Is Basic Training in Palliative Care Sufficient to Guarantee the Improvement of Knowledge and Skills in This Area?-A Medical Knowledge Assessment Study.
Rita Monteiro, Hugo Ribeiro, César Vinicius José, Joana Brandão Silva, Ricardo Marinho, João Rocha Neves, Marília Dourado
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Abstract
Background: With the growing population requiring palliative care (PC), it is essential to enhance and expand the availability of this care in Portugal. Throughout both pre-graduate and post-graduate training for doctors, there are limited learning opportunities in this area, necessitating further training to improve the knowledge and skills needed to support patients at the end of their lives. Studies conducted on doctors and medical students have demonstrated a clear need for improved training. Additionally, others have noted significant benefits for residents who underwent post-graduate training in this field while caring for patients nearing the end of life. This study aims to evaluate the impact of a basic training program on improving palliative care knowledge among medical doctors. Methods: This was a cross-sectional study, carried out by sharing a questionnaire with the participants enrolled in the "Intensive Palliative Medicine Course" organized by a group of doctors in November 2021. The questionnaire was completed by participants at three moments of training (before, immediately after the course, and 6 months after the course), and it contained questions to assess the theoretical knowledge, skills, and abilities obtained. Results: In total, 93 out of 204 (45.58%) doctors responded before training, 80 (39.21%) immediately after training, and 36 (17.64%) six months after training. After training, an improvement in knowledge was observed (p = 0.014), which did not appear to persist six months after the course (p = 0.574). However, six months after training, an increase in doctors' confidence in referring patients to Palliative Care Teams or Units (p = 0.009) and medicating patients who may be in the last months of their lives (p = 0.005) was observed. Conclusions: The results regarding theoretical medical knowledge did not seem to stabilize over time, so it may be necessary to create more specific training opportunities for the medical profession. An increase in doctors' self-confidence in referring and medicating patients with palliative care needs was observed, which may be associated with better medical care provided. It is necessary to carry out more studies to evaluate the impact of combined theoretical and practical training on the knowledge and confidence of doctors in PC.
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