Residents from five training programs report improvements in knowledge, attitudes and skills after a rotation with a hospice program.
BACKGROUND
The faculty of the Center for Palliative Studies teach residents from 5 different primary care residency training programs who rotate at San Diego Hospice: 3 in Internal Medicine, 2 in Family Medicine. Residents participate in the care of patients in the inpatient care setting and make joint home visits with physicians and other team members. A series of 4 lectures on end-of-life care is given on Tuesday mornings: management of pain, other symptoms, interdisciplinary roles of chaplains, social workers, nurses, and grief/bereavement are discussed. In addition, there is a Tuesday noon conference that follows a journal club format. Because of scheduling, residents from some programs are not able to attend all lectures and conferences.


METHODS
A 27-item self-assessment evaluation tool was developed for administration to residents before and after their experience. A total of 65 evaluations for residents rotating in academic year 1997-98 and 1998-1999 were collated and analyzed.


RESULTS
When evaluated as a whole, residents noted significant improvements in their ability to assess and treat symptoms, to tell patient/family about the dying process and to care for dying patients at home (range in improvement from 26% to 67%, p < 0.05 using paired t-test). About half of the residents perceived that the content was not available elsewhere in their training.


CONCLUSIONS
We conclude that a single hospice rotation can effectively contribute to resident education in multiple programs.
Von Gunten
Charles F
CF
Center for Palliative Studies, San Diego Hospice and Palliative Care, San Diego, CA 92103, USA. cvongunten@sdhospice.org
Mullan
Patricia B
PB
Harrity
Shawn
S
Diamant
Joel
J
Heffernan
Edwin
E
Ikeda
Tyson
T
Roberts
William L
WL
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006738:Hospices; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D010166:Palliative Care / Q000379:methods; D015397:Program Evaluation; D013727:Terminal Care / Q000379:methods