The Attitude of Medical Students in Taiwan toward Hospice Palliative Care

Abstract

BACKGROUND AND OBJECTIVES: Care programs targeting the needs of the terminally ill are gaining in importance in Taiwan. In terms of cancer alone, Taiwan has over 40,000 deaths each year. Knowledge and competence related to hospice palliative medicine, however, remains inadequate among Taiwan clinical physicians. The present study was conducted in support of the development of a formal hospice palliative care curriculum for medical students. METHODS: Medical students from twelve Taiwan medical colleges were invited to participate in this survey. Self-administered questionnaires were designed that asked questions in three “domains”: the first assessed students’ basic knowledge regarding hospice care; the second assessed student attitudes toward hospice care; the third acquired background data on the survey participant. RESULTS: Students from Taiwan’s East Coast returned a higher rate of disapproval toward making palliative and end-of-life care part of students’ compulsory education. Students at schools in central Taiwan showed stronger disapproval for making palliative and end-of-life care an elective subject. Junior (second year) and female students, as well as those claiming their religion as “Buddhist”, indicated a relatively stronger approval in their answer to the questing whether they would support payment for hospice care from the National Health Insurance plan. Buddhist respondents also indicated greater relative willingness to become hospice care physicians. Students who had already completed their curriculum in medical ethics indicated relatively stronger disapproval of including hospice-palliative training in the ethics curriculum, although relatively more approved of developing such as an optional course. Medical students with previous hospital volunteer experience did not indicate greater willingness to serve as a hospice volunteer. Those from families with terminally ill relative experience did not show a greater willingness to become hospice care physicians. CONCLUSION: The hospice and palliative medicine education provided medical students in Taiwan remains inadequate. Institutionalizing a curriculum that includes practicum and experiential methodology, which would help medical students achieve basic competency in end-of-life care, would be the best approach to improving the attitude and understanding of Taiwan’s future physicians toward hospice-palliative care.