International Higher Education Teacher Award ^2024/25

The project successfully integrated palliative medicine into the general medicine curriculum through a unified teaching concept and innovative methods led by a newly formed team of educators. The teaching of palliative medicine was enhanced by 420 minutes throughout the study. The effort was coordinated by Dr. Hrdlicková, a pediatric oncologist and palliative care physician. She assembled a team of eight physicians from various specialties, including clinical oncology, internal medicine, geriatrics, hospice care, and pediatric palliative care. These specialists regularly treat palliative care patients in their clinical practice. To prepare the team for teaching, members participated in an 8-hour tailored training on pedagogical skills, emphasizing interactive teaching tools. Additionally, most attended a "To Teach How to Teach" workshop led by prof. Friedrichsdorf, a renowned expert in palliative medicine, which focused on enhancing presentation skills. The team developed a curriculum that introduces palliative care progressively throughout the six years of general medicine studies. Rather than creating a standalone course, palliative care was integrated into existing subjects such as ethics, oncology, neonatology, internal medicine, and geriatrics. Additionally, a compulsory elective course, Introduction to Palliative Medicine, was offered to interested students. The teaching approach emphasized interactivity, innovation, and consistency. Several interactive teaching methods in all the lectures was used. Team members collaborated to create visually interesting, engaging lectures. A faculty pedagogical advisor reviewed the lectures, providing feedback to optimize their quality. Pilot testing of the newly prepared lectures was conducted, incorporating feedback from students to ensure presentations were clear, engaging, and relevant. The teaching team meets regularly to reflect on ongoing teaching practices and adjust presentations based on feedback and socially relevant topics, such as cultural aspects of end-of-life care during the ongoing Ukrainian crisis or the newly discussed topic of euthanasia in the Czechia. By embedding palliative care into existing subjects and designing a compelling elective course, the project has transformed its teaching into a hallmark of the faculty. It serves as a model of good practice for other disciplines, showcasing how innovative and collaborative efforts can enhance medical education.

Methodology

The project methodology was divided into five phases. Preparatory Phase: A literature review was conducted to explore how palliative medicine is taught in several European countries and to examine recommendations from the European Association of Palliative Care (EAPC), which the faculty aims to follow long-term. A detailed analysis of palliative care teaching in the general medicine curriculum revealed that it was fragmented, inconsistent, and insufficient before the project began. First Phase: The Associate Dean for Studies, professional guarantors of each teaching module, and heads of the departments were engaged through meetings led by the Associate Dean for Studies and project coordinator Dr. Hrdlicková. The project was introduced to all the guarantors and their support was gained to proceed with the project. The presentation of the project also took place at the individual departments in the form of educational seminars, at which candidates for the teaching team were recruited. Second Phase: A teaching team of eight physicians from various specialties, including clinical oncology, internal medicine, geriatrics, hospice care, and pediatric palliative care, was formed. It is key to the project that all members of the teaching team are primarily clinicians, not academics, have a great deal of experience in clinical practice and the topic of palliative care is important to them for the sake of patients and their families. A unified teaching concept based on previous literature review was developed, enhancing existing lectures with topics such as pain and terminal symptom management, goals of care conversations, end-of-life care and hospice care. Regular team meetings were scheduled, and all the existing lectures were revised to ensure coherence and relevance to other subjects. Third Phase: Teaching team members underwent intensive training to strengthen their pedagogical skills. This included participation in at least two training events and a tailor-made faculty course focusing on interactive methods to make topics like end-of-life care engaging and comprehensible (case reports, small group work, role-playing, thematic discussion recorded on a flipchart, quizzes, Kahoot, Mentimeter). Fourth Phase: The project is now in its implementation phase. Educational videos are being produced, including professionally engaging content and "trigger videos" designed to open lessons and spark discussion. Resources for educators are also being prepared to ensure sustainability of palliative care teaching even with future team changes. Fifth Phase: Pilot testing of the teaching is underway, including collecting feedback from students and faculty pedagogical advisor. All lectures underwent a critical review by all team members and modifications of lectures were done to maximize clarity, relevance, and engagement.

