gms | German Medical Science

Introduction: Undergraduate Palliative Care Education (UPCE) has become a mandatory topic during medical training in Germany. Challenges, such as large numbers of students relating to small numbers of experienced teachers and appropriate patients need to be considered during curricular development. Our goal was to explore the existing evidence from the user perspective on what constitutes successful and meaningful learning within the context of UPCE.

Methods: Systematic literature review (PRISMA-statement [1]) and qualitative synthesis. We searched PubMed and Google Scholar in 02/2014. The major search filter domains were “palliative care”, “values”, “education” and “medical student”. All study types published between 01/2000 to 01/2014 were included. Additionally, hand searching of German journals (z.B. Zeitschrift für Palliativmedizin) was conducted. Qualitative analysis was based on Thomas´ recommendations concerning thematic synthesis of qualitative research [2] and a structured multi-step qualitative content analysis after Mayring.

Results: A total of n=80 publications were included (n=54 quantitative; n=26 qualitative design). The majority of interventional studies evaluate palliative care training interventions. All observational studies focus on students´ attitudes and experiences during UPCE. In general, students seem to have a positive and interested attitude towards palliative care. Evidence for UPCE didactic interventions hints towards a clear preference for experiential learning with real patient contact and emphasise on effective role modelling. There seems to be an overall feeling of unpreparedness in medical students for dealing with medical decision-making at the end of life and in discussing end of life decisions including requests for euthanasia.

Discussion: The findings from this review could inform and support effective curricular development in UPCE in Germany. Publication and geographical biases need to be considered as the majority of publications originate from anglo-american authors. For future intervention modelling in UPCE, more data from Germany is needed.