Antonio Noguera
Universidad de Navarra, Instituto Cultura y Sociedad, Faculty Member
- Dr. Noguera received his medical degree in 1998 from Universidad Complutense de Madrid, Spain, and trained as Family ... moreDr. Noguera received his medical degree in 1998 from Universidad Complutense de Madrid, Spain, and trained as Family Physician at San Carlos University Hospital. Master in Palliative Medicine by Universidad Autónoma de Madrid. Nowadays works part time as a clinician at the Palliative Care Suppor team at Clínica Universitaria de Navarra, and part time as researcher at Atlantes Program, Instituto de Cultura y Sociedad, Universidad de Navarra. Previously worked as Deputy Medical Director at Fundación Vianorte-Laguna, Madrid. He completed a clinical and research fellowship in Symptom Control and Palliative Medicine in 2007 at Facultad de Medicina, Universidad de Navarra, Spain. He also stayed in 2012 for three months at M D Anderson Cancer Center, Houston, followed by three more months in Edmonton Palliative Care Program as a clinical fellow of the University of Alberta.
His research areas are Palliative Care Medical Education, Delirium and Symptom control.edit - Dr. Carlos Centeno edit
Background Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. This paper describes the... more
Background
Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. This paper describes the curriculum and evaluation results of a unique course centred on palliative care decision-making but aimed at introducing these other important competencies as well.
Methods
The 20 h-long optional course, presented in an art museum, combined different learning methods, including reflections on art, case studies, didactic sessions, personal experiences of faculty, reflective trigger videos and group discussions. A mixed methods approach was used to evaluate the course, including a) a post-course reflective exercise; b) a standardized evaluation form used by the University for all courses; and c) a focus group.
Results
Twenty students (2nd to 6th years) participated. The course was rated highly by the students. Their understanding of palliative care changed and misconceptions were dispelled. They came to appreciate the multifaceted nature of decision-making in the palliative care setting and the need to individualize care plans. Moreover, the course resulted in a re-conceptualization of relationships with patients and families, as well as their role as future physicians.
Conclusions
Palliative care decision-making therefore, augmented by the visual arts, can serve as a vehicle to address several competencies, including the introduction of competencies related to being patient-centred and empathic.
Medical Schools are challenged to improve palliative care education and to find ways to introduce and nurture attitudes and behaviours such as empathy, patient-centred care and wholistic care. This paper describes the curriculum and evaluation results of a unique course centred on palliative care decision-making but aimed at introducing these other important competencies as well.
Methods
The 20 h-long optional course, presented in an art museum, combined different learning methods, including reflections on art, case studies, didactic sessions, personal experiences of faculty, reflective trigger videos and group discussions. A mixed methods approach was used to evaluate the course, including a) a post-course reflective exercise; b) a standardized evaluation form used by the University for all courses; and c) a focus group.
Results
Twenty students (2nd to 6th years) participated. The course was rated highly by the students. Their understanding of palliative care changed and misconceptions were dispelled. They came to appreciate the multifaceted nature of decision-making in the palliative care setting and the need to individualize care plans. Moreover, the course resulted in a re-conceptualization of relationships with patients and families, as well as their role as future physicians.
Conclusions
Palliative care decision-making therefore, augmented by the visual arts, can serve as a vehicle to address several competencies, including the introduction of competencies related to being patient-centred and empathic.
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ABSTRACT We report the case of a 28 year-old patient with a giant cell sacral bone tumour with pelvic invasion for two years, who maintained an excellent functional status. During this time she was cared for by the Home Care Support Team,... more
ABSTRACT We report the case of a 28 year-old patient with a giant cell sacral bone tumour with pelvic invasion for two years, who maintained an excellent functional status. During this time she was cared for by the Home Care Support Team, with two admissions to a chronic Palliative Care Unit. The patient was admitted to our acute Palliative Care Unit for the management of severe breakthrough pain in the right lower limb with 10/10 intensity, associated to severe toxicity induced by ketamine. The multiple pain crises were not adequately controlled with a combination of methadone, venlafaxine, gabapentin, acetaminophen, antiinflammatory drugs, steroids, diazepam, baclofen and ketamine. After an adequate clinical – radiological identification of the origins of the pain crises, the pain was successfully controlled with a multimodal therapeutic approach. This approach included discontinuation of ketamine, opioid rotation to morphine, titration of baclofen doses, palliative radiotherapy and biphosphonates.