Barclay Stephen, Whyte Rebecca, Thiemann Pia, Benson John, Wood Diana F, Parker Richard A, Quince Thelma
Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
Primary Care Unit, Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, Cambridge, United Kingdom.
J Pain Symptom Manage. 2015 Feb;49(2):231-42. doi: 10.1016/j.jpainsymman.2014.06.004. Epub 2014 Jun 26.
Palliative care (PC) education for medical students is important. Knowledge concerning drugs and services can be readily taught, and skills of communicating with terminally ill patients and their families are increasingly being addressed. Developing positive attitudes toward caring for patients near the end of life is more challenging.
To examine medical students' attitudes toward PC in each year of their course, investigate changes in these attitudes over time during their course, and identify gender differences in attitudes and attitudinal change.
Questionnaires administered to four cohorts of preclinical core science and clinical medical students at the University of Cambridge Medical School from 2007 to 2010, with annual longitudinal follow-up in subsequent years; 1027 participants in total.
Students started their medical course with broadly positive attitudes toward PC, which largely persisted into the final years. During the core science component, some attitudes became more negative, whereas during the clinical component, some attitudes became more positive. Over the whole course, there was evidence of increasingly positive attitudes. No significant effect of gender on attitudes or attitudinal change was found. Although statistically significant, all these changes were small.
Medical students' attitudes toward their future role in caring for people with PC needs were broadly positive. Core science was associated with increasingly negative attitudes and clinical studies with increasingly positive attitudes. For teaching faculty, the challenge remains to address negative and foster positive attitudes toward PC during medical school.
对医学生进行姑息治疗(PC)教育很重要。关于药物和服务的知识很容易传授,与绝症患者及其家属沟通的技能也越来越受到关注。培养对临终患者护理的积极态度则更具挑战性。
研究医学生在课程各阶段对PC的态度,调查他们在课程期间这些态度随时间的变化,并确定态度及态度变化方面的性别差异。
对2007年至2010年剑桥大学医学院四个队列的临床前基础科学和临床医学学生进行问卷调查,并在随后几年进行年度纵向随访;共有1027名参与者。
学生们在医学课程开始时对PC的态度总体较为积极,这种态度在很大程度上一直持续到最后几年。在基础科学课程阶段,一些态度变得更加消极,而在临床课程阶段,一些态度变得更加积极。在整个课程中,有证据表明态度越来越积极。未发现性别对态度或态度变化有显著影响。虽然具有统计学意义,但所有这些变化都很小。
医学生对其未来在护理有PC需求者方面的角色态度总体较为积极。基础科学课程与越来越消极的态度相关,而临床研究与越来越积极的态度相关。对于教师而言,挑战仍然是在医学院期间应对消极态度并培养对PC的积极态度。