As more medical schools implement longitudinal palliative care (PC) curricula, the need for robust evaluation that demonstrates curricular outcomes has become increasingly important.
Objectives:
The authors prospectively evaluated a PC curriculum at the University of Pennsylvania’s Perelman School of Medicine, using the Context, Input, Process, Product model.
Design:
Between 2021 and 2025, data that provided evidence of value were generated from a variety of sources and stakeholders to address evaluation questions about acceptability, student knowledge and attitudes about PC topics and engagement in PC opportunities. Both qualitative and quantitative data were collected with an assortment of tools including evaluation scores, focus groups, interviews, written reflections, quiz scores, and medical record notes.
Results:
Results of this evaluation indicated that the curriculum achieved the intended outcomes of acceptance to diverse stakeholders, improved student knowledge and attitudes about PC, and increased student engagement in PC. Unanticipated impacts of the curriculum were also captured.
Conclusions:
The evaluation provided multisource evidence of the value of a longitudinal curriculum in PC and may serve as an example for others charged with evaluating longitudinal PC curricula in medical school.
BrauerDG, FergusonKJ. The integrated curriculum in medical education: AMEE guide no. 96. Med Teach, 2015; 37(4):312–322; doi: 10.3109/0142159x.2014.970998
2.
YoumJ, ChristnerJ, HittleK, et al.The 6 degrees of curriculum integration in medical education in the United States. J Educ Eval Health Prof, 2024; 21:15; doi: 10.3352/jeehp.2024.21.15
3.
GoldmanE, SchrothWS. Perspective: Deconstructing integration: A framework for the rational application of integration as a guiding curricular strategy. Acad Med, 2012; 87(6):729–734; doi: 10.1097/ACM.0b013e318253cad4
Liason Committee on Medical Education. Available from: https://lcme.org/ [Last accessed: April22, 2025].
6.
RoedigerHL3rd, ButlerAC. The critical role of retrieval practice in long-term retention. Trends Cogn Sci, 2011; 15(1):20–27; doi: 10.1016/j.tics.2010.09.003
7.
Van HoofTJ, SumerackiMA, MadanCR. Science of learning strategy series: Article 3, interleaving. J Contin Educ Health Prof, 2022; 42(4):265–268; doi: 10.1097/ceh.0000000000000418
8.
LyonsK, McLaughlinJE, KhanovaJ, et al.Cognitive apprenticeship in health sciences education: A qualitative review. Adv Health Sci Educ Theory Pract, 2017; 22(3):723–739; doi: 10.1007/s10459-016-9707-4
9.
MalikAS, MalikRH. Twelve tips for developing an integrated curriculum. Med Teach, 2011; 33(2):99–104; doi: 10.3109/0142159x.2010.507711
10.
Wijnen-MeijerM, ten CateO, van der SchaafM, et al.Graduates from vertically integrated curricula. Clin Teach, 2013; 10(3):155–159; doi: 10.1111/tct.12022
11.
DavisMH, HardenRM. Planning and implementing an undergraduate medical curriculum: The lessons learned. Med Teach, 2003; 25(6):596–608; doi: 10.1080/0142159032000144383
12.
AllenLM, HayM, PalermoC. Evaluation in health professions education-is measuring outcomes enough? Med Educ, 2022; 56(1):127–136; doi: 10.1111/medu.14654
13.
FryeAW, HemmerPA. Program evaluation models and related theories: AMEE guide no. 67. Med Teach, 2012; 34(5):e288–e299; doi: 10.3109/0142159x.2012.668637
14.
DagherT, OylerJ, PressVG, et al.Development and implementation of an experiential longitudinal health systems science thread into an existing medical school curriculum. Acad Med, 2024; 99(9):971–975; doi: 10.1097/acm.0000000000005784
15.
WestCP, JaegerTM, McDonaldFS. Extended evaluation of a longitudinal medical school evidence-based medicine curriculum. J Gen Intern Med, 2011; 26(6):611–615; doi: 10.1007/s11606-011-1642-8
16.
HaidarDA, KesslerR, KhannaNK, et al.Association of a longitudinal, preclinical ultrasound curriculum with medical student performance. BMC Med Educ, 2022; 22(1):50; doi: 10.1186/s12909-022-03108-0
17.
EllmanMS, FortinAH, PutnamA, et al.Implementing and evaluating a four-year integrated end-of-life care curriculum for medical students. Teach Learn Med, 2016; 28(2):229–239; doi: 10.1080/10401334.2016.1146601
18.
Denney-KoelschEM, HorowitzR, QuillT, et al.An integrated, developmental four-year medical school curriculum in palliative care: A longitudinal content evaluation based on national competency standards. J Palliat Med, 2018; 21(9):1221–1233; doi: 10.1089/jpm.2017.0371
19.
