Instruments to measure skills and knowledge of physicians and medical students in palliative care: A systematic review of psychometric properties

Abstract

Purpose

Palliative care is constantly increasing around the world. The knowledge and skills of future physicians in this area are crucial. This study evaluates the psychometric properties of knowledge and skills questionnaires used in palliative care, validated by physicians or medical students based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology.

Methods

A systematic review was carried out in Cosmin Databases, Cochrane Library, PsycINFO, SciELO, Cinahl, and Medline up to September 2020 (updated June 2021), based on the COSMIN methodology and PRISMA recommendations. The psychometric properties of each included questionnaire were identified. Methodological quality, quality of results, and quality of evidence were evaluated.

Results

The search strategy yielded 12 questionnaires assessing the knowledge and skills of physicians or medical students. The Palliative Care Knowledge Questionnaire for PEACE (PEACE-Q) and Palliative Care Knowledge Test (PCKT) were the instruments with the highest scores for methodological quality, quality of results, and quality of evidence-based on the COSMIN methodology.

Conclusions

PEACE-Q and PCKT should be the preferred choice to assess palliative care knowledge and skills in physicians. In-depth studies following COSMIN validation criteria are recommended to improve the psychometric properties and cross-cultural validation of the questionnaires.

Keywords:

• Palliative care
• knowledge
• questionnaires
• legal medicine
• education

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Author contributions

All authors: substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work, drafting the work or revising it critically for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved, and gave final approval to the submitted paper.

Glossary

COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN): A written method that attempts to evaluate the methodological quality of studies on measurement properties of health-related patient-reported outcomes (HR-PROs). When measuring health-related patient-reported outcomes, it is important to evaluate the methodological quality of studies in which the measurement properties of these instruments are assessed. Whenever studies on measurement properties have good methodological quality, their conclusions are more trustworthy.

Psychometric property: Refers to the validity and reliability of the measurement tool. Both properties, validity, and reliability, can be treated mathematically.

Additional information

Notes on contributors

Mónica López-García

Mónica López-García MD, PhD, is a palliative care physician at CUDECA Hospice Foundation in Benalmádena, Málaga, Spain.

Leticia Rubio

Leticia Rubio MD, PhD, is an Associate Professor of Legal and Forensic Medicine at the University of Málaga Medical School, Málaga, Spain.

Stella Martin-de-las-Heras

Stella Martin-de-las-Heras MD, PhD, is a Full Professor of Legal and Forensic Medicine at the University of Málaga Medical School, Málaga, Spain.

Juan Suárez

Juan Suárez PhD, is an Associate Professor of Legal and Forensic Medicine at the University of Málaga Medical School, Málaga, Spain.

María D. Pérez-Cárceles

María D. Pérez-Cárceles MD, PhD, is a Full Professor of Legal and Forensic Medicine at the University of Murcia Medical School, Málaga, Spain.

Jaime Martin-Martin

Jaime Martin-Martin PhD, is an Assistant Professor of Legal and Forensic Medicine at the University of Málaga Medical School, Málaga, Spain.