title: Evidence of improved knowledge and skills after an elective rotation in a hospice and palliative care program for internal medicine residents.
abstract: There is compelling evidence that residents training in primary care need education in palliative care. Evidence for effective curricula is needed. The objective of this study was to test whether a clinical elective improves measures of knowledge and skill. Residents from three categorical training programs in internal medicine were recruited to an elective including clinical experiences in an acute hospital palliative care consultation service, on an acute hospice and palliative care unit, and in-home hospice care. A 25-question pre- and post-test and a videotaped interview with a standardized patient were used to assess communication skills and measure outcomes. Residents demonstrated a 10 percent improvement in knowledge after the four-week elective (p < 0.05). All residents demonstrated basic competency in communication skills at the end of the rotation. These results indicate that clinical rotation shows promise as an educational intervention to improve palliative care knowledge and skills in primary care residents. An important limitation of the study is that it is an elective; further studies with a required rotation and/or a control group are needed to confirm the findings.
authors.affiliation: Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, California, USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: von Gunten
authors.forename: Martha
authors.initials: M
authors.lastname: Twaddle
authors.forename: Michael
authors.initials: M
authors.lastname: Preodor
authors.forename: Kathy Johnson
authors.initials: KJ
authors.lastname: Neely
authors.forename: Jeanne
authors.initials: J
authors.lastname: Martinez
authors.forename: John
authors.initials: J
authors.lastname: Lyons
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards; D003479:Curriculum / Q000592:standards; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D017051:Hospice Care / Q000592:standards; D006801:Humans; D007087:Illinois; D007388:Internal Medicine; D007396:Internship and Residency / Q000592:standards; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education* / Q000592:standards; D010166:Palliative Care / Q000592:standards; D015397:Program Evaluation; D013337:Students, Medical; D011795:Surveys and Questionnaires