title: Do Doctors Gain More Confidence from a Longer Palliative Medicine Posting?
abstract: Doctors report inadequate training and lack confidence in providing palliative care. Although palliative care training improves self-assessed competence, it is not known whether the duration of a palliative medicine (PM) posting affects the extent of improvement in confidence.
  
  
  
  The aim of this study was to determine whether the duration of a PM posting affects the extent of improvement in doctors' confidence in various aspects of palliative care.
  
  
  
  This was a retrospective study analyzing doctors' self-rated competence level in different aspects of palliative care at the start and end of a PM posting. The change in scores was analyzed to determine the extent of improvement corresponding to the length of the posting. Seventy-one residents and medical officers participated in the study, which was conducted in a hospital-based palliative care consultative service.
  
  
  
  Participants reported low baseline self-rated competence in palliative care. A longer posting duration resulted in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication.
  
  
  
  A one-month posting may suffice in training a doctor in basic end-of-life medical issues, but a longer posting duration results in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication. Trainee doctors in specialties that frequently deal with terminally ill patients should undertake a longer posting in PM to be further equipped with greater confidence to better care for these patients.
authors.affiliation: Division of Palliative Medicine, National Cancer Centre Singapore , Singapore .
authors.forename: Tan Ying
authors.initials: TY
authors.lastname: Peh
authors.affiliation: Division of Palliative Medicine, National Cancer Centre Singapore , Singapore .
authors.forename: Grace Meijuan
authors.initials: GM
authors.lastname: Yang
authors.affiliation: Division of Palliative Medicine, National Cancer Centre Singapore , Singapore .
authors.forename: Lalit Kumar Radha
authors.initials: LK
authors.lastname: Krishna
authors.affiliation: Division of Palliative Medicine, National Cancer Centre Singapore , Singapore .
authors.forename: Alethea Chung Peng
authors.initials: AC
authors.lastname: Yee
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005260:Female; D006801:Humans; D008297:Male; D065126:Palliative Medicine; D010820:Physicians / Q000523:psychology*; D020377:Self Efficacy; D011795:Surveys and Questionnaires
keywords: palliative care; palliative medicine; postgraduate medical education; residency; self-rated competence; training