Pilot of a hospice-based elective to learn comfort with dying patients in undergraduate medical education.

BACKGROUND

A majority of medical students feel uncomfortable with dying patients.

OBJECTIVE

We designed a pilot program to train medical students to be hospice volunteers to determine (1) the value of contact with dying patients in changing medical students' comfort level and (2) the mechanics of starting such a course in cooperation with a nonacademic agency.

DESIGN

Students were required to undergo hospice training provided by the local hospice. Students were eligible for Hospice volunteer placement after the training was completed. This provided students with an opportunity to interact with dying patients in a nonclinical capacity. Quantitative data and qualitative data were collected about the students' experiences with patients as well as about the effectiveness of the rotation.

SETTING/SUBJECTS: First- through fourth-year medical students were recruited to participate in this semester long project via a medical school-wide e-mail.

MEASUREMENTS

(1) A self-rating questionnaire on emotions and attitudes about death and dying at three points in time: before training, after training, and after placement; (2) A Likert-type questionnaire on barriers to participation and the usefulness of the components of an end-of-life course; (3) The "Attitudes About End-of-Life Scale"; (4) An in-depth structured interview with students after completion of the course.

RESULTS

Fourteen students participated in the evaluation phase of the program and reported increased comfort in interacting with dying patients after participating in the program. Students had less anxiety and fear of being around a dying person after placement as compared to before training. In-depth student interviews provided valuable qualitative data on the impact of the pilot, and insight into the strengths and areas for improvement in this type of elective.

CONCLUSIONS

A Hospice based elective can be an effective model for facilitating learning about how to approach the patient with a terminal illness.