End-of-life care education for medical students in mainland China: a cross-sectional survey

Abstract

BackgroundAccording to the 2015 Quality of Death Index, China ranks 71st out of 80 countries in terms of the quality of palliative care. The lack of end-of-life care education has been identified as a key barrier to the improvement of the discipline. The aim of this study is to assess the status of end-of-life care education for medical students in mainland China. MethodsWe obtained a list of all medical schools from the website of the Ministry of Education. We did a telephone survey of associate deans for medical education at all 282 medical schools in mainland China in May, 2019, following a standardised protocol. Telephone interviews focused on attitudes to end-of-life care teaching, and the extent and manner in which end-of-life care is incorporated into the curriculum. Schools that did not reply were contacted again after 1, 3, and 7 days. We obtained ethical approval from Zhejiang University Research Ethics Committee. FindingsAmong the 282 medical schools, associate deans from 120 (43%) schools completed the interview; 53 (19%) schools declined to answer questions related to end-of-life care. 92 (77%) of 120 associate deans regarded end-of-life care education as very important, but only 11 (9%) provided specific teaching about end-of-life care. One dean said that such a course was being planned. 18 schools have integrated end-of-life education within required curricula, such as medical ethics. The main reason reported for not providing end-of-life care was that the medical curriculum dictated by the Chinese Ministry of Education does not require it. InterpretationA minority of medical schools in mainland China provide any formal teaching about end-of-life care. The Chinese Government needs to include end-of-life care in the medical curriculum. FundingStart-up Funds for Foreign Experts of Zhejiang University.