title: Emergency medicine resident education in palliative care: a needs assessment.
abstract: BACKGROUND
  Hospice and Palliative Medicine is a newly designated subspecialty of Emergency Medicine (EM). As yet, no well defined palliative care (PC) models for education or training exist. A needs assessment is the first step towards developing a curriculum.
  
  
  OBJECTIVE
  To characterize emergency physicians' (EP) perceived educational and formal training needs for PC related skills.
  
  
  METHODS
  All EM residents and faculty of one academic facility were asked to complete an anonymous needs-assessment survey. Participants were asked to rank statements related to attitudes about PC and rate their formal training and knowledge in 10 aspects of PC using a 5-point Likert-scale. EPs also ranked 4 learning modalities in order of preference and 12 PC educational topics in order of perceived importance in an EM curriculum.
  
  
  RESULTS
  Ninety-three percent (42/45) of eligible participants completed the survey (28 residents, 14 faculty). Respondents agreed/strongly agreed that PC skills are an important competence for EM (88%, 37/42) and that they would "like to have more training/education in PC" (79%, 33/42). Respondents also disagreed/strongly disagreed with the statement that "PC consult is called when no more can be done for the patient" (90%, 38/42). Important PC topics identified were pain management, discussing code status, and management of dyspnea and other symptoms in terminal illness. Bedside teaching was listed as the preferred learning modality. EM residents reported minimal training in pain management (46%, 13/28), managing hospice patients (54%, 15/28), withdrawal/withholding life support (54%, 15/28), and managing the imminently dying (43%, 12/28). There was no consistent, significant improvement reported in any domain as training and experience progressed from PGY (postgraduate year) 1 to PGY 4 to attending physician.
  
  
  CONCLUSIONS
  EPs view PC skills as important for EM practice and report that they are not yet adequately educated and trained in providing PC. Domains of particular interest and targeted areas for PC skills training for EPs may include managing hospice patients, withdrawal of life support, prognostication, and pain management.
authors.affiliation: Department of Emergency Medicine, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, University Hospital, Newark, New Jersey 07101, USA. @umdnj.edu
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Lamba
authors.forename: Amy
authors.initials: A
authors.lastname: Pound
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rella
authors.forename: Scott
authors.initials: S
authors.lastname: Compton
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003625:Data Collection; D004635:Emergency Medicine; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency; D008297:Male; D020380:Needs Assessment; D009515:New Jersey; D010166:Palliative Care; D012577:Schools, Medical