Is basic training in palliative care sufficient to guarantee the improvement of knowledge and skills in this area? – medical knowledge assessment study

Abstract Background: With the increase in the population needing Palliative Care, it is necessary to increase and improve the supply of this care in Portugal. Throughout doctors' pre-graduate training, there are few learning opportunities in this area, making it necessary to resort to further training to improve the knowledge and skills needed to guide patients at the end of their lives. Studies carried out on doctors and medical students showed a clear need to improve training. Others observed a clear benefit in interns who underwent postgraduate training in the area, in dealing with patients at the end of their lives. The objective is to evaluate the impact of a basic training action on the palliative care knowledge obtained by medical doctors. Methods: Observational and cross-sectional study, carried out by sharing a questionnaire with the 204 participants enrolled in the “Intensive Palliative Medicine Course” organized by a group of doctors in November 2021. The questionnaire was completed by participants at three moments of the training (before, immediately after the course and 6 months after the course), which contained questions to assess theoretical knowledge and the skills and abilities obtained. Results: 209 responses were collected, 93 (45.58%) doctors responded before training, 80 (39.21%) immediately after training and 36 (17.64%) six months after training. After the training, an improvement in knowledge was observed (p=0.014), which does not appear to have persisted six months after the course (p=0.574). However, six months after training, an increase in doctors' confidence in referring patients to Palliative Care Teams or Units (p=0.009) and in medicating patients who may be in the last months of their lives (p=0.005) was observed. Conclusions: The results of theoretical knowledge in medical areas were worse, so it may be necessary to create more specific training opportunities for the medical profession. An increase in doctors' self-confidence in referring and medicating patients with Palliative Care needs was observed, which may be associated with better medical care provided. It is necessary to carry out more studies to evaluate the impact of combined theoretical and practical training on the knowledge of doctors in PC.