Tools, equipment, technology used

The tools used in the project include, above all, methods of high-quality pedagogical and didactic competences. The project does not use any technological advances, its main objective was to provide the teaching of palliative medicine with relevant professional content and high-quality teaching methods. The main tools are interactive modern teaching methods (case reports, small group work, role-playing, quizzes, Kahoot, Mentimeter). The project also includes a series of tutorial videos with expert content and trigger videos to open the topic. An important tool is the preparation of teaching aids for teachers, not only of the current teaching team, but also for future teachers of palliative medicine with the intention of sustainability. Another effective tool of the project is high-quality of the graphics of the lectures so that the student gets to know the "handwriting" of the teaching team, which presents the topics of palliative medicine in an engaging and novel way. In this way, the teaching team has consciously created a “brand” that encompasses a high-quality teaching style, including the enthusiasm of the speakers, the ability of the teaching team members to engage the students, the genuine interest of the palliative medicine educators in the students' opinion and in initiating discussion on the topic. We are convinced that palliative medicine is a challenging field, and the topics related to death and dying touch everyone personally, so it is crucial that the teaching of palliative medicine is of the highest standard, both in terms of the quality of content and the quality of delivery.

Outcomes and outputs, main results

The main aim of the project was to create a unified concept of teaching palliative medicine and its integration into compulsory teaching within the general medicine curriculum. Thanks to the project, the teaching of palliative medicine has been strengthened by 420 minutes, lectures have been spread across the years and have been newly included in the teaching in the final year of study. The main output of the project is balanced, content-relevant and graphically perfectly framed lectures thematically focused on different areas of palliative medicine. The unique value of the project is the intention to teach students a partnership approach to seriously ill people and to learn a respectful approach in medicine in general (hidden curriculum). The principles of palliative medicine such as good communication skills, respect for values, cultural specificities and autonomy of the patient and his/her relatives and the shared decision framework are good practice for all other medical disciplines. The palliative medicine curriculum is also taught for the English branch of the course and all lectures are prepared so that the topics of cultural differences related to end-of-life care in other nationalities, religions and cultures can be discussed. The forthcoming output of the project is teaching videos and learning resources for teachers, as well as a methodology for teaching palliative medicine in an engaging way.

Lessons learnt

The implementation of the project enabled the introduction of the field of palliative medicine to a wide professional community of the faculty and the hospital. During the realization of educational seminars at the individual departments and clinics during the recruitment of candidates to the teaching team at the beginning of the project, the topics of palliative medicine were repeatedly mentioned and the introduction of the project led to the strengthening of knowledge about palliative care among many doctors and teachers. The principles of palliative medicine have thus reached even those who are rather reluctant to start palliative care for their patients. Another lesson learned is the realization that bringing new topics and methods into the classroom works well with a group of enthusiastic, ideally young people who are not afraid of innovation, want to learn and improve, and enjoy interacting with young learners. At the same time, it is key to the project that all members of the teaching team are primarily clinicians, not academics, have a great deal of experience in clinical practice and the topic of palliative care is important to them for the sake of patients and their families. Regular meetings of the palliative care teaching team, in person or online, once a month with regular reflection on the teaching and sharing of experiences, which enabled all the teaching team to learn from each other, gain experience, avoid each other's mistakes and be supportive of each other, proved useful. All members of the palliative teaching team can cover for each other in lecturing so that the whole teaching team has a high level of expertise. We have found it extremely useful to actively solicit feedback from students, both verbally and in writing, as it makes students feel engaged in the class, enjoy the subject more and recommend it to others. Students can influence the way palliative medicine is taught through feedback and this partnership approach contributes to their confidence in the lecturer, in the study as a whole and in the faculty as an institution. We consider it a shortcoming that the faculty does not yet have a separate department to coordinate and guarantee the teaching of palliative medicine. The expert guarantor of the lectures is the project coordinator Dr. Hrdlickova, the head doctor of the Pediatric Supportive and Palliative Care Team of the hospital and an academic employee of the faculty.

