ABSTRACT
BackgroundThe COVID-19 pandemic caused far-reaching disruption and medical education had to rapidly adapt to overcome the many challenges. Palliative and end of life care (PEOLC) is a core competency for all UK graduating medical students, and may involve emotionally confronting topics requiring great care during teaching sessions, which is potentially difficult in a virtual environment. The ability of medical schools to foster experiential PEOLC learning may also have been impacted. However, the pandemic may have been a catalyst for some positive changes in PEOLC teaching too. Questions relating to the pandemic were included as part of a larger national survey of PEOLC teaching.MethodAn anonymised web-based 46-item questionnaire was sent to the PEOLC Teaching Lead(s) at 35 UK medical schools. 12 items related to adaptations to teaching during the COVID-19 pandemic.ResultsResponses received from 31 schools. Previously popular teaching methods, such as lectures and seminars/small group discussions, were newly introduced in an online format in 94% and 87% of medical schools respectively. Utilisation of e-learning increased from 59% to 84%. Other newly introduced teaching methods included: telemedicine, podcasts, augmented reality, virtual reality, and virtual ward rounds. Use of experience in clinical areas as a teaching method decreased from 100% to 68% of medical schools. In 30% of schools, assessments were no longer in-person. 40% of participants declared that they had developed novel teaching methods or resources during the pandemic, mostly relating to technology enhanced learning or simulation. Many participants shared the opinion that the increased use of online resources and pre-recorded sessions will persist after the pandemic.ConclusionThe COVID-19 pandemic necessitated PEOLC teaching to rapidly transition online and the use of novel approaches to facilitate clinical experience, however a number of medical schools intend to continue utilising skills and resources developed during this time.
ABSTRACT
OBJECTIVES: Frailty is common and highly associated with morbidity and mortality, a fact that has been highlighted by COVID-19. Understanding how to provide palliative care for frail individuals is an international priority, despite receiving limited mention in Palliative Medicine curricula or examinations worldwide. This study aimed to synthesise evidence and establish expert consensus on what should be included in a Palliative-Medicine Specialist Training Curriculum for frailty. METHODS: Literature Meta-synthesis conducted by palliative medicine, frailty and education experts produced a draft curriculum with Bologna based Learning-Outcomes. A Delphi study asked experts to rate the importance of Learning-Outcomes for specialist-training completion and propose additional Learning-Outcomes. This process was repeated until 70% consensus was achieved for over 90% of Learning-Outcomes. Experts divided Learning-Outcomes into specific (for inclusion in a frailty subsection) or generic (applicable to other palliative conditions). The Delphi panel was Subject Matter Experts: Palliative-Medicine Consultants (n=14) and Trainees (n=10), representing hospital, community, hospice and care home services and including committee members of key national training organisations. A final reviewing panel of Geriatric Medicine Specialists including experts in research methodology, national training requirements and frailty were selected. RESULTS: The meta-synthesis produced 114 Learning-Outcomes. The Delphi Study and Review by Geriatric Medicine experts resulted in 46 essential and 33 desirable Learning-Outcomes. CONCLUSIONS: This frailty curriculum is applicable internationally and highlights the complex and unique palliative needs of frail patients. Future research is required to inform implementation, educational delivery and service provision.