Palliative care in conflict; a novel undergraduate medical curriculum in gaza.
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1 Palliative care in conflict; a novel undergraduate medical curriculum in gaza. Dr Mhoira E F Leng 2,3,4, Dr Khamis Elessi 1, Dr Tony Jefferis 2, Dr Janet Gillet 2, Dr Colin Cooper 2, Dr Liz Grant 2, Dr Fadel N Naim 1, Dr Anwar Alshaihkalil 1 1 Islamic University of Gaza, Faculty of Medicine 2 Global Health Academy, University of Edinburgh 3 Makerere University Palliative Care Unit, Uganda 4 Cairdeas International Palliative Care Trust
2 Gaza; humanitarian needs High area of vulnerability Chronic issues (almost 70yrs) Poor access to basic needs Major impact on health Growing NCD and mental health issues
3 Gaza; humanitarian needs 2.3 m people affected in occupied Palestinian territories protection of civilians forced displacement erosion of resilience access to medicine Gaza 1.4m out of 1.8m
4 Gaza; palliative care Scoping visit with to Gaza Hosted by University of Edinburgh and Islamic University of Gaza PC steering group includes Ministry of Health, academics, UN, WHO and international partners who agreed curriculum integration as a priority.
5 Islamic University of Gaza
6 IUG; undergrad PC curriculum Method PC core competencies developed, delivered and assessed using a blended learning experiential model within a 4th year clinical curriculum. 6 core domains identified using the PC Curriculum Toolkit derived from international frameworks 1. Basics of palliative care 2. Pain and symptom management 3. Psychosocial and spiritual 4. Ethical and legal 5. Communication skills 6. Teamwork and professionalism
7 IUG; undergrad PC curriculum 7 competencies 1. Understand the principles of PC as part of chronic disease management and whole person medicine with an evidence based approach. 2. Identify patients who need PC and manage alongside disease modifying treatment 3. Assess and manage patients and families holistically 4. Demonstrate skills in pain assessment and management Demonstrate skills in symptom prevention, assessment and management in palliative care patients 5. Demonstrate skills and attitudes to effectively communicate with patients and their families 6. Understand and apply ethical principles and clinical judgment in managing patients and their families with PC needs 7. Work effectively within a multi-professional team
8 IUG; undergrad PC curriculum Blended learning Core texts and reading material Classroom teaching Experiential learning style Clinical bedside teaching; oncology, ICU, paediatrics, medical
9 IUG; undergrad PC curriculum Results: Students participated enthusiastically within a well organised curriculum with excellent collaboration from clinical and academic colleagues in Islamic University Gaza. Feedback from students included evidence of learning and attitude change MCQ assessment (20 questions with 5 stems) average score of 88% post training. OSCE stations submittted
10 Impact Attitude change The course added to the clinical practice makes us feel the suffering of patients and how we can help them.
11 Impact Holistic care Patients cope better when we tell them the truth
12 Impact Attitude change I have learned to add smile and life to days not just days to life
13
14 IUG; undergrad PC curriculum Conclusion An integrated curriculum with agreed core competencies for PC is an essential component in developing competent PC practitioners and changing attitudes. Future needs include developing trainer capacity within Gaza and participating in the overall policy and service planning for PC integration within a newly convened steering group. This curriculum can acts as a model for other settings in Palestine and has wider relevance.
15 Class of
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