Self-assessed palliative care competency acquisition across academic cycles among Brazilian medical students: a cross-sectional study

Palliative care (PC) supports individuals with life-limiting conditions by enhancing the quality of life for both patients and their families. Although international guidelines recommend PC training during medical school, Brazilian students often receive insufficient preparation in this area. This study aimed to evaluate the self-assessed acquisition of PC competencies across academic cycles among medical students in Brazil using the Palliative Competence Tool (PalliComp), a specialists-validated questionnaire. A cross-sectional, observational, and quantitative study was conducted online between February 1st and August 31, 2024. Eligible participants were medical students aged 18 years or older enrolled in programs accredited by Brazil’s Ministry of Education. They provided demographic information and completed the PalliComp questionnaire, which consists of 25 statements rated on a five-point Likert scale. A total of 385 students participated, with most from public institutions (n = 247, 64%) and the Southeast region (n = 169, 44%). Mean overall PalliComp scores increased across educational stages: 0.66 in the basic cycle, 0.71 in the clinical cycle, and 0.74 during the internship (p < 0.001). Significant improvements were observed in most competencies, particularly in communication and symptom management. However, competencies related to ethical and complex clinical decision-making, comprehensive care coordination, interdisciplinary teamwork, self-awareness, and continuing professional development showed no notable gains. An improvement in the acquisition of PC competencies was observed, particularly between the basic and internship cycles of medical training. However, three competencies demonstrated limited progression throughout the curriculum and therefore warrant special attention. These findings highlight the need to strengthen both teaching and practical experiences in PC within medical education. Brazilian Registry of Clinical Trials (UTN: U1111-1298-0091), registered 10 September 2023.