Attitudes of preclinical medical students towards caring for chronically ill and dying patients: does palliative care teaching make a difference?

Abstract

Introduction: Students entering medical school today will encounter an ageing population and a higher incidence of diseases affecting the elderly-for example, chronic respiratory and cardiac disease and malignancy. Purpose: This study was carried out to determine the attitudes of preclinical medical students towards the care of patients for whom a cure is not possible. Methods: All students were invited to complete a 23 item questionnaire prior to initial teaching and again following the second teaching session in palliative care. Results: Overall, 149 of the 186 students (80%) completed the pre-teaching questionnaire (59 males and 90 females; median age 20 years, range 19-27 years), and 66 students (35%) completed the postteaching questionnaire. Attitudes towards chronically ill and dying patients were generally positive. It was found that increasing age was associated with a more positive view of caring for patients with chronic or terminal illness, a more positive view of listening to patients reminisce, and a more positive view of patients dying at home (p = 0.014). The only notable result was that after palliative care teaching students had a significantly more positive view of hospices. Conclusion: Caring for patients at the end of life can be one of the most rewarding aspects of being a doctor. This study suggests that the majority of medical students have a positive attitude towards patients with chronic incurable illness, and the trend for encouraging older students to enter medicine may be an influencing factor.

Impact of the educational session on knowledge and attitude toward palliative care among undergraduate medical, nursing, and physiotherapy students: a comparative study

“…7 Following the session, there was an overall significant improvement in knowledge, pain management and attitude scores in all the three groups (Table 2) showing the impact of the session and ability of the students in gaining knowledge about palliative care, which was similar to previous studies. 12,13 The knowledge scoring was based on students' awareness about the term palliative care, approaches and goal of palliative care and also, any need for psychological, emotional, spiritual support along with medical treatment. The pre-session and post-session knowledge scores were analyzed.…”

Perception and attitudes of medical students toward communication, chronic disease and death

“…There is emphasis on students gaining clinical exposure during the preclinical years and building on that during subsequent clinical attachments. There were scanty studies, [7][8][9]12,15 undertaken to assess the perception of medical graduates regarding communication, chronic diseases and death in the western world. However, few studies have been conducted in Indian setup.…”

“…With the aging of society, deaths due to chronic diseases have outnumbered those due to acute diseases. 7,8 Where over 90% of hospital beds are occupied with patients suffering from chronic disease or illness. 8,9 For these patients, the control of symptoms and supportive care or palliative care is important.…”

“…7,8 Where over 90% of hospital beds are occupied with patients suffering from chronic disease or illness. 8,9 For these patients, the control of symptoms and supportive care or palliative care is important. Patients with chronic diseases, who must live with lifelong medical problems caused by the disease, have difficulty building sufficient relations with physicians due to insufficient time and literacy barriers.…”

Detecting Attitudinal Changes about Death and Dying as a Result of End-of-Life Care Curricula for Medical Undergraduates

“…23 Another hindrance to EOL curriculum evaluation relates to the quality and standards of measures of attitudinal constructs that are at least as important to delivering quality EOL care as their cognitive and behavioral counterparts, but may present more of a challenge to evaluate effectively. Attitudinal constructs have been assessed in a small number of EOL curriculum evaluation studies, and have focused on perceived value of 24 or comfort with 25 the course, or attitudes towards hospice, 26,27 or the perspective of various stakeholders in the hospital community (e.g., learners, attending physicians, nursing staff) toward the curriculum. 28 These attitudinal constructs have usually been assessed by single questions, which are likely to be less reliable than multi-item scales, or focus group interviews, an approach that can be valuable for hypothesis generation but less so SCHWARTZ ET AL.…”