title: Palliative and end-of-life care training during the surgical clerkship.
abstract: BACKGROUND
  In 2000, the Liaison Committee on Medical Education required that all medical schools provide experiential training in end-of-life care. To adhere to this mandate and advance the professional development of medical students, experiential training in communication skills at the end-of-life was introduced into the third-year surgical clerkship curriculum at Wright State University Boonshoft School of Medicine.
  
  
  METHODS
  In the 2007-08 academic year, 97 third-year medical students completed six standardized end-of-life care patient scenarios commonly encountered during the third-year surgical clerkship. Goals and objectives were outlined for each scenario, and attending surgeons graded student performances and provided formative feedback.
  
  
  RESULTS
  All 97 students, 57.7% female and average age 25.6 ± 2.04 y, had passing scores on the scenarios: (1) Adult Hospice, (2) Pediatric Hospice, (3) Do Not Resuscitate, (4) Dyspnea Management/Informed Consent, (5) Treatment Goals and Prognosis, and (6) Family Conference. Scenario scores did not differ by gender or age, but students completing the clerkship in the first half of the year scored higher on total score for the six scenarios (92.8% ± 4.8% versus 90.5% ± 5.0%, P = 0.024).
  
  
  CONCLUSIONS
  Early training in end-of-life communication is feasible during the surgical clerkship in the third-year of medical school. Of all the scenarios, "Conducting a Family Conference" proved to be the most challenging.
authors.affiliation: Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio. Electronic address: kathryn.tchorz@wright.edu.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Tchorz
authors.forename: S Bruce
authors.initials: SB
authors.lastname: Binder
authors.forename: Mary T
authors.initials: MT
authors.lastname: White
authors.forename: Larry W
authors.initials: LW
authors.lastname: Lawhorne
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Bentley
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Delaney
authors.forename: Jerome
authors.initials: J
authors.lastname: Borchers
authors.forename: Melanie
authors.initials: M
authors.lastname: Miller
authors.forename: Linda M
authors.initials: LM
authors.lastname: Barney
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Dunn
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Rundell
authors.forename: Thavm
authors.initials: T
authors.lastname: Thambipillai
authors.forename: Randy J
authors.initials: RJ
authors.lastname: Woods
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Markert
authors.forename: Priti P
authors.initials: PP
authors.lastname: Parikh
authors.forename: Mary C
authors.initials: MC
authors.lastname: McCarthy
mesh_terms: D000328:Adult; D002982:Clinical Clerkship / Q000379:methods*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D010166:Palliative Care; D016414:Resuscitation Orders; D013727:Terminal Care; D014481:United States
keywords: Do-not-resuscitate; End-of-life care; Family conference; Hospice; Medical education; OSCE; Palliative care; Standardized patients; Surgery; Surgical clerkship