Master of Philosophy in Palliative Medicine

Purpose

The purpose of the Master of Philosophy in Palliative Medicine is to develop clinical and governance leadership in Palliative Medicine, which will contribute to the development of palliative medicine knowledge at an advanced level. This qualification will equip learners with the ability to solve complex problems, build capacity in their work environment, and be able to contribute to national, regional and international policy debates, research and development, at sub-speciality level. This qualification will also equip learners with advanced Palliative Medicine knowledge, critical thinking and the application of evidence-based approaches, using resources wisely and protecting the most vulnerable in society.

On completion of the qualification, qualifying learners will be able to

• Apply advanced palliative care principles in a variety of clinical settings.
• Manage distressing physical and psychological symptoms presented by patients with a life-threatening or life-limiting illness.
• Provide advanced physical, psycho-social, and spiritual comfort to the patient.
• Demonstrate the ability to meet the needs of the family and carers in relation to the patients' care goals.
• Respond to the challenges of clinical and ethical decision-making in palliative care in the South African context.
• Practice comprehensive care co-ordination and interdisciplinary teamwork.
• Develop advanced interpersonal communication skills.
• Produce and evaluate PC research and teaching.
• Demonstrate advanced professional integrity, ethical reasoning, and advocacy skills in complex clinical contexts, upholding human rights and dignity in the care of patients and families.
• Apply advanced problem-solving and research skills, critically evaluating and synthesising evidence to guide palliative care practice, policy, and service development in the African context.
• Integrate advanced clinical knowledge and interprofessional teamwork skills to deliver holistic, patient- and family-centred care across diverse healthcare systems.
• Demonstrate advanced, compassionate, and culturally sensitive communication skills across patient, family, and professional interactions, including breaking bad news, conflict resolution, and mentoring others.
• Recognise and address the influence of culture, spirituality, and social context on care, contributing to equitable and inclusive healthcare delivery in diverse African settings.
• Design, conduct, and disseminate research that advances the discipline of palliative medicine and supports evidence-informed practice and teaching.
• Engage in continuous professional development, self-reflection, and self-care, fostering resilience and sustainability in their practice.

Rationale

Globally, research and teaching in palliative medicine have been mainly Eurocentric and there is a huge need to develop and support African Palliative Care services through an evidence-based approach aligned clinical needs in the African setting. This is an application for a transversal subspecialty in Palliative Medicine across the disciplines of Family Medicine, Emergency Medicine, Internal Medicine, Radiation Oncology and Paediatrics following the recommendation from the National Policy for Palliative Care and World Health Assembly Resolution on Palliative Care.

Palliative medicine, the medical contribution to palliative care, has grown considerably internationally and was recognised in 1987 in the United Kingdom as a speciality, in 1995 in Ireland and recent American Board of Medical Specialties also granted palliative medicine specialty status. This global trend was further supported by the World Health assembly in 2014 when resolution 67.19 was unanimously accepted which: Recognizing that palliative care, when indicated, is fundamental to improving quality of life, well-being, comfort and human dignity for individuals, being an effective person-centred health service that values patients' need to receive adequate, personally and culturally sensitive information on their health status, and their central role in making decisions about the treatment received.

The resolution recommended that palliative care training should be included in all basic (undergraduate) health professions training; that there should be intermediate training for clinicians managing patients with life-threatening illness; and "specialist palliative care training should be available to prepare health care professionals who will manage integrated care for patients with more than routine symptom management needs. This resolution was co-sponsored by South Africa and, in May 2016, the then Minister of Health appointed a National Steering Committee for Palliative Care "to create a revolution in healthcare through palliative care".

In 2017 the South African Policy Framework and Strategic Plan on Palliative Care was approved. The document clearly states that palliative care should be delivered on specialist level. Palliative Care is also included in the National Health Insurance and 2018 the Declaration of Astana in 2018 includes palliative care as a fundamental component of Universal Health Coverage. The qualification was approved by the Health Professions Council of South Africa (HPCSA).

