Chapter 2 38 as the addition of internships in hospices and more education about palliative care.14-17 By contrast, little is known about the status of ELC in the Dutch medical curricula. In a report on appropriate care in the last phase of life, the Royal Dutch Association on the Advancement of Medicine (KNMG) stressed the importance of appropriate caregiving to terminally ill patients and of proper education about ELC.18 However, no studies have been performed yet to determine to what extent ELC is taught in the Dutch medical curricula. Therefore, this study assesses ELC in the Dutch national blueprint (Raamplan Artsopleiding 2009)19 and the Dutch medical curricula. METHODS To investigate to what extent ELC is currently taught at Dutch medical schools, we used the following definition of end-of-life, as described by the KNMG: ‘the phase of very old age, or the phase of a condition that will be life-threatening in the near future.’ Care for those who are at the end of life includes concepts such as appropriate care, curative and palliative care, and over- or under-treatment.18 To study the themes regarding ELC systematically, we designed a checklist. This checklist combined the criteria for essential elements in ELC education established by two international expert groups,8,20 and consisted of five main domains and twenty-two subdomains of ELC education (see Tab. 1). To assess the national blueprint and the medical curricula in the Netherlands, we took the same approach as a Dutch assessment of medical education on geriatrics:21 we assessed the national level by studying the national blueprint and we assessed the faculty level by contacting the bachelor and master directors of medical curricula of the Dutch medical faculties. Firstly, the national blueprint for higher medical education was studied using our checklist.19 The national blueprint serves to secure that future doctors are trained in the basic competencies they need in their medical practice. This was done by two researchers ( JdB and MV) independently. If they came to different assessments, their findings were discussed until agreement was reached. Secondly, we assessed the curricula of the eight medical faculties by developing a questionnaire based on our checklist. The questionnaire studied the content and the didactic form of the current formal ELC education at the Dutch medical faculties. All eight medical schools in the Netherlands were approached: University of Groningen, University of Amsterdam, VU University Amsterdam, Leiden University, Erasmus University Rotterdam, Utrecht University, Maastricht University and Radboud University Nijmegen. To investigate the formal medical curricula, the coordinators of the bachelor and master programs of each medical faculty were invited to participate in the study.
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