Assessing palliative care education in undergraduate medical students: translation and validation of the Self-Efficacy in Palliative Care and Thanatophobia Scales for Brazilian Portuguese

Abstract

Background As the global population ages, palliative care is ever more essential to provide care for patients with incurable chronic conditions. However, in many countries, doctors are not prepared to care for dying patients. Palliative care education should be an urgent concern for all medical schools all around the world, including Latin America and Brazil. Advances in palliative care education require robust assessment tools for constant evaluation and improvement of educational programmes. Bandura’s social cognitive theory proposes that active learning processes are mediated by self-efficacy and associated outcome expectancies, both crucial elements of developing new behaviour. The Self-Efficacy in Palliative Care (SEPC) and Thanatophobia Scales were developed using Bandura’s theory to assess the outcomes of palliative care training. Objectives We aimed to translate and validate these scales for Brazilian Portuguese to generate data on how well doctors are being prepared to meet the needs of their patients. Design Cross-sectional study. Setting One Brazilian medical school. Participants Third-year medical students. Methods The authors translated the scales following the European Organisation for Research and Treatment of Cancer’s recommendations and examined their psychometric properties using data collected from a sample of 111 students in a Brazilian medical school in 2017. Results The Brazilian versions of SEPC and Thanatophobia Scales showed good psychometric properties, including confirmatory factor analysis, replicating the original factors (factor range: 0.51–0.90), and acceptable values of reliability (Cronbach’s alpha: 0.82–0.97 and composite reliability: 0.82–0.96). Additionally, the Brazilian versions of the scales showed concurrent validity, demonstrated through a significant negative correlation. Conclusions The Brazilian version of the scales may be used to assess the impact of current undergraduate training and identify areas for improvement within palliative care educational programmes. The data generated allow Brazilian researchers to join international conversations on this topic and educators to develop tailored pedagogical approaches.