There is hope for the future: national survey results reveal that geriatric medicine fellows are well-educated in end-of-life care

Abstract

Objectives: To assess the status of geriatric medicine (GM) fellows' training experiences in end-of-life care via self-report.

Design: Anonymous surveys completed by mail, Web access, and telephone.

Setting: U.S. accredited GM fellowship training programs.

Participants: Two hundred ninety-six surveys were sent to graduating GM fellows in 1- and 2-year programs across the Unites States.

Measurements: Measurements assessed self-reported attitudes, quantity and quality of end-of-life care education, preparation to provide care, and perceived value of caring for dying patients.

Results: Response rate was 74%. Ninety-five percent or more of respondents held positive views about physicians' responsibility and ability to help dying patients. Seventy percent of fellows had completed a rotation focused on end-of-life care. Fellows who had done such rotations rated their end-of-life care education as highly as their overall geriatrics training. Fellows frequently received teaching in many end-of-life care topics, with lower rates of teaching how to say goodbye and responding to requests for assisted suicide. Overall, fellows felt well prepared to care for dying patients. Four factors independently predicted such preparedness: having had a palliative or end-of-life care rotation, being female, having been taught how to say goodbye to patients, and perceiving that it is important to attending physicians that fellows learn to care for dying patients.

Conclusion: GM fellows feel their end-of-life care education is excellent and feel prepared to take care of dying patients. It is critical that geriatricians in training have access to and take advantage of palliative and end-of-life care rotations.