[Knowledge and attitude of medical students in Germany towards palliative care : Does the final year of medical school make a difference?].
BACKGROUND
The practical year (PY) during the final year of medical education is intended to deepen and broaden knowledge, skills, and abilities that were acquired during previous years of their studies. Against this background, this study pursues the question of how the knowledge of future physicians and their confidence in terms of cancer pain therapy and other palliative care issues develops during the PY.


METHODS
At the end of the PY, students from two university hospitals completed a 3-part online questionnaire (self-assessment of the confidence, questions about palliative care knowledge, and assessment of palliative care training during the PY). These results are compared with previously published data from the same collective that had been collected at the beginning of the PY.


RESULTS
Overall, 92 of 318 students participated (28.9 %). Less than 10 % of students said that they were more confident regarding palliative care topics at the end of their medical studies. Improvements in the self-assessment could only be observed in the recognition of and screening for cancer pain (increase from 36 % to 65%). With regard to the palliative care knowledge, only the knowledge of how to treat symptoms other than pain improved significantly; however, knowledge in this regard prior to the PY was particularly low (an increase from 25 % to 35 %, p < 0.05). In the only multiple-choice question about ethics, the correct answer rose slightly from 51 % (before) to 55 % (after the PY). Of participating students, 21% (prior to the PY 27 %) stated that not providing fluids to dying patients is a form of euthanasia. In terms of palliative care training, between 36 and 83 % of participants stated having insufficient opportunities to gain knowledge and experience on various topics in the treatment of patients with advanced and incurable diseases during their PY.


CONCLUSIONS
In the present study, considerable deficits in confidence and knowledge regarding palliative care issues were also observed at the end of PY. Integration of palliative care into the medical school curriculums should be given special attention in terms of a longitudinal training of the PY.
Interdiszplinäre Abteilung für Palliativmedizin, III. Medizinische Klinik, Universitätsmedizin Mainz, Mainz, Deutschland.
M
M
Weber
Institut für Medizinische Biometrie, Epidemiologie und Informatik (IMBEI), Universitätsmedizin Mainz, Mainz, Deutschland.
S
S
Schmiedel
Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
F
F
Nauck
Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland. bernd.alt-epping@med.uni-goettingen.de.
B
B
Alt-Epping
D001291:Attitude of Health Personnel; D000072716:Cancer Pain / Q000523:psychology* / Q000628:therapy*; D002983:Clinical Competence; D003479:Curriculum; D004992:Ethics, Medical; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D059408:Pain Management / Q000941:ethics / Q000523:psychology; D010166:Palliative Care / Q000941:ethics / Q000523:psychology*; D011231:Preceptorship / Q000941:ethics; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
Education, palliative medicine; Ethics; Pain management; Survey; Symptom control