Caring for dying patients?what are the attitudes of medical students?

Abstract

Students entering medical school today will encounter an ageing population and a higher incidence of patients with terminal and life threatening illness. This study was carried out to determine the attitudes of pre-clinical medical students towards the care of patients for whom a cure is not possible. All students were invited to complete a 23-item questionnaire prior to any teaching in palliative care. Of the 186 students who participated in the study, 151 (79%) completed the pre-teaching questionnaire (males=59; females 90; median age 20 years; range 19-27]. Attitudes towards chronically ill and dying patients were generally positive. When comparing age with attitudes 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. 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 and terminal illness-the trend for encouraging older students to enter medicine may be an influencing factor.

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

“…The questionnaire was specifically designed for the study, based on previous studies. 7,9 To make it suitable to our objectives. The content of the questionnaire was validated before study.…”

“…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.…”

“…11 Most medical students state that the main reason for them to be a physician is to cure patients; medical education prepares physicians this way. 7,10 For these students, it may be difficult to accept that all diseases may not be curable, death is sometimes inevitable and more so to communicate the same to patients/patients relatives. This dynamic situation has changed physicians-patient relationship and requirements, 12 to address these issue's recently, much attention has been directed toward death-related topics, including the role of the physician in caring for terminally ill patients and communicating with patients and their families about death and dying.…”

“…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.…”

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.…”