Impact of a Geriatric and Palliative Medicine Clerkship on Knowledge and Attitudes about End-Of-Life Care
Nguyen, Linh M.T.
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Previous interventions of students and residents suggest that those which employ patient encounters increases attitude towards end-of-life care and performance on a palliative care knowledge examination, but those studies did not include geriatric preceptors. From a population of third-year medical students, the researcher surveyed attitudes and tested knowledge before and after a combined geriatric and palliative clerkship to determine the impact on these outcomes and if there were any differences among the preceptor or the clinical site. After the rotation, students’ perceptions of the importance that medical students learn about how to care for dying patients of resident and attending physicians increased from 77.5% to 89.6% (p <0.001) and 87.4% to 92.9% (p = 0.001) respectively. More students agreed that physicians have a responsibility to provide bereavement care (p < 0.001) and that depression is treatable among patients with terminal illness (p = 0.017). More students disagreed that they dread having to tell patients the truth about a terminal prognosis and still maintain hope (p = 0.003), that caring for dying patients is depressing (p < 0.001), and that they feel guilty after a death (p <0.001). Test scores increased from a mean of 59.8% to 70.4% (p < 0.001). There were no differences in attitude or knowledge among the preceptors or clinical sites. This rotation was associated with an increase in attitudes and knowledge regardless of the preceptor or clinical site. Results indicated that palliative educational programs should receive more institutional support to better prepare future physicians.