of the medical course teaching characteristics between the two Medicine schools, student's empathy levels being higher when earlier and more intense contact with patients accompanied by skilled tutors was developed.

Dataset Information

Examining the effect of non-specialised clinical rotations upon medical students' Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools.

Introduction

Objective

Design

Setting

Participants

Methods

Primary outcomes

Results

Conclusion

Publications

Examining the effect of non-specialised clinical rotations upon medical students' Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools.

Similar Datasets

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