An Intervention to Improve Knowledge of Care Options and Self-Management Among Women with Breast Cancer (S788)

Abstract

Methods. Residents during their geriatric rotation were randomized to standard rotation curriculum (n1⁄412) or standard curriculum plus a half-day of supervised home visits with a hospice team (n1⁄411). All residents completed an Objective Structured Clinical Examination (OSCE) at the end of the rotation that measured the ability to effectively discuss prognosis and recommend hospice. Results. Residents were competent in patientcentered communication skills including exploring patients’ goals and values (100%) and exploring patients’ understanding of their illnesses (96%). Most residents also described hospice’s focus on quality of life (100%) and its concordance with the goal of not going to the hospital (96%). Compared to communicating the overall goals of hospice, residents had more difficulty describing the specifics of hospice such as the need for a primary caregiver (26%) and hospice’s provision of bereavement support (9%). Overall, few residents stated a recommendation for hospice (48%); however, of those who did, 64% experienced a home hospice visit and 36% did not. Additionally, the only residents to describe bereavement support participated in the home hospice experience. Conclusions. Preliminary analysis suggests a trend towards a significant increase in recommending hospice and describing the provision of bereavement care among residents who participated in the hospice home visit experience. Implications forResearch, Policy, or Practice. Home hospice visits may be a high value educational activity for residents.