Summary 225 3. To describe the end-of-life trajectory and quality of care of patients with a haematological malignancy who visited the ED in the last three months of their lives, compared to patients with advanced cancer. 4. To evaluate the performance of the surprise question to identify palliative care needs in patients with advanced cancer visiting the ED. 5. To explore the association between symptom burden and information needs of patients referred to a hospital palliative care consultation team using the Leiden Guide on Palliative care (LGP). 6. To evaluate and further develop the question prompt list of the LGP to prepare the question prompt list for use by generalist palliative care clinicians. CHAPTER 2. END-OF-LIFE CARE IN THE DUTCH MEDICAL CURRICULA This chapter describes a cross-sectional study assessing the extent to which end-oflife care was part of Dutch medical curricula. The focus on end-of-life care was chosen because it can be considered as essential part of palliative care. The study was conducted during the academic year of 2015-2016. A checklist including the essential domains of endof-life care education was constructed based on scientific literature. The checklist was used to assess the Dutch national blueprint on medical education21 and the Dutch medical curricula of the eight medical faculties in the Netherlands. The assessed education included eight bachelor studies, eight master studies and elective courses. Study coordinators of bachelor and master curricula were approached to fill out a questionnaire derived from the checklist and were interviewed afterwards to acquire explanation on their answers in the questionnaire. The study guides of all medical faculties were used to assess the electives. The blueprint included four of the five domains of end-of-life care. None of the eight medical faculties taught all domains specifically on end-of-life care. Most attention was given to psychological, sociological, cultural and spiritual aspects; communication and conversational techniques; and juridical and ethical aspects. One faculty taught an elective course that included all essential aspects of the international standards. We concluded that to improve education on end-of-life care, the five essential domains should be added to the Dutch national blueprint on medical education, which was due for revision in 2019. Additionally, medical faculties should review their curricula and offer end-of-life care as compulsory part of the medical curricula to prepare medical students for their future medical practice. 9
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