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Palliative care teaching: Student perspective

A. Sabir,M. Fairey,M. Bayne

Published 2019 in Medical Teacher

ABSTRACT

We read with interest the recent article by Boland et al. (2019), discussing palliative care teaching. As medical students, we write to share our experiences of our own palliative care curriculum. As discussed in Tip 2, seeing palliative care patients is undoubtedly essential. However, in our experience students can be unable to ask more personal questions, afraid it may cause undue anguish for the patient or loved ones. The addition of a retrospective talk by a relative discussing his son’s palliative care provided a safe learning environment where students could ask the questions they really wanted to, which gave invaluable insight. The article also mentions cadaveric dissection as a medium for palliative care learning which, in our course, began in the first week. The introduction was handled sensitively, encouraging a positive interaction with the “stark and potentially damaging” environment. At the end, we wrote letters of gratitude to our donor’s family and attended a ceremony in which we gave thanks, and where we could see some more personal information about our donors. These processes encouraged deep emotional reflection on death and dying early in our curriculum and have certainly improved our ability to confront the harsh realities of mortality on hospital wards in our clinical years. The encouragement of interprofessional learning (Tip 12) is also invaluable. Replicating real life, our palliative care teaching went beyond the realm of health care workers and included expertise from coroners’ assistants, whom we will undoubtedly liaise with in our future careers. While many palliative care sessions focus on biopsychosocial aspects of death and dying, it was extremely useful to receive teaching on the logistical aspects surrounding death, including certification, as this equips us to assist families through an understandably difficult period without unnecessary upset. The course nurtures open discussion and includes refreshment breaks to reflect with peers and facilitators, therefore acknowledging that the topic of death can be emotionally provocative, particularly for those who have lost loved ones. Ultimately, the success of our palliative care course reflects not only its content, evinced in the article’s 12 tips, but also its approach.

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