Senior medical students' perceptions of the adequacy of education on end-of-life issues.
BACKGROUND
It is unclear how well prepared U.S. senior medical students are to handle end-of-life issues as they reach the end of medical school. Additionally, the most optimal way of providing medical student end-of-life education has not been adequately defined.


OBJECTIVE
This study aims to determine the preparedness of senior medical students at U.S. medical schools regarding end-of-life issues.


METHODS
A self-administered survey.


METHODS
Six medical schools throughout the United States, two of which have a formal curriculum on end-of-life issues, and four of which do not.


METHODS
Fourth-year medical students during November through February of their senior year.


METHODS
Self-reported preparation on a number of end-of-life competencies.


RESULTS
Of the 757 surveys sent out, 262 responses were received (34.6%). Only 22% to 53% of students (varying by topic) felt prepared by their education in the selected end-of-life competencies. Students attending medical schools with a formal end-of-life curriculum were more likely to feel prepared than students with no formal curriculum to address psychosocial issues (21% higher, p = 0.008), cultural/spiritual issues (21% higher, p = 0.005), technical aspects of end-of-life care (18% higher, p = 0.001), and treatment of common symptoms (34% higher, p = 0.001). Students who had more clinical experiences in palliative care were more likely to feel prepared to discuss end-of-life issues with patients (p = 0.013) and to treat common symptoms (p = 0.011).


CONCLUSIONS
This study demonstrates support for development of formal curriculum on end-of-life issues, and emphasizes the importance of clinical exposure to terminally ill patients to prepare medical students to provide quality end-of-life care.
Fraser
H C
HC
University of Colorado Health Sciences Center School of Medicine, Denver, Colorado, USA.
Kutner
J S
JS
Pfeifer
M P
MP
D000704:Analysis of Variance; D001293:Attitude to Death; D004501:Education, Medical / Q000379:methods*; D004992:Ethics, Medical / Q000193:education; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D010465:Perception / Q000145:classification*; D010817:Physician-Patient Relations; D013337:Students, Medical / Q000145:classification / Q000523:psychology*; D013727:Terminal Care / Q000379:methods / Q000523:psychology