Effect of a 1-week clinical rotation in palliative medicine on medical school graduates' knowledge of and preparedness in caring for seriously ill patients

Abstract

Objectives: To assess the effect of a required 1-week clinical rotation in palliative medicine during a 12-week internal medicine-geriatrics clerkship on graduating medical students' knowledge and self-assessed preparedness in caring for seriously ill patients.

Design: Historical control trial.

Setting: Mount Sinai School of Medicine (MSSM), New York, New York.

Participants: Students from the MSSM classes of 2007 (MS07) and 2008 (MS08).

Intervention: MS08 was the first class to complete the required clinical rotation in palliative medicine. MS07 served as a historical control, having received only didactics in palliative care but no clinical rotation.

Measurements: Both classes were invited to complete an anonymous online survey designed to assess experiences and preparedness in caring for seriously ill patients and a 30-question multiple choice knowledge examination.

Results: Fifty-eight (55%) students from MS07 and 59 (51%) students from MS08 completed the survey. Students from MS08 rated their skill level in several areas of pain management and communication more favorably than did students from MS07. Mean scores on the knowledge portion of the survey were not significantly different between the two classes.

Conclusion: Graduating medical students who had a 1-week clinical rotation in palliative medicine had higher self-assessed skills in pain management and communication than students who received no clinical exposure. A brief clinical experience in palliative care should be considered for integration into the curriculum at all medical schools.