P. P. Parikh1, M. T. White1, K. Tchorz1, L. Smith1, P. P. Parikh1 1Wright State University,Surgery,Dayton, OH, USA
Introduction: Palliative and end-of-life care training have been introduced in medical education. However, the impact of such training and the retention of skills and knowledge have not been studied in detail. This work provides information on long-term follow up on the training, evaluation, and skill retention in medical students.
Methods:
All the medical students received simulation based palliative care training in their third year of Surgery clerkship at our institution. The training included three scenarios that reflected surgical patients and conditions commonly encountered during the surgical clerkship. Moreover, the training was intended to expose students to: (i) learning about diversity and importance of religious beliefs, (ii) experience with advance directives, (iii) learning about palliative care management, (iv) giving bad news, (v) end-of-life preferences/DNR, (vi) talking about death and dying, (vii) talking about religious/spiritual values as they contribute to end-of-life care. All the students were surveyed after one year to ascertain if they used any skills/knowledge learned in this training in their other rotations, any knowledge they retained, and their overall perception of the training.
Results:
The survey was sent to all the graduating fourth year medical students (105) in our program out of which 69 students completed the survey (66% response rate), where 57% were male. All (100%) students agreed that the palliative care training is essential in medical school training. Seventy percent of the students agreed that the training they received at our institution helped them develop the skills needed for palliative/end-of-life care communication with the most useful part of the training being ‘giving bad news’ (85%). Moreover, when a question on knowledge or skill retention was asked after a year of training, the majority of students felt that they had retained the skills on giving bad news (80%), talking about death and dying (45%), and end-of-life preferences/advance directives/DNR (44%). A small number of students (16%) claimed they retained their skills on talking about religious/spiritual values. Several students mentioned that more of such training (probably in other rotations) would be beneficial and also indicated the value of seeing their residents or physicians leading these conversations during their clinical rotations.
Conclusion:
Early training in palliative and end-of-life care communication is feasible during clerkships and students retain the skills and knowledge they gain from this experience. However, more practical experience would help by getting students involved in such discussions or just by seeing their attendings or residents leading such discussions during their clinical rotations.