PhD defence: Lama Sultan

This thesis explores the feasibility and implementation of palliative care and interprofessional shared decision-making (IP-SDM) education for undergraduate health professionals’ students. 

In Chapter 1, we highlight the increasing global demand for palliative care due to an aging population and rising life-threatening illnesses like cancer. Palliative care is defined by the World Health Organization (WHO) as a holistic approach aimed at improving the quality of life for patients and families through early identification and treatment of physical, psychosocial, and spiritual issues. The chapter emphasizes that despite the significance of palliative care, education in this area is still inadequate across many countries, with students graduating without sufficient training. Interprofessional collaboration (IPC) and shared decision-making (SDM) are crucial components in delivering effective palliative care, especially given the complexity of decisions at the end of life. However, educational institutions often lack structured curricula and interprofessional education (IPE) opportunities for health professions students. In Saudi Arabia, palliative care is gaining prominence as part of the national Vision 2030 healthcare reform, with efforts focused on expanding services and integrating education into healthcare training programs. Yet, undergraduate education remains limited, necessitating innovative strategies to prepare students for real-world collaboration in palliative care settings. Chapter 1 outlines the thesis’ aim to explore educational approaches that enhance IP-SDM in palliative care in undergraduate health professions programs. Using David Kern’s Curriculum Development Model, the research seeks to address gaps in palliative care training by examining current trends, stakeholders’ perceptions, and the impact of structured workshops on students’ collaborative practices. We concluded Chapter 1 with research questions that will direct the exploration of the educational intervention in this thesis. 

In Chapter 2, we provide a comprehensive scoping review to identify current trends in IP-SDM programs. The analysis focused on educational interventions, theories, and outcomes related to IP-SDM. Most studies reviewed lacked a clear theoretical framework, though those that did referenced models such as adult learning theory and experiential learning. Common teaching methods included workshops, simulations, and case-based learning, targeting skills like collaboration, communication, and SDM. However, significant variability existed in implementation methods, content, and evaluation, highlighted a need for greater consistency in developing and accessing IP-SDM education. 

In Chapter 3, we explore stakeholders’ perspectives on implementing IP-SDM education in palliative care, employing qualitative research methods. The study collected insights from healthcare policymakers, faculty members, health professionals, and students. Participants emphasized the importance of IPC and communication but noted various challenges, such as institutional barriers, cultural factors, and resource limitations. Recommendations included increasing leadership support, improving faculty training, and fostering an inclusive learning environment to promote collaborative decision-making in palliative care. 

In Chapter 4, we use a cross-sectional study design to assess perceptions and practices related to IP-SDM in palliative care among faculty members and students. A questionnaire distributed at health professions students and faculty members revealed positive attitudes towards IP-SDM and areas for improvement. Factors such as previous IPE experience and department support influenced perceptions and practices. The study suggested that fostering practical opportunities for interprofessional interaction could improve the effectiveness of IP-SDM education. 

In Chapter 5, we investigate the outcomes of an educational intervention aimed at improving undergraduate students’ IP-SDM skills in palliative care. The intervention included a workshop and was evaluated through both self-assessment and team objective structured clinical examinations (TOSCEs). Results indicated that students demonstrated improved collaboration, communication, and decision-making skills. The study emphasized the importance of hands-on training and feedback mechanisms to enhance students’ readiness to engage in interprofessional teamwork in real-world healthcare settings. 

In Chapter 6, we discuss how the findings from the different chapters align with existing literature and contribute new insights to the field. We noted that while there is a strong interest in IP-SDM education among stakeholders, significant barriers remain, including institutional constraints and cultural factors that influence the implementation of effective educational programs. This chapter emphasized the need for structured curricula that incorporate IP-SDM principles and the importance of training faculty and healthcare professionals (HCPs) to facilitate these educational efforts. Moreover, the chapter addressed the challenges identified throughout the research, such as the variability in educational interventions and the lack of standardized frameworks for assessing IP-SDM outcomes. It calls for a more cohesive approach to curriculum development that aligns with the needs of healthcare systems and the cultural contexts of palliative care. 

In conclusion, in Chapter 6, we reinforce the thesis’s contributions to health professions education, advocating for the integration of practical, hands-on experiences in IP-SDM training. We stressed the need for ongoing research to evaluate the long-term impacts of IP-SDM education on patient care and the emotional preparedness of HCPs. This chapter serves as a call to action for educational institutions to prioritize collaborative training in palliative care, ultimately enhancing the quality of care provided to patients and their family members.