Adaptability and sustainability of the best practice (for other institutions)

The project methodology described above is transferable to other medical faculties and our approach proved to be effective for the development of a new concept of teaching palliative medicine and its implementation in compulsory teaching. The sustainability of the project is ensured by the newly formed teaching team, which consists of 8 physicians who are mutually substitutable, know their own and each other's lectures and can substitute each other in lecturing on all the palliative care topics. The members of the teaching team have entered an employment relationship with the faculty and have become employees of the faculty through teaching palliative medicine. Sustainability is also enhanced by the current curriculum materials for educators, which will be available to new faculty teaching palliative medicine, as well as a methodology for how to teach palliative care well and effectively. No turnover of the teaching team will adversely affect the quality or delivery of teaching as the team meets regularly, reflects on teaching, shares experiences and any new team member will be guided in the rails of this well-established practice. Further supporting sustainability is the fact that the teaching concept has been prepared in line with the graduate profile, which includes several topics and areas that are covered in the newly established teaching concept.

Promotion of best practice

The promotion of the project is ongoing, mainly through social media. Interviews with Dr. Hrdlicková, the project coordinator, were conducted for the faculty podcast published on YouTube and on the faculty website. Ongoing partial achievements such as the establishment of a new teaching concept, the establishment of a new teaching team, positive feedback from students is continuously communicated on the social media of the faculty and the project coordinator. The promotion of the project is closely linked to the promotion of the field of palliative medicine. In accordance with professional recommendations in the literature, the project and the topics of palliative care were presented to the professional and lay public in a positive manner, with a framework “to live well”, omitting depressing images, pictures of old hands and other attributes that the public typically associates with dying in hospice care, which represents only a small part of the palliative medicine issue (Back et al, Top 10 Tips Palliative Care Clinicians Should Know About Messaging for the Public. J Palliat Med. 2024;27(3):405-410). Course guarantors, heads of departments and clinics and faculty management are kept informed about the project progress and partial achievements. The project was presented at the XVI. National Palliative Medicine Conference in October 2024 in the form of a poster. The members of the teaching team are in contact with other medical faculties in the Czech Republic that are also seeking to implement palliative medicine in their teaching, and during joint meetings, teaching experiences and ways of implementing palliative care topics in the studies are shared.

Scope and impact

• Course/department level
• Faculty level
• Institutional level
• Cross-institutional level
• National level

- Course/department level - the integration of palliative medicine into the compulsory general medicine curriculum has a positive impact on the knowledge of palliative care that students acquire throughout their studies thanks to the new concept of the palliative care teaching. - Faculty level - the teaching concept positively influences the graduate profile, which includes requirements for a range of knowledge, practical skills and attitudes to be acquired by the student during their studies, many of which are covered in the teaching of palliative medicine - Institutional level - the 2nd Faculty of Medicine can be an example of good practice in implementing a new topic in teaching across the university and can be an inspiration to other faculties in developing curricula and teaching methodologies - Inter-institutional level - continuous contact with medical faculties in the Czech Republic brings useful networking, the possibility of sharing good practice and mutual support in teaching an important and challenging subject such as palliative medicine. - National level - our project can support the National Palliative Care Strategy currently being developed by the Ministry of Health and professional societies, through advocacy on behalf of the field of palliative medicine, through strengthening palliative care knowledge in core specialties and among graduate doctors.

6.1 Digitalization

• NOT RELEVANT

Reasoning:

---

6.2 Internationalization

• Developing students' multicultural awareness

Reasoning: The teaching of palliative medicine includes the topic of death and dying, which is addressed as an open discussion of cultural specifics in different countries. Cultural differences in palliative care also relate to issues of autonomy and shared decision-making, which vary from country to country. Teaching also takes place in the English branch of the course, which involves students from countries all over the world, and sharing their experiences is always a great enrichment for all present.

---

6.3 Inclusion and diversity, universal design

• NOT RELEVANT

Reasoning:

---

6.4 Sustainability

• Sustainability goals are addressed in the course(s)
• Teaching material contains profession related sustainability aspects

Reasoning: In collaboration with the faculty management, the teaching methodology was made so that the members of the teaching team were substitutable. The project is now finalizing the teaching methodology that will be available to any new teacher. The members of the teaching team are new faculty members. The concept is now awaiting approval by the Faculty Research Council. Teaching the principles of palliative medicine will enable students to adopt a respectful approach in any other discipline.

3.3 Public contact datas

Name	Email address	Website
Lucie Hrdlickova	lucie.hrdlickova@fnmotol.cz