As nearly all doctors deal with patients requiring palliative care, it is imperative that palliative care education starts early. This study aimed to validate a national, palliative care competency framework for undergraduate medical curricula. We conducted a Delphi study with five groups of stakeholders (palliative care experts, physicians, nurses, curriculum coordinators, and junior doctors), inviting them to rate a competency list. The list was organized around six key competencies. For each competency, participants indicated the level to which students should have mastered the skill at the end of undergraduate training. Stability was reached after two rating rounds ( = 82 round 1, = 54 round 2). The results showed high levels of agreement within and between stakeholder groups. Participants agreed that theoretical knowledge is not enough: Students must practice palliative care competencies, albeit to varying degrees. Overall, communication and personal development and well-being scored the highest: Junior doctors should be able to perform these in the workplace under close supervision. Advance care planning scored the lowest, indicating performance in a simulated setting. A wide range of stakeholders validated a palliative care competency framework for undergraduate medical curricula. This framework can be used to guide teaching about palliative care.
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http://dx.doi.org/10.3390/ijerph17072396 | DOI Listing |
J Palliat Med
January 2025
Department of Community and Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Australia.
Palliative care (PC) in rural aged care facilities faces significant challenges, including late referrals and insufficient staff training, leading to a risk of suboptimal end-of-life care. The aim of the project was to develop and implement an evidence-based Palliative Care Assessment Toolkit (PCAT) to improve PC in rural aged care facilities and evaluate its impact on care delivery and staff practices. The study employed a mixed-methods design across three phases: codesign of the toolkit, implementation, and evaluation (using pre- and post-data).
View Article and Find Full Text PDFMed Care Res Rev
January 2025
Duke University School of Medicine, Durham, NC, USA.
While community-based palliative care (CBPC) programs have been expanding, there remain important obstacles to widespread use. Since provider perspectives on CBPC remain underexplored, we conducted a scoping review to summarize provider perspectives regarding barriers and facilitators to implementation of adult CBPC in the United States. We systematically searched OVID, MEDLINE, and CINAHL for peer-reviewed qualitative research published from January 1, 2010 to January 9, 2024, then used PRISM framework synthesis to organize themes into provider, organization, and external environment levels.
View Article and Find Full Text PDFJ Clin Invest
January 2025
Department of Medicine, Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Idiopathic pulmonary fibrosis (IPF) is etiologically complex, with well-documented genetic and nongenetic origins. In this Review, we speculate that the development of IPF requires two hits: the first establishes a vulnerable bronchoalveolar epithelium, and the second triggers mechanisms that reprogram distal epithelia to initiate and perpetuate a profibrotic phenotype. While vulnerability of the bronchoalveolar epithelia is most often driven by common or rare genetic variants, subsequent injury of the bronchoalveolar epithelia results in persistent changes in cell biology that disrupt tissue homeostasis and activate fibroblasts.
View Article and Find Full Text PDFContemp Clin Trials
December 2024
Neuroscience Research Australia (NeuRA), Sydney, Australia; School of Psychology, University of New South Wales, Sydney, Australia. Electronic address:
Background: Advance care planning (ACP) is potentially helpful for older adults, however, the rate of uptake in community aged care settings is low. Previous pilot studies suggest that holistic, person-centered ACP approaches may be effective for older adults who experience functional impairment but do not necessarily have life-limiting conditions with clear prognoses. This paper describes the protocol of a randomized trial to test the effectiveness of combined life story work and facilitated ACP in promoting ACP engagement among older adults receiving community aged care services.
View Article and Find Full Text PDFClin Hematol Int
December 2024
Department of Hematology, Institut Paoli-Calmettes, Cancer Sports Management Lab, Aix- Marseille University, Marseille, France.
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