End-of-life care in the Dutch medical curricula 41 The medical curricula The questionnaire for the assessment of the curricula was completed by all eight Dutch medical faculties (see Supplement 1 for the respondents and their positions). In five of the eight participating faculties, both the bachelor and the master education directors participated. In the case of Maastricht University, data were collected via another curriculum expert with permission of the bachelor and master coordinators. Since the respondent of Radboud University Nijmegen was responsible for both the bachelor and the master curriculum, a distinction could not be made. Data of the master programof Erasmus University Rotterdamwere not available due to time restraints of the responsible persons. Tab. 3 shows the assessment of the medical faculties. We found that none of the medical curricula taught all subdomains specifically on ELC and that no faculty addressed all five ELC domains in a specific course in the compulsory curricula. The form of ELC education varied. Education was considered specific on ELC if education was dedicated to the topic, for instance working groups on breaking bad news. Our study shows that 6 of the 8 faculties offered ELC-specific education for at least 1 subject. Of the 8 faculties, 2 did not offer ELC-specific education. The first domain was taught best, being offered specifically on ELC in 6 of the 8 faculties. The fifth domain received the least attention in Dutch medical education: in 4 of the 8 faculties, as ELC-specific education was only offered in 2 of the 4 subdomains. Most ELC-specific education was taught in an interactive way; only 2 faculties used passive educational forms (i.e., lectures) to educate their students about 4 subjects regarding ELC. In all domains, ELC-related subjects were interwoven in lectures, working groups, discussion groups or practical training on more general topics; this education is not specific on ELC, but ELC does have a place in this education. For example, treatment options for pain in ELC was often part of a lecture on pain treatments in general. The University Medical Center Groningen facilitates education driven by students’ preferences and therefore does not offer ELC-specific education in the compulsory curriculum. We also studied the elective curricula of the eight faculties. One faculty, Radboud University Nijmegen, offered the elective course Coping with death that covered all five domains. Three of the eight faculties taught in total five elective courses in which ELC plays a role: Pain and pain treatment; Palliative care; Oncology; Paediatric oncology; Intensive care medicine; and Ethics in health care. 2
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