Basic Training in Palliative Medicine for Internal Medicine Residents: Pilot Testing of a Canadian Model in Switzerland

Andreas Samuel Ebneter; Ebru Kaya; Petra Mair; Barbara Affollter; Steffen Eychmueller

doi:10.1089/pmr.2024.0004

Basic Training in Palliative Medicine for Internal Medicine Residents: Pilot Testing of a Canadian Model in Switzerland

Palliat Med Rep. 2024 Apr 15;5(1):171-176. doi: 10.1089/pmr.2024.0004. eCollection 2024.

Authors

Andreas Samuel Ebneter¹, Ebru Kaya², Petra Mair³, Barbara Affollter⁴, Steffen Eychmueller¹

Affiliations

¹ University Center for Palliative Care, University Hospital, Inselspital Bern, Switzerland.
² Division of Palliative Medicine, University of Toronto and University Health Network, Toronto, Ontario, Canada.
³ Palliative Care Unit, Internal Medicine Clinic, Spital Thun, Thun, Switzerland.
⁴ Palliative Care Unit, Internal Medicine Clinic, Spital Emmental, Burgdorf, Switzerland.

Abstract

Background: In Switzerland, palliative care (PC) clinical training is well established at undergraduate and specialist postgraduate levels. However, postgraduate nonspecialist training curricula are less documented.

Local problem: A structured curriculum for nonspecialist rotation within internal medicine (IM) in specialized PC wards is lacking.

Objective: To pilot two versions of a PC nonspecialist curriculum for IM residents in Swiss PC units.

Methods: In the pilot phase, two curricula-short immersion (3-10 weeks, based on the University of Toronto's Internal-Medicine PC Rotation) and standard nonspecialist (11-18 weeks, based on the Canadian Society of Palliative Care Physician Competencies)-were assessed using a mixed-method online survey. One university and two nonuniversity sites participated. The analysis was descriptive.

Results: Five residents and eight supervisors of five training rotations (July-October 2023) responded. Overall, curriculum quality and feasibility (content and time) received positive ratings across all groups, with high satisfaction concerning organization, educational design, learning support, climate, experience, and facilities. Nonuniversity sites were generally rated more positively than university sites. Qualitative feedback paralleled these findings, highlighting the curriculum's relevance and fit with learners' needs and suggesting potential simplifications and more personalized planning.

Conclusions: Establishing short and standard duration curricula for a PC program is viable and well received by nonspecialist trainees. Future implementation should concentrate on personalized learning objectives and streamlining the content and structure of the competencies. Cooperation within various training settings (university and regional hospitals) as well as on an international level (e.g., Canada-Switzerland) may further improve the quality of the proposed training formats.

Keywords: curriculum; internal medicine; palliative care; palliative care unit; palliative medicine; postgraduate training.