Currently, the institution offers a research-based Master of Philosophy in Palliative Medicine, which does not respond to the need to have a recognised specialised qualification that includes teaching of advanced clinical skills. As this qualification is not in line with the purpose of a subspecialty, its name will be changed to appropriately reflect the purpose of the qualification. Health professionals who have completed specialist training will be eligible to enrol in the qualification for the new qualification for the subspecialty of Palliative Medicine.

Recognition of Prior Learning (RPL)

RPL for Access

• Learners who have completed the post-graduate Diploma in Palliative Care, MPhil Palliative Care or equivalent qualifications will be assessed for RPL with respect of the theoretical courses.

Due to the statutory requirements of the HPCSA and the Medical, Dental and Supplementary Health Services Act, candidates must hold specialist registration in a base discipline (e.g., Family Medicine, Emergency Medicine, Internal Medicine, Radiation Oncology, Paediatrics). RPL for access is therefore not feasible, as clinical competence at specialist level cannot be substituted by experiential learning.

Entry Requirements

• Bachelor of Medicine and Bachelor of Surgery, NQF Level 8.

Or

• Postgraduate Diploma in Palliative Medicine, NQF Level 8.

And

• Minimum experience in palliative medicine or relevant coursework.

This qualification consists of the following compulsory modules at National Qualifications Framework, Level 9 totalling 180 Credits.

Coursework, 135 Credits.

• Palliative Care Principles and Ethics.
• Psychosocial, Spiritual and Cultural Care.
• Advanced Palliative Care Communication Skills.
• Foundations of Advanced Physical Care and Collaborative Care Delivery (introduced and applied, with assessed portfolio).
• Advanced Physical Care (continued, advanced application).
• Collaborative Care Delivery (continued, advanced application).
• Research, Leadership and Governance in Palliative Medicine.
• Research Project, 45 Credits.

1. Apply advanced palliative care principles in a variety of clinical settings.
2. Manage distressing physical and psychological symptoms presented by patients with a life-threatening or life-limiting illness.
3. Provide advanced physical, psycho-social, and spiritual comfort to the patient.
4. Demonstrate the ability to meet the needs of the family and carers in relation to the patients' care goals.
5. Respond to the challenges of clinical and ethical decision-making in palliative care in the South African context.
6. Practice comprehensive care co-ordination and interdisciplinary teamwork.
7. Develop advanced interpersonal communication skills.
8. Produce and evaluate Palliative Care research and teaching.

Associated Assessment Criteria for Exit Level Outcome 1

• Analyse ethical case and reflective portfolio.
• Discuss adult vs pediatric care differences in a variety of clinical settings.

Associated Assessment Criteria for Exit Level Outcome 2

• Discuss clinical case-based physical and psychological symptoms presented by patients with a life-threatening or life-limiting illness.
• Conduct and observe direct patient management.

Associated Assessment Criteria for Exit Level Outcome 3

• Discuss and reflect on case-based bereavement and family care.

Associated Assessment Criteria for Exit Level Outcome 4

• Observe patient/family interactions and teaching evaluations.
• Simulate case discussions in relation to the patients' care goals.

Associated Assessment Criteria for Exit Level Outcome 5

• Write reflections on culture/spirituality in palliative care.
• Observe discussions on spiritual distress.

Associated Assessment Criteria for Exit Level Outcome 6

• Analyse legal/advocacy issues and interdisciplinary teamwork.
• Discuss ethical dilemmas.

Associated Assessment Criteria for Exit Level Outcome 7

• Observe teamwork in clinical settings.
• Gather feedback from colleagues.
• Observe team development.

Associated Assessment Criteria for Exit Level Outcome 8

• Compile research proposal and conduct literature review.
• Compile audit or research project report.

Integrated Assessment

In alignment with the learning outcomes for this qualification, there will be formative and summative assessment of learners. The coursework will contribute to 50 % of the overall result for the degree while the Portfolio of learning (POL) and the research project will contribute to 25% each, of the overall marks for the qualification.

Formative assessment

Formative assessment and feedback will relate to the research proposal.

• Case assessments,
• Case-based discussions,
• Clinical evaluation exercises,
• Written reports, and oral presentations.

Summative assessment

The summative assessment is the assessment of the research report.