title: Internal Medicine Residents' Beliefs, Attitudes, and Experiences Relating to Palliative Care: A Qualitative Study.
abstract: BACKGROUND
  Internal medicine residents are frequently called upon to provide palliative care to hospitalized patients, but report feeling unprepared to do so effectively. Curricular development to enhance residents' palliative care skills and competencies requires an understanding of current beliefs, attitudes and learning priorities.
  
  
  METHODS
  We conducted a qualitative study consisting of semi-structured interviews with ten internal medicine residents to explore their understanding of and experiences with palliative care.
  
  
  RESULTS
  All of the residents interviewed had a sound theoretical understanding of palliative care, but faced many challenges in being able to provide care in practice. The challenges described by residents were system-related, patient-related and provider-related. They identified several priority areas for further learning, and discussed ways in which their current education in palliative care could be enhanced.
  
  
  CONCLUSIONS
  Our findings provide important insights to guide curricular development for internal medicine trainees. The top five learning priorities in palliative care that residents identified in our study were: 1) knowing how and when to initiate a palliative approach, 2) improving communication skills, 3) improving symptom management skills, 4) identifying available resources, and 5) understanding the importance of palliative care. Residents felt that their education in palliative care could be improved by having a mandatory rotation in palliative care, more frequent didactic teaching sessions, more case-based teaching from palliative care providers, opportunities to be directly observed, and increased support from palliative care providers after-hours.
authors: 1 Division of Palliative Care, Department of Family and Community Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.
authors: S
authors: S
authors: Kawaguchi
authors: 2 Faculty of Medicine, Institute for Life Course and Aging, University of Toronto, Toronto, Ontario, Canada.
authors: R
authors: R
authors: Mirza
authors: 3 Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors: R
authors: R
authors: Nissim
authors: 4 Division of Palliative Care, Department of Family and Community Medicine, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
authors: J
authors: J
authors: Ridley
mesh_terms: D002983:Clinical Competence; D003142:Communication; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D007407:Interviews as Topic; D008297:Male; D059408:Pain Management; D010166:Palliative Care / Q000458:organization & administration* / Q000523:psychology; D036301:Qualitative Research; D013997:Time Factors
keywords: internal medicine; medical education; palliative care; palliative care curriculum; palliative care education; resident education