title: Communicating With Dying Patients and Their Families: Multimedia Training in End-of-Life Care.
abstract: BACKGROUND
  The need for end-of-life (EOL), high-impact education initiatives to prepare medical students to communicate with dying patients and their families and to cope with issues of death and dying, is well recognized.
  
  
  METHODS
  Third-year medical students (n = 224), during their ambulatory rotation, completed a multimedia EOL curriculum, which included pre-/posttests, an online case-based module, didactic presentation, and a tablet computer application designed to demonstrate the signs and symptoms seen in the last hours of life for families of dying patients. Pre- and posttests were compared using Pearson χ2or Fisher exact test, and improvement was measured by weighted κ coefficient.
  
  
  RESULTS
  On preintervention surveys, the majority of students demonstrated positive attitudes toward the care of dying patients and their families. Despite this high pretest positive attitude, there was a statistically significant overall positive attitude change after the intervention. The lowest pretest positive attitudes and lowest posttest positive attitude shifts, although all statistically improved, involved addressing the thoughts and feelings of dying patients and in coping with their own emotional response.
  
  
  CONCLUSIONS
  Medical students exposure to this multimedia EOL curriculum increases positive attitudes in caring for dying patients and their families.
authors.affiliation: 1 Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Phylliss M
authors.initials: PM
authors.lastname: Chappell
authors.affiliation: 2 GRECC/GECC, South Texas Veterans Health Care System, San Antonio, TX, USA.|3 Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Healy
authors.affiliation: 2 GRECC/GECC, South Texas Veterans Health Care System, San Antonio, TX, USA.|3 Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.affiliation: 3 Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.|4 University Health System, San Antonio, TX, USA.
authors.forename: Glen
authors.initials: G
authors.lastname: Medellin
authors.affiliation: 2 GRECC/GECC, South Texas Veterans Health Care System, San Antonio, TX, USA.|3 Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sanchez-Reilly
mesh_terms: D000328:Adult; D003142:Communication; D003479:Curriculum; D004501:Education, Medical / Q000379:methods*; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D019212:Multimedia; D010817:Physician-Patient Relations; D013663:Teaching; D013727:Terminal Care / Q000523:psychology; D055815:Young Adult
keywords: communication; end-of-Life care; end-of-life education; medical students