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Evidence of improved knowledge and skills after an elective rotation in a hospice and palliative care program for internal medicine residents

Center for Palliative Studies, San Diego Hospice & Palliative Care, San Diego, California

Martha Twaddle, MD

Palliative Care Center and Hospice of the North Shore, Evanston, Illinois

Michael Preodor, MD

Horizon Hospice, Chicago, Illinois

Kathy Johnson Neely, MD

Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Jeanne Martinez, RN, MPH

Buehler Center on Aging, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

John Lyons, PhD

Division of Psychology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

There is compelling evidence that residents training in primary care need education in palliative care. Evidence for effective curricula is needed. The objective of this study was to test whether a clinical elective improves measures of knowledge and skill. Residents from three categorical training programs in internal medicine were recruited to an elective including clinical experiences in an acute hospital palliative care consultation service, on an acute hospice and palliative care unit, and in-home hospice care. A 25-question pre- and post-test and a videotaped interview with a standardized patient were used to assess communication skills and measure outcomes. Residents demonstrated a 10 percent improvement in knowledge after the four-week elective (p < 0.05). All residents demonstrated basic competency in communication skills at the end of the rotation. These results indicate that clinical rotation shows promise as an educational intervention to improve palliative care knowledge and skills in primary care residents. An important limitation of the study is that it is an elective; further studies with a required rotation and/or a control group are needed to confirm the findings.

Key Words: hospice • palliative care • resident • communication • education

American Journal of Hospice and Palliative Medicine®, Vol. 22, No. 3, 195-203 (2005)
DOI: 10.1177/104990910502200309


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