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“The education is a mirror of where palliative care stands in Israel today”: An exploration of palliative care undergraduate education at medical schools in Israel

Published online by Cambridge University Press:  10 September 2021

Frank Elsner ,
Anne Müller ,
Woukelyne Gil  and
Piret Paal Open the ORCID record for Piret Paal [Opens in a new window]
Frank Elsner*
Affiliation:
Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany
Anne Müller
Affiliation:
Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany Department of Internal Medicine, St. Elisabeth-Krankenhaus Geilenkirchen, Geilenkirchen, Germany
Woukelyne Gil
Affiliation:
Rambam Health Care Campus, Haifa, Israel
Piret Paal
Affiliation:
Institute for Nursing Research and Practice, Paracelsus Medical University, Salzburg, Austria
*
Author for correspondence: Frank Elsner, Klinik für Palliativmedizin, Universitätsklinikum Aachen, Pauwelsstraße 30, 52074Aachen, Germany. E-mail: felsner@ukaachen.de
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Abstract

Objective

Israel serves as a case study for understanding the importance of undergraduate palliative care (PC) education in implementing, developing, and enabling access to palliative care services. This article presents the findings collected from the five medical schools.

Method

This qualitative study supported by a survey explores and describes the state of undergraduate PC education at medical schools in Israel. The survey included questions on voluntary and mandatory courses, allocation of different course models, teaching methods, time frame, content, institutions involved, and examinations. Semi-structured interviews with teaching faculty were conducted at the same locations.

Results

Eleven expert interviews and five surveys demonstrate that PC is taught as a mandatory subject at only two out of the five Israeli universities. To enhance PC in Israel, it needs to become a mandatory subject for all undergraduate medical students. To teach communication, cultural safety, and other basic competencies, new interactive teaching forms need to be developed and adapted. In this regard, nationwide cooperation is proposed. An exchange between medical schools and university clinics is seen as beneficial. The new generation of students is open to PC philosophy and multidimensional care provision but resources to support their growth as professionals and people remain limited.

Significance of results

This study underlines the importance of teaching in PC at medical schools. Undergraduate education is a central measure of PC status and should be used as such worldwide. The improvement of the teaching situation would automatically lead to a better practical implementation for the benefit of people. Medical schools should cooperate, as the formation of expertise exchange across medical schools would automatically lead to better PC education.

Keywords

Cultural safetyIsraelMedical curriculumPalliative careUndergraduate education
Type
Original Article
Information
Palliative & Supportive Care , Volume 20 , Issue 5 , October 2022 , pp. 646 - 653
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

†

These authors contributed equally to this work.

