title: Teaching palliative care and end-of-life issues: a core curriculum for surgical residents.
abstract: BACKGROUND
  Most surgical training programs have no curriculum to teach palliative care. Programs designed for nonsurgical specialties often do not meet the unique needs of surgeons. With 80-hour workweek limitations on in-hospital teaching, new methods are needed to efficiently teach surgical residents about these problems.
  
  
  METHODS
  A pilot curriculum in palliative surgical care designed for residents was presented in three 1-hour sessions. Sessions included group discussion, role-playing exercises, and instruction in advanced clinical decision making. Residents completed pretest, posttest, and 3-month follow-up surveys designed to measure the program's success.
  
  
  RESULTS
  Forty-seven general surgery residents from Brown University participated. Most residents (94%) had "discussed palliative care with a patient or patient's family" in the past. Initially, 57% of residents felt "comfortable speaking to patients and patients' families about end-of-life issues," whereas at posttest and at 3-month intervals, 80% and 84%, respectively, felt comfortable (P < .01). Few residents at pretest (9%) thought that they had "received adequate training in palliation during residency," but at posttest and at 3-month follow-up, 86% and 84% of residents agreed with this statement (P < .01). All residents believed that "managing end-of-life issues is a valuable skill for surgeons." Ninety-two percent of residents at 3-month follow-up "had been able to use the information learned in clinical practice."
  
  
  CONCLUSIONS
  With a reasonable time commitment, surgical residents are capable of learning about palliative and end-of-life care. Surgical residents think that understanding palliative care is a useful part of their training, a sentiment that is still evident 3 months later.
authors.affiliation: Department of Surgery, Brown Medical School, Rhode Island Hospital, APC Room 437, 593 Eddy Street, Providence, Rhode Island 02903, USA.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Klaristenfeld
authors.forename: David T
authors.initials: DT
authors.lastname: Harrington
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Miner
mesh_terms: D001291:Attitude of Health Personnel; D001293:Attitude to Death; D003142:Communication; D003479:Curriculum; D003657:Decision Making; D004501:Education, Medical; D030141:Feedback, Psychological; D005260:Female; D005500:Follow-Up Studies; D013502:General Surgery / Q000193:education*; D017051:Hospice Care; D006801:Humans; D007396:Internship and Residency; D008297:Male; D010166:Palliative Care; D010817:Physician-Patient Relations; D010865:Pilot Projects; D011788:Quality of Life; D012381:Role Playing; D013663:Teaching / Q000379:methods*; D013727:Terminal Care