Training needs and curricular priorities for managing multimorbidity in Spanish primary care: findings from a national exploratory online survey

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BACKGROUND: Multimorbidity is highly prevalent and poses clinical and organisational challenges, yet the training of doctors and nurses continues to focus mainly on single conditions. In recent years, training interventions for healthcare professionals on multimorbidity have emerged, but evidence of their effectiveness remains limited. Understanding the learning needs of professionals is essential for guiding educational programmes. This study aimed to identify the perceived training needs of primary care physicians and nurses in the management of multimorbidity and to contribute to a proposal of updated curriculum content. METHODS: Exploratory cross-sectional study using an online survey of doctors and nurses in primary care and out-of-hospital emergency services in Spain. The questionnaire was developed based on the literature, existing curriculum frameworks and previous findings from the MULTIPAP study, and collected sociodemographic, professional and educational data, as well as perceptions about resources, difficulties and training needs in multimorbidity. Descriptive, bivariate, and multivariable analyses were conducted, and open-ended responses were analysed using thematic content analysis. RESULTS: The main difficulties and training needs concerned medicines management and diagnostic and therapeutic challenges, followed by communication and time management. Participants valued patient-caregiver-centred care, medicines management, and care coordination. An online format with videos was preferred. Differences were observed by profession, gender, field of work, trainee status, and prior participation in the MULTIPAP study. The proposed curriculum comprised eight competency groups, including professionalism and social sciences along with other key issues, especially clinical, communication, and management skills. CONCLUSION: Professionals share many training needs, obstacles, and resources related to multimorbidity care, with some differences between subgroups. These findings informed a proposal for an updated curriculum content.

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