Chapter 8 208 a study among experts, for example by using a Delphi technique. The list with cues for proactive palliative care can be used in evaluation studies on the proactivity of palliative care, for example in a cohort study in patients identified as having palliative care needs. 2. Discussing future scenarios The discussion of future scenarios is part of a two-track approach. Chapter 6 has demonstrated that patients and family have information needs about symptoms and situations that are not actual yet. In Chapter 7, non-specialist palliative care clinicians indicated that the Leiden Guide on Palliative Care (LGP) included items that can support discussing and explaining future scenarios to patients and their family during palliative care conversations. To study if non-specialist clinicians feel supported in discussing future scenarios by using the LGP, a study can be conducted in two groups of clinicians: 1) those trained to use the LGP, and 2) those who were not trained to use the LGP. Both groups can be asked by using interviews or a questionnaire if they discuss future scenarios, and if they feel comfortable doing it. Also, for example one and six months after implementation, patient records can be searched for if discussed future scenarios are documented, and if the number of discussions is increased in the group that was trained in using the LGP. 8.5. RECOMMENDATIONS FOR EDUCATION, CLINICAL PRACTICE, AND POLICY Recommendations for education, clinical practice, and policy following from this thesis will be addressed in three paragraphs: 1. Promoting knowledge and self-initiation in clinicians, and patients and family 2. Intention to produce good results and avoid (future) problems 3. Thinking ahead to be able to act before things happen 8.5.1 Promoting knowledge and self-initiation in clinicians, and patients and family 1. Good education for undergraduate medical students Following the results from Chapter 2, addition of the five essential domains of end-of-life care education to the Dutch national blueprint on medical education was recommended. The study was one of the many efforts to improve undergraduate medical education on palliative care, including the PASEMECO and the O2PZ projects. With the revised blueprint published in 2020, generalist palliative care has become a compulsory part of the formal medical curricula in the Netherlands.
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