처음 의사가 되어, 가장 어려웠던 순간이 어떤 상황이었는지?
'외부병원에 파견 나가서 선배의사의 도움없이,
임종환자를 보다가 사망을 선언해야 하는 순간' 등
대부분 임종과 관련된 문제입니다.
그런데, 우리나라 의학교육은 end-of-life care에 대하여
어떻게 교육하고 있는지? 궁금합니다.
유럽국가는 국가지침으로 의무적으로 시행하고 있으며,
미국은 대학별로 자율적으로 실시하고 있습니다.
1. 교육목표
A learning experience has to be promoted which permits students to develop the attitude, knowledge and skills necessary to participate in effective and compassionate Palliative Care.
Goals are:
to show that medical treatment is far beyond diagnostic investigations and healing, the patient is meant to be considered, cared for and treated holistically
to show how to relieve symptoms (pain and others) by pharmacological and nonpharmacological means
to show that Palliative Care of patients and their relatives is a process that does not only include crisis intervention but also an anticipatory treatment and attention to need
to show that care and treatment have to be adopted to the individual needs, wishes and values of a certain patient and his relatives
to show that the quality of care for the terminally ill patients will only succeed if the attending physician is able to reflect his own attitude towards disease, dying, death and mourning
to show that the quality of medical treatment cannot only be improved by enlarging knowledge but also by the competence of team-working, communicating and the willingness to discuss ethical issues
(출처) European Association for Palliative Care. Curriculum in Palliative Care for Undergraduate Medical Education. EAPC 2007.
2. 교육 Domain
(출처) Meekin SA1, Klein JE, Fleischman AR, Fins JJ. Development of a palliative education assessment tool for medical student education. Acad Med. 2000 Oct;75(10):986-92.
3. 국가간 비교
(출처) Schiessl C, Walshe M, Wildfeuer S, Larkin P, Voltz R, Juenger J.
Undergraduate curricula in palliative medicine: a systematic analysis based on the palliative education assessment tool. J Palliat Med. 2013 Jan;16(1):20-30.