Changes in Perceptions and Attitudes of Medical Students toward End-of-Life Care after Hospice and Palliative Medicine Education

Abstract

High-quality hospice and palliative medicine curricula are necessary in Korean medical schools. This study evaluated changes in students' knowledge and attitudes toward both hospice and palliative care following the completion of a course on these topics, as well as the course's overall role in the basic medical education curriculum. Methods: Questionnaires measuring knowledge and attitudes were collected before and after the course from 76 fourth-year medical students, who had received instructions integrating both hospice and palliative care in 2016. Results: The questionnaire item "Select the correct answer on the use of opioid pain control in hospice and palliative care" changed the most in terms of number of correct answers pre-and post-course (3.50 and 5.32, respectively; P＜0.001). Pre-and post-course, the numbers of students who answered "Strongly Agree" and "Agree" to questions concerning their attitudes toward hospice and palliative care ("I know the purposes and roles of hospice and palliative care") were 17 (22.4%) and 65 (85.6%), respectively (P≤0.001). Affirmative responses also increased for "As a pre-physician, I know when to describe and advise hospice and palliative care to patients", from 22 (28.9%) to 65 (85.6%; P≤0.001). Conclusion: This study showed that comprehensive hospice education in the form of an integrated educational course might promote changes in medical students' knowledge and attitudes toward hospice and palliative medicine.

Impact of a pharmacist-led palliative care education program focused on the appropriate use of opioids in Vietnam

“…Thus, while morphine and opioid-related products are amongst "taboo" topics in Vietnam and controlled drug prescriptions are restricted, not having a general understanding of the definition, role, and necessity of palliative care, a specialist care field that is still in the initial setup phase in Vietnam, healthcare providers are less likely to be confident in prescribing, dispensing or instructing patients to use this medication. A comprehensive education in the form of an integrated curriculum in medicine and pharmacy school introducing palliative care might promote changes in knowledge and attitudes toward using opioids for pain control [15][16] .…”

Assessing Medical Students’ Confidence towards Provision of Palliative Care: A Cross-Sectional Study

“…[12,13]. Compared to South Korea (18th) with a similar ranking as Hong Kong (22nd), the "non-confidence" rate researched among undergraduates is 14.4% [34]. The difference in results could be influenced by the rich resources implemented by the government, including a 60-h standard hospice and palliative care education program for all related disciplines in 2005 [43], and the 2.3 billion USD subsidization on palliative care units, through which, palliative care units increased from 15 (2005) to 44 (2011).…”

“…Eligible participants were recruited through convenience sampling with a link of an anonymous, self-administered quantitative questionnaire (i.e., Google Form) sent to medical students for four months. Due to the unavailability of local data on the confidence rate of palliative care among medical undergraduates, the data from South Korea with a rate of 85.6% are referenced [34], in which, South Korea has a very similar context as Hong Kong, having a similarly advanced medical system yet a relatively low quality of palliative care (in terms of the Quality of Death Index ranking) [26]. Moreover, both medical curriculum in South Korea and Hong Kong are undergoing a Western medical education, following a six-year training system before starting their clinical career [35].…”

Metodologías para la enseñanza de cuidados paliativos en estudiantes de áreas de la salud

“…Dos de los cinco estudios en este subtema usaron diseños experimentales, uno usó un diseño de casos y controles, uno descriptivo y uno mixto. Frente a los contenidos, se encontró la enseñanza de temas como conceptos generales de cuidado en hospicios, compasión, manejo del dolor, uso de opioides y otros analgésicos; manejo de síntomas, cuidado al paciente agónico, cuidado en el hogar, problemas legislativos o problemas de salud frente a la atención al nal de la vida; CP perinatales y neonatales, el duelo y la pérdida de seres queridos; calidad de vida, perspectivas culturales y globales de los CP, espiritualidad, consideraciones éticas y competencias interprofesionales (14)(15)(16)(17). Tres de los estudios, además (16)(17)(18), estructuraron sus contenidos a partir de las recomendaciones del Consorcio de educación en enfermería al nal de vida con base en Estados Unidos (Elnec por sus siglas en inglés), que es una iniciativa que busca mejorar la enseñanza en CP a nivel nacional e internacional (19).…”

“…En cuanto al modo de entrega de estos cursos, se encontró que se impartieron en sesiones presenciales de dos horas semanales cada dos semanas (16), dos días (17), un día (15) y dos días con una rotación de cuatro horas en el área clínica (14). Sobre las estrategias didácticas utilizadas en estos cursos se encontraron lecturas, entrevistas, conferencias magistrales, casos y rondas clínicas o de opiniones, discusiones de grupo, análisis de películas, juegos y presentaciones (14)(15)(16)(17).…”