Undergraduate palliative care education in Brazil: a qualitative study on the challenges for clinical teachers

Background: In Brazil, previous research has highlighted that clinical teachers have little interest for teaching palliative care to undergraduate medical students and there is a need to obtain greater understanding of the reasons for this disinterest. Objectives: Our objective was to explore the challenges experienced by Brazilian clinical teachers responsible for palliative care in undergraduate medical education. Design, setting, participants: A qualitative exploratory study using semi-structured interviews and analysed by thematic analysis. A total of 6 teachers responsible for teaching palliative care to medical students in the state of São Paulo, Brazil, were recruited. Interviews were conducted via video conferencing. Results: Four themes were identified from the data: (1) Conflicting Ideals on Clinical Care, (2) Teaching in palliative care: from the possible to the ideal, (3) Missed teaching opportunities in palliative care, (4) Challenges of palliative care in the health system. The main challenge of teaching palliative care was the lack of understanding of the concept and importance of palliative care within the healthcare system. Conclusion: Challenges in teaching palliative care in Brazil include limited understanding of its importance, conflicting clinical care perspectives, and emotional discomfort. Targeted strategies are recommended to prepare clinical teachers, integrate palliative care into curricula, and address systemic barriers in similar low and middle income contexts.