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

Abstract

; Reed, George W.; and Clay, Marjorie, "Detecting attitudinal changes about death and dying as a result of end-of-life care curricula for medical undergraduates" (2005 Design: A case control design (n ‫؍‬ 100) and a one group pretest-posttest design (n ‫؍‬ 98) were used to ask: (1) Are these two attitudinal measures responsive to changes induced by two undergraduate EOL curricula? (2) Do these two curricula have an additive effect (i.e., taking both yields a stronger attitudinal change than taking only one)? (3) Are there attitudinal and sociodemographic differences between students who took the year-long elective EOL course and those who did not?Subjects: Undergraduate medical students. Measurements: Two self-report measures: Concept of a Good Death and Concerns about Dying.Results: Compared to nonelective participants, Elective participants reported less concern about working with dying patients at the end of the course and increased their valuation of clinical criteria in thinking about a "good death." There were trends suggesting decreased general concern about dying and increased valuation of closure, and an interaction suggesting a larger impact on those with higher precourse concern scores. There were no differences between elective and nonelective participants at baseline. The Interclerkship increased students' valuation of personal control aspects of death, and there was a trend in reducing con-

Instruments used to measure the effectiveness of palliative care education initiatives at the undergraduate level: a critical literature review

“…Two studies modified the tool for the purpose of their research either by changing the terminology or the format 25 26. Five studies included original measures 16 18 19 22 23. The tables give an overview of the research articles (supplementary table 1) and they included measures ranging from more widely used and tested tools (supplementary table 2) to more recent instruments (supplementary table 3).…”

Effectiveness of an Integrated Ward-based Program in Preparing Medical Students to Care for Patients at the End of Life

“…Furthermore, the self-perception of a higher level of preparedness itself may give students the willingness and confidence to remain engaged in the care of patients at the end of life as they advance in their training. Attitudinal changes, including less concern about working with dying patients, have been reported among students participating in elective end-of-life curricula 18 and self-rated knowledge and attitudes about end-oflife care may influence a physician's likelihood to refer to hospice. 19 A second potential limitation is that about 35% of graduating students did not complete the survey.…”

End-of-Life and Palliative Care Issues in Medical and Nursing Schools in the United States

“…For example, a recent study of third-year medical students, who took a 4-day orientation to end-of-life issues in which they were exposed to concepts regarding hospice and palliative care, were given a session on breaking bad news, and then visited hospice patients, revealed that the students showed significant improvements in competence and knowledge and a reduction in concern about end-of-life issues (Porter-Williamson et al, 2004). In another study, control and experimental groups of medical students were used to evaluate the responsiveness of attitudes to changes caused by an end-of-life curriculum (Schwartz et al, 2005). Those students in the end-of-life curriculum, compared with those not in this program, reported less concern about working with dying patients at the end of the course and increased their valuation of clinical criteria in thinking about a ''good death.''…”