WeissmanDE. Palliative medicine education at the Medical College of Wisconsin. Wis Med J, 1995; 94(9):505–508.
20.
RadwanySM, StovskyEJ, FrateDM, et al.A 4-year integrated curriculum in palliative care for medical undergraduates. Am J Hosp Palliat Care, 2011; 28(8):528–535; doi: 10.1177/1049909111406526
21.
BarrE, ChinEL, NewmanCB, et al.Reflecting on progress in and establishing benchmarks for sex and gender health education. Acad Med, 2024; 99(1):16–21; doi: 10.1097/acm.0000000000005444
22.
LawrenceEC, SheridanC, HurtadoA, et al.A guiding model for undergraduate medical education well-being programs. Acad Med, 2024; 99(9):946–952; doi: 10.1097/acm.0000000000005755
23.
DraperJK, FeltnerC, Vander SchaafEB, et al.Preparing medical students to address health disparities through longitudinally integrated social justice curricula: A systematic review. Acad Med, 2022; 97(8):1226–1235; doi: 10.1097/acm.0000000000004718
24.
BarberC, van der VleutenC, LeppinkJ, et al.Social accountability frameworks and their implications for medical education and program evaluation: A narrative review. Acad Med, 2020; 95(12):1945–1954; doi: 10.1097/acm.0000000000003731
25.
HeadBA, SchapmireTJ, EarnshawL, et al.Improving medical graduates’ training in palliative care: Advancing education and practice. Adv Med Educ Pract, 2016; 7:99–113; doi: 10.2147/amep.S94550
26.
Lloyd-WilliamsM, CarterYH. Can medical education extend palliative care? Palliat Med, 2003; 17(7):640–642; doi: 10.1191/0269216303pm831xx
27.
WeissmanDE, QuillTE, BlockSD. Missed opportunities in medical student education. J Palliat Med, 2010; 13(5):489–490; doi: 10.1089/jpm.2010.9838
SchaeferKG, ChittendenEH, SullivanAM, et al.Raising the bar for the care of seriously ill patients: Results of a national survey to define essential palliative care competencies for medical students and residents. Acad Med, 2014; 89(7):1024–1031; doi: 10.1097/acm.0000000000000271
30.
SaginA, BalmerD, RoseS, et al.Evaluation of a palliative care longitudinal curriculum for medical students using the context-input-process-product model. Am J Hosp Palliat Care, 2024; 41(2):158–166; doi: 10.1177/10499091231165504
31.
ToosiM, ModarresM, AminiM, et al.Context, input, process, and product evaluation model in medical education: A systematic review. J Educ Health Promot, 2021; 10(1):199; doi: 10.4103/jehp.jehp_1115_20
32.
BalmerDF, RamaJA, SimpsonD. A standards-based checklist for program evaluation as scholarly activity. J Grad Med Educ, 2022; 14(5):617–618; doi: 10.4300/jgme-d-22-00603.1
33.
ThomasDR. A general inductive approach for analyzing qualitative evaluation data. Am J Eval, 2006; 27(2):237–246; doi: 10.1177/1098214005283748
34.
SolimanAA, OlenikJM, SaginA, et al.Qualitative study of preclinical medical student reflections on required palliative care experience. J Pain Symptom Manage, 2025; 70(3):287–294.e2; doi: 10.1016/j.jpainsymman.2025.05.017
35.
BolandJW, BrownMEL, DuenasA, et al.How effective is undergraduate palliative care teaching for medical students? A systematic literature review. BMJ Open, 2020; 10(9):e036458; doi: 10.1136/bmjopen-2019-036458
36.
ChiuN, CheonP, LutzS, et al.Inadequacy of palliative training in the medical school curriculum. J Cancer Educ, 2015; 30(4):749–753; doi: 10.1007/s13187-014-0762-3
37.
ReidyJA, ChanSH, BoelitzKM, et al.A call to action: Using curriculum mapping at four medical schools in Massachusetts to advance serious illness communication training in undergraduate medical education. J Palliat Med, 2024; 27(1):39–46; doi: 10.1089/jpm.2022.0562
38.
HorowitzR, GramlingR, QuillT. Palliative care education in U.S. medical schools. Med Educ, 2014; 48(1):59–66; doi: 10.1111/medu.12292
39.
DeCoste-LopezJ, MadhokJ, HarmanS. Curricular innovations for medical students in palliative and end-of-life care: A systematic review and assessment of study quality. J Palliat Med, 2015; 18(4):338–349; doi: 10.1089/jpm.2014.0270
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
