BACKGROUND: Medical care at the end of life remains poor. One approach to improving end-of-life care is through education of medical trainees. However, evidence regarding the structure of an ideal educational intervention is sparse. OBJECTIVE: To test an innovative curriculum designed to improve medical resident knowledge and decrease anxiety surrounding end-of-life care. METHODS: Quasiexperimental study of medical trainees in a large academic internal medicine residency. Attitudes and knowledge were measured at baseline and at completion of a 1-month clinical ward rotation for both control (n = 40) and intervention groups (n = 30) using the Collett-Lester Death Anxiety Scale (C-LDAS), the Semantic Differential Scale (SDS), and a 16-question knowledge-based test. Residents in the intervention group completed four 1-hour sessions focused on end-of-life issues. RESULTS: Baseline anxiety levels were high while knowledge scores were poor. Linear regression modeling demonstrated that pretest scores were the strongest predictor of post-test scores for all three measures. Additional significant predictors for the knowledge test were prior palliative care experience and year of training (p = 0.02), while prior palliative care experience alone contributed to the SDS model (p = 0.06). No significant improvements on the SDS, C-LDAS, or knowledge test occurred after the curriculum intervention. CONCLUSIONS: Our classroom intervention had no significant effect on residents' attitudes towards or knowledge of end-of-life care. The fact that prior palliative care experience affects baseline scores provides a strong argument for continued research for an effective curriculum for end-of-life education, perhaps focusing on clinical rather than didactic experiences in palliative care.
BACKGROUND: Medical care at the end of life remains poor. One approach to improving end-of-life care is through education of medical trainees. However, evidence regarding the structure of an ideal educational intervention is sparse. OBJECTIVE: To test an innovative curriculum designed to improve medical resident knowledge and decrease anxiety surrounding end-of-life care. METHODS: Quasiexperimental study of medical trainees in a large academic internal medicine residency. Attitudes and knowledge were measured at baseline and at completion of a 1-month clinical ward rotation for both control (n = 40) and intervention groups (n = 30) using the Collett-Lester Death Anxiety Scale (C-LDAS), the Semantic Differential Scale (SDS), and a 16-question knowledge-based test. Residents in the intervention group completed four 1-hour sessions focused on end-of-life issues. RESULTS: Baseline anxiety levels were high while knowledge scores were poor. Linear regression modeling demonstrated that pretest scores were the strongest predictor of post-test scores for all three measures. Additional significant predictors for the knowledge test were prior palliative care experience and year of training (p = 0.02), while prior palliative care experience alone contributed to the SDS model (p = 0.06). No significant improvements on the SDS, C-LDAS, or knowledge test occurred after the curriculum intervention. CONCLUSIONS: Our classroom intervention had no significant effect on residents' attitudes towards or knowledge of end-of-life care. The fact that prior palliative care experience affects baseline scores provides a strong argument for continued research for an effective curriculum for end-of-life education, perhaps focusing on clinical rather than didactic experiences in palliative care.
Authors: Giampiero Porzio; Marco Valenti; Federica Aielli; Lucilla Verna; Enrico Ricevuto; Anna Iolanda Rispoli; Katia Cannita; Paolo Marchetti; Corrado Ficorella Journal: Support Care Cancer Date: 2005-04-29 Impact factor: 3.603
Authors: Lorenzo Di Francesco; Michael J Pistoria; Andrew D Auerbach; Robert J Nardino; Eric S Holmboe Journal: J Gen Intern Med Date: 2005-12 Impact factor: 5.128
Authors: Helena E A Aho-Özhan; Sarah Böhm; Jürgen Keller; Johannes Dorst; Ingo Uttner; Albert C Ludolph; Dorothée Lulé Journal: J Neurol Date: 2017-01-24 Impact factor: 4.849