Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Do Korean Medical Schools Provide Adequate End-of-Life Care Education? A Nationwide Survey of the Republic of Korea's End-of-Life Care Curricula

  • Kim, Kyong-Jee (Department of Medical Education, Dongguk University School of Medicine) ;
  • Kim, Do Yeun (Department of Internal Medicine, Dongguk University School of Medicine) ;
  • Shin, Sung Joon (Department of Internal Medicine, Dongguk University School of Medicine) ;
  • Heo, Dae Seog (Department of Internal Medicine, Seoul National University Hospital) ;
  • Nam, Eun Mi (Department of Internal Medicine, Ewha Womans University College of Medicine)
  • Received : 2019.09.05
  • Accepted : 2019.11.27
  • Published : 2019.12.01
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Abstract

Purpose: Physician competency in end-of-life (EOL) care is becoming increasingly important. This study investigated the EOL care curricula in Korean medical schools. Methods: Questionnaires were issued to the faculty members responsible for the EOL care curricula at each of the medical schools. These included questions on the structure and content of the curricula, teaching methods, and faculty members' attitudes to the curricula. Results: Characteristics of the EOL care curricula were compiled from 27 (66%) of the 41 medical schools. All of the medical schools taught essential aspects of the EOL care curriculum either as a separate course or embedded within other medical education courses. The mean time spent on EOL care teaching was 10 hrs (range, 2~32 hrs). The most frequently taught topics were delivering bad news (100%) and symptom management (74%). When the palliative care education assessment tool (PEAT) was used to evaluate the curricula, a median of 11 PEAT objectives was met (range, 2~26; maximum, 83). More than two teaching methods were used in most of the curricula. However, lectures were the only teaching method used by three medical schools. 78% of faculty members who were responsible for curriculum reported dissatisfaction with it, whereas 18% believed that the time allotted to it was adequate. Only 7% of these faculty members believed that their students were adequately prepared to practice EOL care. Conclusion: There is a need to improve EOL care education in basic medical curricula and to take a more systematic approach to achieving learning outcomes.

목적: 임상 의사가 생의 말기 '임종 돌봄(end of life care)'에 대한 진료 역량을 갖추는 것은 점차 중요해 지고 있다. 본 연구는 국내 의과대학에서 임종 돌봄에 대한 교과과정에 대해 조사하고자 하였다. 방법: 각 의과대학에서 임종 돌봄 교과과정에 책임을 지고 있는 교수들에게 교과과정에 대한 내용, 강의 시간, 강의 방법과 교과과정에 대한 태도를 설문지를 통해 분석하였다. 결과: 전체 41개 의과대학 중 27개 의과대학(66%)에서 설문에 응하였다. 모든 의과대학에서 임종 돌봄 교과과정을 단독교과목이나 다른 교과과정 중 포함시켜 교육하고 있었다. 임종 돌봄을 가르치는 시간의 중앙값은 10시간(2~32 시간 범위)였다. 가장 많이 강의 되고 있는 주제는 나쁜 소식 전하기(100%)와 증상 조절(74%)이였다. 완화의료교육과정 평가 도구(palliative care education assessment tool; PEAT)를 적용하였을 때 11개(범위: 2~26; 최대: 83)의 PEAT 목적이 만족되었다. 교육과정에 대부분 2가지 이상의 교육방법이 사용되었으나 3개 의과대학에서는 오직 강의만을 교육방법으로 사용하고 있었다. 교과과정 책임 교수의 78%가 교과과정에 대해 만족하지 않는다고 응답하였고 18%만이 임종 돌봄 강의 시간이 적당하다고 생각하였다. 단지 7%의 교수만 학생들이 임종 돌봄 관련 실제 진료를 할 수 있는 역량을 갖췄다고 답했다. 결론: 의과대학 교육과정 내에 임종 돌봄 관련 학습성과가 도출되고 이를 달성하기 위해 교육과정이 체계적으로 운영되어 졸업 후 학생들이 실제 진료 역량을 갖출 수 있도록 하는 것이 필요할 것으로 생각된다.

Keywords

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  1. 우리나라 의과대학의 호스피스 완화의료 교육 vol.22, pp.3, 2019, https://doi.org/10.17496/kmer.2020.22.3.146