title: Senior medical students' perceptions of the adequacy of education on end-of-life issues.
abstract: 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.
authors.affiliation: University of Colorado Health Sciences Center School of Medicine, Denver, Colorado, USA.
authors.forename: H C
authors.initials: HC
authors.lastname: Fraser
authors.forename: J S
authors.initials: JS
authors.lastname: Kutner
authors.forename: M P
authors.initials: MP
authors.lastname: Pfeifer
mesh_terms: 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