Palliative and end-of-life care training during the surgical clerkship |
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Authors: | Kathryn M. Tchorz S. Bruce Binder Mary T. White Larry W. Lawhorne Deborah M. Bentley Elizabeth A. Delaney Jerome Borchers Melanie Miller Linda M. Barney Margaret M. Dunn Kenneth W. Rundell Thavm Thambipillai Randy J. Woods Ronald J. Markert Priti P. Parikh Mary C. McCarthy |
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Affiliation: | 1. Department of Surgery, Boonshoft School of Medicine, Wright State University, Dayton, Ohio;2. Department of Family Medicine, Boonshoft School of Medicine, Wright State University, Dayton, Ohio;3. Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, Ohio;4. Department of Geriatrics, Boonshoft School of Medicine, Wright State University, Dayton, Ohio;5. Miami Valley Hospital, Palliative Care, Dayton, Ohio |
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Abstract: | BackgroundIn 2000, the Liaison Committee on Medical Education required that all medical schools provide experiential training in end-of-life care. To adhere to this mandate and advance the professional development of medical students, experiential training in communication skills at the end-of-life was introduced into the third-year surgical clerkship curriculum at Wright State University Boonshoft School of Medicine.Materials and methodsIn the 2007–08 academic year, 97 third-year medical students completed six standardized end-of-life care patient scenarios commonly encountered during the third-year surgical clerkship. Goals and objectives were outlined for each scenario, and attending surgeons graded student performances and provided formative feedback.ResultsAll 97 students, 57.7% female and average age 25.6 ± 2.04 y, had passing scores on the scenarios: (1) Adult Hospice, (2) Pediatric Hospice, (3) Do Not Resuscitate, (4) Dyspnea Management/Informed Consent, (5) Treatment Goals and Prognosis, and (6) Family Conference. Scenario scores did not differ by gender or age, but students completing the clerkship in the first half of the year scored higher on total score for the six scenarios (92.8% ± 4.8% versus 90.5% ± 5.0%, P = 0.024).ConclusionsEarly training in end-of-life communication is feasible during the surgical clerkship in the third-year of medical school. Of all the scenarios, “Conducting a Family Conference” proved to be the most challenging. |
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Keywords: | Palliative care End-of-life care Surgery OSCE Medical education Surgical clerkship Standardized patients Family conference Do-not-resuscitate Hospice |
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