Knowledge and attitude of final - year medical students in Germany towards palliative care - an interinstitutional questionnaire-based study

Abstract

BackgroundTo care for terminally ill and dying patients requires a thorough medical education, encompassing skills, knowledge, and attitudes in the field of palliative care. Undergraduate medical students in Germany will receive mandatory teaching in palliative care in the near future driven by recent changes in the Medical Licensure Act. Before new curricula can be implemented, the knowledge of medical students with respect to palliative care, their confidence to handle palliative care situations correctly, their therapeutic attitude, and their subjective assessment about previous teaching practices have to be better understood.MethodWe designed a composite, three-step questionnaire (self estimation of confidence, knowledge questions, and opinion on the actual and future medical curriculum) conducted online of final - year medical students at two universities in Germany.ResultsFrom a total of 318 enrolled students, 101 responded and described limited confidence in dealing with specific palliative care issues, except for pain therapy. With regard to questions examining their knowledge base in palliative care, only one third of the students (33%) answered more than half of the questions correctly. Only a small percentage of students stated they had gained sufficient knowledge and experience in palliative care during their studies, and the vast majority supported the introduction of palliative care as a mandatory part of the undergraduate curriculum.ConclusionThis study identifies medical students' limited confidence and knowledge base in palliative care in 2 German universities, and underlines the importance of providing a mandatory palliative care curriculum.

Palliativmedizinisch orientierte Therapieansätze für alle Patienten

“…Die Palliativmedizin ist seit 2011/2012 integraler Bestandteil der ärztlichen Ausbildung (Querschnittfach 13 "Palliativ-und Schmerzmedizin"; [1,12,16]). Patienten mit lebenslimitierenden Erkrankungen im weit fortgeschrittenen Erkrankungsstadium werden zunehmend auch in der Regelversorgung betreut [1].…”

“…Die Behandlung von Palliativpatienten benötigt nach Aussagen mehrerer Autoren und der Expertenrunde besondere Kenntnisse und Ausbildungs-bzw. Weiterbildungsinhalte [1,16]. In diesem Zusammenhang stellt sich jedoch die Frage, ob die palliativmedizinisch orientierte Behandlung und deren Inhalte lediglich Patienten am Lebensende bzw.…”

“…Information des Hausarztes, Integration eines ambulanten Pflegediensts, Nutzen ambulanter ehrenamtlicher Versorgungs-und Betreuungsangebote). Ziele der palliativmedizinischen Betreuung können sich also in Bezug auf die allgemeine medizinische Versorgung unter Berücksichtigung aller Patienten nicht nur auf einen angemessenen Umgang mit Schwerstkranken und Sterbenden beschränken, wie es im Kurs buch Palliativmedizin definiert und in entsprechenden Curricula sowie der studentischen Ausbildung gelehrt wird [1,4,16]. Von besonderer Bedeutung ist in diesem Zusammenhang auch, dass wie bereits zuvor beschrieben, die Palliativmedizin nicht als Medizin des sterbenden Menschen isoliert und darauf reduziert wird.…”

A Pilot Study on Undergraduate Palliative Care Education – A Study on Changes in Knowledge, Attitudes and Self-Perception

“…The Collet Lester Fear of Death and Dying Scale-Revised [23][24][25] was used to obtain information about attitudes towards and fears of death and dying of self and others. Data about participants' palliative care knowledge was collected by means of the Three Step Questionnaire [6,7], an instrument consisting of 21 questions related to eight case examples.…”

“…A current survey conducted in 2012 to investigate the progress of implementation of palliative care curricula in medical faculties in Germany [6,7] demonstrated that UPCE was mainly taught interprofessionally and in an advanced semester and comprised twelve to forty-three TU.…”