Palliative care is an important and emerging medical specialty in the area of end-of-life care. Almost all physicians are required to take care of a terminally ill patient at some point in their care, but previous studies from around the world have identified inadequate palliative care training for both medical students and general practitioners. The objectives of this study were to understand junior medical student knowledge of palliative care and how it improved after a one week training course. The study, a quasi-experimental design, recruited eighty medical students between 2001 and 2003 participating in a one-week course named “The human side of medicine” in the hospice palliative care unit of the National Taiwan University Hospital. The questionnaire, assessing medical student palliative care knowledge and attitudes towards ethical dilemmas, was used to assess knowledge of palliative care philosophy and clinical management, and attitudes regarding common ethical issues before and after the training course. The findings showed that the training increased medical student knowledge of palliative care philosophy with a mean score of 4.12 before the training and 4.75 afterwards (range 0-6; t=3.534, p<0.001). Their knowledge of clinical management increased as well, with a mean score of 5.86 before training and 7.69 afterwards (range 0-12; t=7.651, p<0.001). Regarding attitudes towards four common ethical dilemmas, medical students mostly agreed on discharge planning (mean: 4.35, range 1-5) before the course and truth-telling (4.600) after the training course. However, the issue of ‘artificial hydration and nutrition does not benefit terminal patients’ was the most contentious issue both before and after the training. Based on the findings of this study, an appropriate palliative care training program can increase medical student understanding of palliative care philosophy, management and attitudes in the area of ethical decision-making. The results of this study should encourage those providing or planning to provide training opportunities for medical students in the area of end-of-life care.
Palliative care is an important and emerging medical specialty in the area of end-of-life care. Almost all physicians are required to take care of a terminally ill patient at some point in their care, but previous studies from around the world have identified inadequate palliative care training for both medical students and general practitioners. The objectives of this study were to understand junior medical student knowledge of palliative care and how it improved after a one week training course. The study, a quasi-experimental design, recruited eighty medical students between 2001 and 2003 participating in a one-week course named “The human side of medicine” in the hospice palliative care unit of the National Taiwan University Hospital. The questionnaire, assessing medical student palliative care knowledge and attitudes towards ethical dilemmas, was used to assess knowledge of palliative care philosophy and clinical management, and attitudes regarding common ethical issues before and after the training course. The findings showed that the training increased medical student knowledge of palliative care philosophy with a mean score of 4.12 before the training and 4.75 afterwards (range 0-6; t=3.534, p<0.001). Their knowledge of clinical management increased as well, with a mean score of 5.86 before training and 7.69 afterwards (range 0-12; t=7.651, p<0.001). Regarding attitudes towards four common ethical dilemmas, medical students mostly agreed on discharge planning (mean: 4.35, range 1-5) before the course and truth-telling (4.600) after the training course. However, the issue of ‘artificial hydration and nutrition does not benefit terminal patients’ was the most contentious issue both before and after the training. Based on the findings of this study, an appropriate palliative care training program can increase medical student understanding of palliative care philosophy, management and attitudes in the area of ethical decision-making. The results of this study should encourage those providing or planning to provide training opportunities for medical students in the area of end-of-life care.
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