Abstract
1.Discuss the need to assess students’ experiences and attitudes when incorporating a new palliative medicine curriculum into medical schools.2.Recognize the role of self-reflection as a key component to evaluating students’ competency in end-of-life care. Background. An innovative, longitudinal educational program in end-of-life (EOL) care is being integrated across all four years of medical school at University of Chicago (UC). Self-reflection is one modality of evaluation proposed in the literature to assess students’ comfort in dealing with death and dying. The validity and utility of this method of evaluation is being explored at UC. Research objectives. (1) Assess medical students’ experiences and attitudes towards EOL care utilizing a death attitudes survey and narrative exercises. (2) Perform a qualitative analysis of narratives to assess their utility as an evaluation method. Methods. First-year medical students enrolled in a 4-week elective comprised of didactic and experiential training. Data includes pre/post course (N = 11) attitudes surveys (2008 and 2009) utilizing an adapted version of Bugen's Coping with Death Scale and self-reflection exercises (five per student, N = 4, 20 essays total, 2009) detailing (1) personally experienced loss; (2) attitudes/expectations of one's own death; (3) experience with communication of bad news; (4) meaning of suffering; and (5) EOL decision making and surrogacy. Results. Analysis of attitudes surveys using a paired samples test showed a significant increase in mean scores from 109 to 146 (p < 0.001, SD = 24). Themes emerging from the qualitative narrative analysis included students’ attitudes towards (1) different coping methods for personal loss; (2) preferences for place of death; (3) perceived need for communication training; (4) heterogeneous interpretation of suffering; and (5) early advance care planning. Implications for research, policy, or practice. Future research will explore the longitudinal use of narrative exercises as an evaluation tool during implementation of the new EOL curriculum at UC.
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