References

Ami, SB and Yaffe, A (2015) Palliative care in Israel: The nursing perspective. Journal of Palliative Care & Medicine S5, 1–4.Google Scholar
Anneser, J, Kunath, N, Krautheim, V, et al. (2014) Needs, expectations, and concerns of medical students regarding end-of-life issues before the introduction of a mandatory undergraduate palliative care curriculum. Journal of Palliative Medicine 17, 1201–1205.CrossRefGoogle ScholarPubMed
Arias-Casais, N, Garralda, E, Rhee, J, et al. (2019) EAPC Atlas of Palliative Care in Europe 2019. Vilvoorde: EAPC Press.Google Scholar
Arias-Casais, N, Garralda, E, Sánchez-Cárdenas, MA, et al. (2021) Evaluating the integration of palliative care in national health systems: An indicator rating process with EAPC task force members to measure advanced palliative care development. BMC Palliative Care 20. doi:10.1186/s12904-021-00728-zCrossRefGoogle ScholarPubMed
Baider, L and Goldzweig, G (2016) The magic of dreams: Conflicts and quandaries within multicultural societies in transition. In Silbermann, M (ed.), Cancer Care in Countries and Societies in Transition. Basel: Springer International Publishing, pp. 47–64.CrossRefGoogle Scholar
Bar-Sela, G, Mitnik, I, Zalman, D, et al. (2017) Medical students’ attitudes towards participating in a palliative medicine course: A new specialty in Israel. Palliative and Supportive Care 16, 528–533.CrossRefGoogle Scholar
Baur, N, Centeno, C, Garralda, E, et al. (2019). Recalibrating the ‘world map’ of palliative care development. Wellcome Open Research. Available at: doi:10.12688/wellcomeopenres.15109.2.CrossRefGoogle Scholar
Bentur, N, Emanuel, LL and Cherney, N (2012) Progress in palliative care in Israel: Comparative mapping and next steps. Israel Journal of Health Policy Research 20, 9.CrossRefGoogle Scholar
Best, M, Leget, C, Goodhead, A, et al. (2020) An EAPC white paper on multi-disciplinary education for spiritual care in palliative care. BMC Palliative Care 19, 9.CrossRefGoogle ScholarPubMed
Bogner, A, Littig, B and Menz, W (2009) Interviewing Experts. Methodology and Practice. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
Carrasco, JM, Lynch, TJ, Garralda, E, et al. (2015) Palliative care medical education in European universities: A descriptive study and numerical scoring system proposal for assessing educational development. Journal of Pain and Symptom Management 50, 516–523.CrossRefGoogle ScholarPubMed
Centeno, C, Garralda, E, Carrasco, JM, et al. (2017) The palliative care challenge: Analysis of barriers and opportunities to integrate palliative care in Europe in the view of National Associations. Journal of Palliative Medicine 20(11), 1195–1204.CrossRefGoogle ScholarPubMed
Committee for the Evaluation of Medical Study Programs (2014) General Report. Available at https://che.org.il/wp-content/uploads/2015/08/General-Report-8-19-14-final-to-CHE.pdf.Google Scholar
Council of Europe (2013) Recommendation Rec(2003)24 of the Committee of Ministers to Member States on the Organisation of Palliative Care, Adopted by the Committee of Ministers on 12 November 2003 at the 860th meeting of the Ministers’ Deputies. Available at: https://www.dgpalliativmedizin.de/images/stories/pdf/GR%20Europarat%202003%20MK%20%28E%29.pdf.Google Scholar
Curtis, E, Jones, R, Tipene-Leach, D, et al. (2019) Why cultural safety rather than cultural competency is required to achieve health equity: A literature review and recommended definition. International Journal for Equity in Health 18, 174.CrossRefGoogle ScholarPubMed
Dresing, DT and Pehl, TP (2015). Praxisbuch Interview, Transkription & Analyse. Anleitungen und Regelsysteme für qualitativ Forschende. 6. Auflage. Marburg, 2015. Available at: www.audiotranskription.de/praxisbuch.Google Scholar
Etikan, I and Bala, K (2017) Sampling and sampling methods. Biometrics & Biostatistics International Journal 5(6), 215–217.CrossRefGoogle Scholar
Even, D (2018) Israeli Health Care Ranks High in OECD, but Public System Still Showing Signs of Distress. Available at: https://www.haaretz.com/.premium-israeli-healthcare-in-rude-health-or-just-rude-1.5236537.Google Scholar
Gamondi, C, Larkin, P and Payne, S (2013) Core competencies in palliative care: An EAPC white paper on palliative care education — Part 1. European Journal of Palliative Care 20, 86–91.Google Scholar
Gibbins, J, McCoubrie, R, Maher, J, et al. (2009) Incorporating palliative care into undergraduate curricula: Lessons for curriculum development. Medical Education 43, 776–783.CrossRefGoogle ScholarPubMed
Hadad, S, Hadad, Y and Simon-Tuval, T (2013) Determinants of healthcare system's efficiency in OECD countries. European Journal of Health Economics 14(2), 253–265.CrossRefGoogle ScholarPubMed
Jones, KF, Paal, P, Symons, X, et al. (2021) The content, teaching methods and effectiveness of spiritual care training for healthcare professionals: A mixed-methods systematic review. Journal of Pain and Symptom Management. doi:10.1016/j.jpainsymman.2021.03.013.CrossRefGoogle ScholarPubMed
Kuper, A, Reeves, S and Levinson, W (2008) An introduction to reading and appraising qualitative research. British Medical Journal 337, a288.CrossRefGoogle ScholarPubMed
Lamnek, S and Krell, C (2010) Qualitative Sozialforschung (Vol.5). Weinheim: Beltz Verlag.Google Scholar
Martins Pereira, S, Hernández-Marrero, P, Pasman, HR, et al. (2021) Nursing education on palliative care across Europe: Results and recommendations from the EAPC taskforce on preparation for practice in palliative care nursing across the EU based on an online-survey and country reports. Palliative Medicine 35, 130–141.CrossRefGoogle Scholar
Mason, S, Paal, P, Elsner, F, et al. (2020a) Palliative care for all: An international health education challenge. Palliative and Supportive Care 18, 760–762.CrossRefGoogle Scholar
Mason, SR, Ling, J, Stanciulescu, L, et al. (2020b) A new approach to the international development of a free-to-access, blended, standardised undergraduate curriculum in palliative medicine: The EDUPALL project. Journal of Palliative Medicine 23, 1–15.CrossRefGoogle Scholar
Mayring, P (2015) Qualitative Inhaltsanalyse, Grundlagen und Techniken (Vol. 12). Weinheim: Beltz Verlag.Google Scholar
Ministry of Health (2009) Circular of the General Administration No. 30/09: Operation of Palliative Care Services (Hospice) in the Community, General Hospitals and Nursing Institutions. The State of Israel: Ministry of Health.Google Scholar
Paal, P, Brandstötter, C, Lorenzl, S, et al. (2019) Post-graduate palliative care education for all healthcare providers in Europe: Results from an EAPC survey. Palliative Care & Supportive Care 17, 495–506.CrossRefGoogle ScholarPubMed
Reis, S, Glick, SM, Urkin, J, et al. (2017) The medical education system in Israel. The Lancet 389, 2570–2574.CrossRefGoogle ScholarPubMed
Rosen, B, Waitzberg, R and Merkur, S (2015) Israel: Health system review. Health Systems in Transition 17, 1–212.Google ScholarPubMed
Shaulov, A, Baddarni, K, Cherny, N, et al. (2019) Death is inevitable—a bad death is not” report from an international workshop. Israel Journal of Health Policy Research 8, 79.CrossRefGoogle Scholar
Shvartzman, P, Singer, Y, Bentur, N, et al. (2011) Constructing a postgraduate palliative care curriculum: The Israeli national palliative care training (INPACT) experience. Journal of Palliative Care 27, 238–243.CrossRefGoogle Scholar
Stähli, A, Stiel, S, Paal, P, et al. (2020) Postgraduate palliative care education and curricular issues in Central Asia, eastern and south-Eastern Europe: Results from a quantitative study. Palliative Medicine in Practice 14, 81–88.CrossRefGoogle Scholar
Vaismoradi, M, Turunen, H and Bondas, T (2016) Qualitative descriptive study. Nursing & Health Sciences 15, 398–405.CrossRefGoogle Scholar
Wittkowski, J (2013) Das Interview in der Psychologie: Interviewtechnik und Codierung von Interviewmaterial. Wiesbaden: VS Verlag für Sozialwissenschaften.Google Scholar
Würth, K, Langewitz, W, Reiter-Theil, S, et al. (2018) Their view: Difficulties and challenges of patients and physicians in cross-cultural encounters and a medical ethics perspective. BMC Medical Ethics 19, 1–10.CrossRefGoogle Scholar
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