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Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

16.11. - 18.11.2007, Hannover

Bringing Evidence to Palliative Care Education: Evaluation of a New Palliative Care Curriculum in a Quasi-experimental Study

Evidenz in der Palliative Care Lehre: Evaluation eines Neuen Curriculums "Palliativmedizin" in einer Quasi-experimentellen Studie


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Jahrestagung der Gesellschaft für Medizinische Ausbildung - GMA. Hannover, 16.-18.11.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gma47

The electronic version of this article is the complete one and can be found online at:

Published: November 14, 2007

© 2007 Mitzkat et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: To meet the requirements of modern health care, physicians are called upon not only to deliver curative but also palliative medical care. However, palliative care issues are underrepresentated in undergraduate medical teaching. At Witten/Herdecke University, an evidence based curriculum with 33 teaching units was implemented in the basis curriculum of 4th year medical students. To measure the effects of the curriculum it was evaluated in a longitudinal controlled study.

Aims: To determine the preparation of students regarding palliative care issues before and after the palliative care curriculum and to evaluate teaching regarding effectiveness and efficiency in the program.

Methods: Main outcome measure was self-reported palliative care competencies using a pre-, post- and post-pre-program data collection with an online questionaire ( The questionnaire was developed on the basis of the Harvard Medical School Instrument, the Collet-Lester Fear of Death Scale and the Thanaphobia Scale Assessment. The instruments were adapted and translated into German. Validity was tested by pretest and a Delphi process. The definite instrument comprised a 70-items questionnaire using 5-Point-Likert-Scales. Categories were: self-reported competencies in palliative care issues, personal attitudes and fears towards palliative care, death, dying, self-reported preparation for communicating with the dying patient and his relatives and preparation to perform adequate pain- and symptom control. Additionally, the intervention group evaluated each course by a standardised evaluation-form.

Setting: The study took place between September 2006 and April 2007 at Witten Herdecke/University. Intervention period was October 2006 until March 2007. The intervention group (n=41) was assigned to the 33 teaching units palliative care curriculum. The control group copmrised 42 3rd year medical students.

Results: Results are preliminary as data analysis is still in progress and will be finished until July 2007. A total of 43 students completed the pre-program-questionnaire, 37 completed both questionnaires. Pre-program, no significant difference in self-reported preparation were found between the two groups. The intervention group showed an marked increase of self-reported confidence especially regarding communication with the dying patient and symptom management in palliative care. In contrast, the control group didn't show any competence shift. Evaluation of the individual courses showed, that all themes offered where regarded as very important for the medical practice and found adequately presented regarding the student's level of education.

Discussion: The palliative care curriculum targets knowledge, skills and attitudes of the students regarding palliative care issues. At this point, the study shows an increase of self-reported confidence. More results are to follow. However, with this assessment instrument no conclusion can be drawn concerning skills and knowledge. To evaluate these aspects, it will be necessary to use other instruments. A follow-up study will use additional tools apart from the questionnaire (attitude) for assessing knowledge (written test) and skills (OSCE).

Our oral presentation will introduce the study, present the extended results and discuss opportunities and drawbacks of assesing effectiveness and efficiency in undergraduate medical education programs by the example of palliative care education.