Abstract
This article was migrated. The article was not marked as recommended. AimsResearch with residents demonstrates perceptions of insufficient skills and comfort with end of life (EOL) care, and there is a paucity of evidence regarding attending physicians' competencies in such care. The purpose of this study was to gain an understanding of self-reported competencies among medical school graduates and to assess the impact of a 3rd year hospice rotation.MethodsAn online survey was sent to 510 medical school alumni assessing experiences, self-rated competencies and preparedness regarding EOL care, and perceptions of the hospice rotation. Analyses explored a range of possible variable associations.Results116 surveys were completed. EOL care experience was substantial during undergraduate and residency training. More experience was predictive of greater skills and comfort. Pain management skills were rated lower than other skills. Completion of the hospice rotation was associated with confidence-building and perceptions of preparedness. Attending physicians did not report stronger skills than residents. There was strong support for training in EOL care.ConclusionsOur findings support previous research about the benefits of EOL care experiences for residents and exposure to such care during undergraduate training, underscoring the importance of well-tailored EOL care education at all levels of training for optimal development of competencies.
Highlights
The Liaison Committee for Medical Education (LCME) recommends the inclusion of end of life (EOL) care topics in medical school curricula (LCME, 2012) and The Accreditation Council for Graduate Medical Education (ACGME) requires that residents and fellows in a number of specialties (ACGME, 2015)
Research with residents demonstrates perceptions of insufficient skills and comfort with end of life (EOL) care, and there is a paucity of evidence regarding attending physicians' competencies in such care
The purpose of this study was to gain an understanding of self-reported competencies among medical school graduates and to assess the impact of a 3rd year hospice rotation
Summary
Design We conducted a cross-sectional survey of alumni from one medical school between one and seven years subsequent to their graduation. Survey Monkey (Palo Alto, CA) was employed as means of survey administration. Respondents returned their surveys anonymously to the Alumni Office. Study measures Survey items addressed extent of clinical experiences and perceived preparedness with EOL care during medical school and residency, views of the 3rd year hospice rotation, and post-graduate formal training in palliative care. Mean composite scores were calculated for scales measuring comfort, EOL care preparedness, and clinical and communication skills. Background characteristics and extent of clinical EOL care experiences, including completion of hospice rotation, were examined as independent variables in relation to perceived skills, preparedness and comfort. Attitude variables were treated as possible predictors as well as outcomes and were examined in relation to clinical experience, preparedness, skills and comfort
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