title: A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation.
abstract: An estimated 6,000 to 18,000 additional hospice and palliative medicine (HPM) physicians are needed in the United States. A source could be the military graduate medical education system where 15% of U.S. medical residents are trained. A community-based hospice and palliative care organization created a one-week rotation for military residents including participation in interdisciplinary group visits at patients' homes, facilities, and an inpatient hospice unit.
  
  
  
  Our goal was to evaluate the effectiveness of a one-week community HPM rotation for military medical residents.
  
  
  
  A mixed-methods, multi-stakeholder perspective program evaluation model was used for program years 2011 to 2013. Data were managed and analyzed using Microsoft Excel and Atlas.ti. Participants in the rotation were residents training at two local military hospitals. Program evaluation data were collected from residents, military program liaisons, and hospice clinical preceptors. Quantitative data included pre- and post-tests based on Accreditation Council for Graduate Medical Education competencies completed by residents. Qualitative data included resident essays and semi-structured interviews with hospice preceptors and military program liaisons.
  
  
  
  Quantitative and qualitative data suggested that the rotation increased military residents' knowledge, attitudes, and comfort level with HPM. Quantitative analysis of test scores indicated improvements from pre- to post-tests in each of five areas of learning. Qualitative data indicated the rotation created a greater appreciation for the overall importance of HPM and increased understanding of eligibility and methods for pain and symptom management.
  
  
  
  A one-week community hospice rotation for medical military residents impacts participant's knowledge of and attitudes toward HPM.
authors.affiliation: 1 Division of Geriatrics, School of Medicine, University of California , San Francisco, California.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Harrison
authors.affiliation: 2 School of Nursing, University of Pennsylvania , Philadelphia, Pennsylvania.
authors.forename: Jackelyn Y
authors.initials: JY
authors.lastname: Boyden
authors.affiliation: 3 Department of Family Medicine, Fort Belvoir Community Hospital , Fort Belvoir, Virginia.
authors.forename: Virginia B
authors.initials: VB
authors.lastname: Kalish
authors.affiliation: 4 Capital Caring Hospice , Merrifield, Virginia.
authors.forename: J Cameron
authors.initials: JC
authors.lastname: Muir
authors.affiliation: 4 Capital Caring Hospice , Merrifield, Virginia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Richardson
authors.affiliation: 4 Capital Caring Hospice , Merrifield, Virginia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Connor
mesh_terms: D002983:Clinical Competence; D006738:Hospices; D006801:Humans; D007396:Internship and Residency; D008889:Military Personnel; D015397:Program Evaluation; D012399:Rotation