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Research article
Education is as an important factor in palliative care knowledge: results from a survey of physicians attitudes and knowledge in Palliative Medicine
Raymon Pizzoni
Universidade Federal do Rio Grande do Sul
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Education.
Background: According to the Latin America Association for palliative care, Brazil offers only 0.48 palliative care services per 1 million inhabitants. In 2012, no accredited physicians were working in palliative care, while only 1.1% of medical schools included palliative care education in their undergraduate curricula. Aim: The aim of the study is to assess medical knowledge in end-of-life care, in order to identify key factors that could be useful in improving palliative care in Brazilian medical schools and residency. Design: Cross sectional study, conducted in São Paulo, Brazil. Students were invited to voluntarily participate in an anonymous and self-administered questionnaire survey. The latter included demographic information, attitudes, prior training in palliative care, prior palliative care experience and the 20-item Palliative Care Knowledge Test (PCKT). Participants: Physicians applying for the medical residency of the Federal University of São Paulo. Results: Of the 3086 subjects, 2349 (76%) answered the survey, 2225 were eligible for analysis while 124 were excluded due to incomplete data. Although the vast majority (99,2%) thought it was important to have palliative care education in the medical curriculum, less than half (46,2%) reported having received any education on palliative care. The overall performance in the PCKT was poor, with a mean score of 10,79 (± 3). While philosophical questions were correctly answered (81,8%), most participants lacked knowledge in symptom control (50,7% for pain, 57,3% for dyspnea, 52,2% for psychiatric and 43,4% for gastrointestinal problems). The high performance group (> 50% of correct answers) had received more training, showed more interest in learning, had a better sense of preparedness, as well as a higher percentage of experience in caring for terminal patients (p<0,001). Conclusions: Our study showed that Brazilian’s physicians lack not only knowledge, but also training in palliative medicine. Important factors to better knowledge in end-of-life care were prior training, previous contact with dying patients and prior medical residency. Corroborating the literature, training showed to be a key factor in overall knowledge. Therefore, medical schools and residency programs should focus on improving palliative training, especially those involving contact with dying patients.
Keywords
education, palliative care, knowledge, palliative care knowledge test (PCKT), palliative medicine, medical residency, developing countries
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CURRENT STATUS: Published
Version 1
Posted 03 Jan, 2020
Published
On 02 Oct, 2020
Published
On 02 Oct, 2020
Published
On 02 Oct, 2020
No community comments so far
Editorial decision: Major revision
On 11 Mar, 2020
Reviewer #2 agreed
On 25 Jan, 2020
Review #2 received
Received 25 Jan, 2020
Review #1 received
Received 25 Jan, 2020
Reviewers invited
Invitations sent on 20 Jan, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Editor assigned
On 09 Jan, 2020
Submission checks complete
On 31 Dec, 2019
Editor invited
On 31 Dec, 2019
First submitted
On 23 Dec, 2019
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This preprint is under consideration at BMC Medical Education. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Education is as an important factor in palliative care knowledge: results from a survey of physicians attitudes and knowledge in Palliative Medicine
Raymon Pizzoni
Universidade Federal do Rio Grande do Sul
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 1
Posted 03 Jan, 2020
Published
On 02 Oct, 2020
Published
On 02 Oct, 2020
Published
On 02 Oct, 2020
No community comments so far
Editorial decision: Major revision
On 11 Mar, 2020
Reviewer #2 agreed
On 25 Jan, 2020
Review #2 received
Received 25 Jan, 2020
Review #1 received
Received 25 Jan, 2020
Reviewers invited
Invitations sent on 20 Jan, 2020
Reviewer #1 agreed
On 20 Jan, 2020
Editor assigned
On 09 Jan, 2020
Submission checks complete
On 31 Dec, 2019
Editor invited
On 31 Dec, 2019
First submitted
On 23 Dec, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Medical Education.
Background: According to the Latin America Association for palliative care, Brazil offers only 0.48 palliative care services per 1 million inhabitants. In 2012, no accredited physicians were working in palliative care, while only 1.1% of medical schools included palliative care education in their undergraduate curricula. Aim: The aim of the study is to assess medical knowledge in end-of-life care, in order to identify key factors that could be useful in improving palliative care in Brazilian medical schools and residency. Design: Cross sectional study, conducted in São Paulo, Brazil. Students were invited to voluntarily participate in an anonymous and self-administered questionnaire survey. The latter included demographic information, attitudes, prior training in palliative care, prior palliative care experience and the 20-item Palliative Care Knowledge Test (PCKT). Participants: Physicians applying for the medical residency of the Federal University of São Paulo. Results: Of the 3086 subjects, 2349 (76%) answered the survey, 2225 were eligible for analysis while 124 were excluded due to incomplete data. Although the vast majority (99,2%) thought it was important to have palliative care education in the medical curriculum, less than half (46,2%) reported having received any education on palliative care. The overall performance in the PCKT was poor, with a mean score of 10,79 (± 3). While philosophical questions were correctly answered (81,8%), most participants lacked knowledge in symptom control (50,7% for pain, 57,3% for dyspnea, 52,2% for psychiatric and 43,4% for gastrointestinal problems). The high performance group (> 50% of correct answers) had received more training, showed more interest in learning, had a better sense of preparedness, as well as a higher percentage of experience in caring for terminal patients (p<0,001). Conclusions: Our study showed that Brazilian’s physicians lack not only knowledge, but also training in palliative medicine. Important factors to better knowledge in end-of-life care were prior training, previous contact with dying patients and prior medical residency. Corroborating the literature, training showed to be a key factor in overall knowledge. Therefore, medical schools and residency programs should focus on improving palliative training, especially those involving contact with dying patients.
Figure 1
Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF.