title: Effects of a multimodule curriculum of palliative care on medical students.
abstract: OBJECTIVE
  The objective of this study was to investigate the effects of educational intervention using a multimodule curriculum of palliative care on medical students, and to explore significant factors that influence improvement in beliefs of ethical decision-making.
  
  
  METHODS
  A total of 259 medical students enrolled in the "Family, Society and Medicine" course, and accepted a multimodule palliative care curriculum that included a 1-hour lecture, 1 hour of patient contact, 1 hour of literature reading, and 1 hour of discussion. A questionnaire was administered before and after the course to evaluate improvements in medical students' knowledge (principles and clinical management) of palliative care and their beliefs concerning ethical decision-making in palliative care.
  
  
  RESULTS
  The students showed significant improvements after the course in their knowledge of the principles of palliative care (pretest 58.4% vs. posttest 73.1%; p less than 0.01) and clinical management of palliative care (pretest 58.8% vs. posttest 67.9%; p less than 0.01). Although their beliefs about ethical decision-making were also improved after the course, the medical students did not have a positive belief of "artificial nutrition and hydration is not always beneficial for terminal cancer patients", with a mean score of only 3.15 and 3.51 (pretest and posttest, respectively; range, 1-5). The logistic regression model showed that improvement in knowledge of either principles or clinical management did not significantly improve beliefs about ethical decision-making.
  
  
  CONCLUSIONS
  A multimodule curriculum of palliative care for medical students can significantly improve their knowledge on principles of clinical management and beliefs about ethical decision-making in palliative care. As for changes in beliefs about ethical decision-making in palliative care, continued ethical and clinical training is required.
authors.affiliation: Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Stanley S L
authors.initials: SS
authors.lastname: Tsai
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Hu
authors.forename: Hao-Hsiang
authors.initials: HH
authors.lastname: Chang
authors.forename: Shan-Chwen
authors.initials: SC
authors.lastname: Chang
authors.forename: Chin-Yu
authors.initials: CY
authors.lastname: Chen
authors.forename: Tai-Yuan
authors.initials: TY
authors.lastname: Chiu
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003469:Culture; D003479:Curriculum; D003657:Decision Making; D004504:Education, Medical, Undergraduate; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008297:Male; D010166:Palliative Care; D013337:Students, Medical