Teaching end-of-life care to family medicine residents–what do they learn?

Abstract

Background: In order to address adequately basic palliative care issues, post graduate teaching programs for physicians should provide, in addition to basic knowledge in the field and clinical skills, also training in terms of orientations and skills which enable physicians to overcome their emotional difficulties as well as professional barriers. This paper presents a model of teaching and its evaluation.Aims: The purpose of this project was to develop an educational program for residents in family medicine and evaluate its effect over time. The focus was on the self-perceived ability of physicians for understanding and communicating with terminally ill patients; the physicians’ ability to deal with their own emotional difficulties while caring for the terminally ill; and the physicians’ confidence regarding the management of over-all suffering.Methods: Structured questionnaires were filled out by 21 physicians before and after an 8 months program of residency training in palliative care.Results: Factor analysis yielded three factors: (A) Beliefs focusing on the resident's ability to understand terminally-ill patients and to communicate with them, (B) Beliefs regarding the effect of the program on the resident, and (C) Beliefs about self-professional skills. A comparison with the responses at the end of the program indicated a trend towards increased communication capabilities, relating increased importance to the program and a significant improvement in self confidence in professional skills.Conclusions: The results of the evaluation indicate that this teaching program has achieved its goals by not only improving the physician's knowledge, but also causing a positive change in attitudes regarding end-of-life care. Considering our positive results it is recommended to incorporate similar training programs in physicians’ post-graduate studies.