Improved competence after a palliative care course for internal medicine residents

Abstract

Residents report that they received inadequate teaching in palliative care and low levels of comfort and skills when taking care of dying patients. This study describes the effects of a problem-based palliative care course on perceived competence and knowledge in a representative Dutch cohort of residents in internal medicine. Before and after the course, we carried out a questionnaire survey and knowledge test in 91 residents. The results show that many residents felt they had limited competence or were incompetent when taking care of patients in the palliative care phase. This was particularly true with respect to communication concerning euthanasia and physician-assisted suicide or hastened death (86% and 85% respectively reported limited competence or incompetence). Participants reported that they received inadequate training in palliative care and believed that specific education would make them feel more competent. The number of times that residents were engaged in palliative care situations and the years of clinical experience had a positive influence on perceived competence. Participating in the course improved perceived competence and knowledge in palliative care. No correlation was found between perceived competence and knowledge of palliative care.

The effectiveness of communication-skills training interventions in end-of-life noncancer care in acute hospital-based services: A systematic review

“…The remaining studies conducted a mixture of repeated measures analyses such as paired t-tests (Mulder et al, 2009;Smith et al, 2013), and random effects repeated measures regression model (Zapka et al, 2006). One study also conducted correlations (Mulder et al, 2009) using Pearson's or Spearman's Rank, and one conducted non-parametric analyses (Clayton et al, 2012) …”

“…Seven studies were conducted in the United States of America (Betcher, 2010;Kelley et al, 2012;Kerai & Wheeler, 2013;Krimshtein et al, 2011;Schell et al, 2013;Smith et al, 2013;Zapka et al, 2006); one study in the Netherlands (Mulder et al, 2009); one study in Australia (Clayton et al, 2012); and one study in the United Kingdom (Bristowe et al, 2014). Only four studies reported sex of participants (Clayton et al, 2012;Mulder et al, 2009;Schell et al, 2013;Smith et al, 2013).…”

“…Only four studies reported sex of participants (Clayton et al, 2012;Mulder et al, 2009;Schell et al, 2013;Smith et al, 2013). All four of these studies reported a greater female proportion of participants (>50% female participants).…”

“…One study (Mulder et al, 2009) reported inclusion of questions in the post-intervention questionnaire to evaluate the training; however no results for this are reported in the paper. All studies that presented results highlighted how participants valued communication skills training, and would recommend it to colleagues.…”

An Educational Intervention To Improve Resident Comfort with Communication at the End of Life

“…[6][7][8][9][10][11] Several studies have developed didactic modules to teach residents the communication skills necessary for caring for patients at the end of life. 10,[12][13][14][15][16][17] Although such modules have demonstrated a measurable impact on resident knowledge and attitudes regarding end-of-life care, none has been widely adopted into resident curricula. Utilizing a strategy of facilitated, case-based, peer interactions, we sought to assess the feasibility and impact of a novel curriculum in end-of-life education that would be easily incorporated into the preexisting internal medicine resident curriculum.…”