The preparedness of students to discuss end-of-life issues with patients.
OBJECTIVE
To explore how well medical schools prepare students to address end-of-life issues with their patients.


METHODS
In 1997, the authors surveyed 226 fourth-year students at Georgetown University School of Medicine and Mayo Medical School, assessing relevant knowledge, experiences, and attitudes, and the students' sense of preparedness to address end-of-life issues.


RESULTS
Seventy-two percent (162) of the eligible students responded. Almost all (99%) recognized the importance of advance directives and anticipated discussing end-of-life issues with patients in their practices (84%). However, only 41% thought their education regarding end-of-life issues had been adequate, only 27% had ever discussed end-of-life issues with a patient themselves, and only 35% thought they had had adequate exposure and education regarding advance directives. Eighty percent favored more education about end-of-life issues. Educational exposure to end-of-life issues and to role models, ability to correctly define an advance directive, number of end-of-life discussions witnessed, and age all were associated the students' sense of preparedness to discuss advance directives with patients.


CONCLUSIONS
Most of the students felt unprepared to discuss end-of-life issues with their patients, but wanted to learn more. The factors associated with a sense of preparedness suggest several possible, easily made, educational interventions, but further research is required to understand the scope of the problem and to implement curricular modifications.
Buss
M K
MK
Department of Medicine, University of Pittsburgh, Pennsylvania, USA.
Marx
E S
ES
Sulmasy
D P
DP
D000328:Adult; D032722:Advance Care Planning; D016223:Advance Directives; D000367:Age Factors; D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003142:Communication; D003479:Curriculum; D003643:Death; D004219:District of Columbia; D004501:Education, Medical; D033061:Ethics Consultation; D004992:Ethics, Medical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D007858:Learning; D016015:Logistic Models; D008297:Male; D008910:Minnesota; D010817:Physician-Patient Relations; D010820:Physicians; D011368:Professional-Family Relations; D013337:Students, Medical; D017236:Suicide, Assisted; D019452:Terminally Ill