Consenso Delphi sobre la formación de grado en medicina paliativa (EDUPAL-Ar)

Abstract

Palliative care is an “ethical responsibility of healthcare systems”. The WHO proposes undergraduate and postgraduate medical education as one dimension to assess its development in a country. In Latin America, 15% of medical schools have an undergraduate palliative care course. In Argentina, there is still no consensus on the essential content of undergraduate medical curricula.

Method

This study sought to reach a consensus on what an undergraduate curriculum in palliative medicine should look like in Argentina using the Delphi methodology (2019–2020). Sociodemographic data, profession, years of experience, university education, thematic content, pedagogical modality, study plan and hourly load were collected. Quantitative analysis was performed using percentages and mean values to indicate the level of agreement on 5-point scales. Interquartile ranges were calculated to provide indicators of agreement and consensus. Thematic content analysis was carried out.

Results

Two hundred fifty experts were convened, of whom 85 responded to two rounds of consultation. A high degree of agreement was reached on ten general, dynamic, and flexible recommendations adapted to different contexts. 98% considered it necessary to teach palliative care transversally and suggested a specific course contextualised to chronic patients and end-of-life situations. However, there was a tension between the traditional training model and competency-based education. Experiential learning is appropriate, but linking theory and practice was recommended.

Conclusion

For the first time in Argentina, a consensus of experts was reached, which defined a set of recommendations on content, teaching methodology, academic cycle and competencies in palliative care.