Abstract
Dear Editor:
Palliative medicine has been acknowledged as an important component of undergraduate medical training; however there are inherent difficulties in teaching the principles of the specialty.1–3
We describe how, in response to a change in recommendations from the Irish Medical Council to include optional Special Study Modules (SSM) in the curriculum, we created an opportunity for students to learn these principles. An SSM entitled ‘End-of-Life Enhancement’ has been designed and delivered to first year medical students at the National University of Ireland, Galway, Ireland for the past three academic years.
This special study module has a number of specific objectives for the student, central to which are an understanding of (1) the principles of palliative care, (2) the concept of quality of life and (3) the role of the palliative care team.
Methods
Twelve students completed the special study module annually. Demand by students to take this SSM far exceeded availability of places. Students were selected based on written testimonials outlining their reasons for choosing the module.
The module was delivered each year by three specialist palliative care physicians over ten weeks in a large university teaching hospital. It comprised 1.5 contact teaching hours per week and three hours per week that the students spent on background reading and assessment of patients' quality of life. Care was taken to focus more on a psychosocial health model than a biomedical one given the students' limited medical knowledge. Students spent time with the palliative care team in a clinical setting and assessing patients' quality of life.
The tool chosen to measure quality of life was the Schedule for the Evaluation of Individual Quality of Life (SEIQoL).4,5
The assessment process consisted of an oral presentation summarizing their experiences and results of SEIQoL assessments, and a written assignment exploring students' knowledge of and insight into palliative medicine.
The students grasped the principles of palliative medicine very well. Equally, their assessments of patients'quality of life were excellent, with an internal validity for the SEIQoL of 80%, comparing favorably with that of experienced clinicians.
Feedback was sought from the students by an electronic questionnaire, to which a 70% response rate was achieved. All students enjoyed the module and believed it would help them in their future medical careers; 86% would recommend it to future students. The component of the SSM that the students enjoyed most was assessing patients.
Discussion
We believe this is the first special study module in palliative medicine delivered in the United Kingdom and Ireland. It has been a successful development in our undergraduate curriculum and we unequivocally recommend it to colleagues.
Medical students are interested in the discipline of palliative medicine. The specialty lends itself well to such a module as its principles are generic and not disease specific; therefore, a student's limited knowledge of disease does not prohibit its delivery. There has been criticism that the assessment of palliative care is too knowledge focused and omits a student's attitudes and insight. 2 We believe this module serves to redress this weakness.