Structuring Palliative Care Education for Medical Students: Impact of a Novel Framework and Pocket Card.

Margot Manning, Logan N Beyer, Dorothy W Tolchin
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Abstract

Introduction: Palliative care (PC) education is not uniformly provided across U.S. medical schools. While PC competencies for medical students have been articulated, no student-facing, unifying framework for competency-based PC learning exists.

Methods: In 2022, we developed a student-facing organizing framework (the "6 Ps") based on existing PC competencies and created a pocket card introducing foundational PC concepts organized within the 6 Ps framework. In 2023, we provided a mandatory 15-minute session to introduce the 6 Ps and pocket card to the first-year class of our large, urban medical school. We provided voluntary pre- and post- session surveys to evaluate usability and impact of the framework and pocket card.

Results: One hundred-twenty students of the 204-student class (59%) attended. Survey response rate was 106/120 (88%) pre-session and 101/120 (84%) post-session. Following the session, students agreed the 6 Ps was a good framework for conceptualizing PC (95/101; 94%), that the pocket card was understandable (96/101; 95%), and they would use the pocket card to teach fellow students about PC (85/101; 84%). Nearly all students endorsed learning novel concepts (95/100; 95%). Pre/post session comparison of self-assessed confidence approaching hypothetical clinical tasks, such as educating a patient about PC and hospice, revealed significant improvement (P < .01).

Discussion: First-year medical students were able to use the 6 Ps framework and pocket card after a brief introduction, endorsing new learning and demonstrating significant gains in knowledge and self-assessed confidence. Medical educators across schools may consider adopting this novel tool and approach to introduce or support student learning about PC.

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医学生缓和疗护教育之建构:新架构与袖珍卡片之影响。
导读:姑息治疗(PC)教育并没有在美国医学院统一提供。虽然医学生的PC能力已经明确,但没有面向学生的、基于能力的PC学习的统一框架。方法:在2022年,我们基于现有的PC能力开发了一个面向学生的组织框架(“6p”),并创建了一个口袋卡,介绍在6p框架内组织的基本PC概念。在2023年,我们提供了一个强制性的15分钟课程,向我们大型城市医学院的一年级学生介绍6p和口袋卡。我们提供了自愿的会前和会后调查,以评估框架和口袋卡的可用性和影响。结果:204名学生中有120名学生(59%)出席。调查回复率为会前106/120(88%),会后101/120(84%)。会议结束后,学生们一致认为,6p是一个很好的框架,以概念化PC (95/101;94%),认为口袋卡片是可以理解的(96/101;95%),他们会用口袋卡教同学们关于电脑的知识(85/101;84%)。几乎所有的学生都赞同学习新概念(95/100;95%)。对于假设的临床任务,如教育病人关于PC和安宁疗护的知识,自我评估的自信在会前和会后的比较显示有显著的改善(P < 0.01)。讨论:经过简短的介绍,一年级医学生能够使用6p框架和口袋卡,认可新的学习,并展示知识和自我评估的信心方面的显着收获。学校的医学教育者可以考虑采用这种新颖的工具和方法来介绍或支持学生学习PC。
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