9. Semester: seminars palliative care in geriatrics (since 2010)

1. Knowledge and attitudes concerning end-of-life care in medical education – a survey of 5th year students in a German university hospital Dr. med. Birgitt van OorschotInterdiciplinary Center Palliative MedicineClinic and Polyclinic for Radiotherapy, University Hospital Würzburg,Josef-Schneider-Str. 11, 97080 Würzburge-mail: Oorschot_b@klinik.uni-wuerzburg.de Aims: Undergraduatepalliative care teaching will be an obligatory part in the curriculum of medical degree as of 2013. In Würzburg we start in Octobre 2012 with an obligatory lecture and 3 teaching courses in smaller groups with 12 students in the 5th year (9. semester). Up to now, we offer a seminar entitled “palliative care in geriatics“ in the 5th year too and a training how to bring over bad news using standardized patients in the 4th year. In order to improve the subjects of the new regular seminar and to avoid duplications in the curriculum a survey was carried out. Training Palliative Care University Hospital Würzburg 2. Semester (first year since 2011) Medizinische Psychologie: Visit a Palliative Care Ward History and Ethics of Medicine: Lecture: Basics of Palliative Care 7. Semester (4th year since 2007) Communication skills: breaking bad news Seminary with standardized patients Fotos: Nils Eckel 9. Semester: seminars palliative care in geriatrics (since 2010) start 10/12: curriculum palliative care 7 lectures + 3 workshops (12 students) Survey: status of medical education in end-of-life Care Methods: In the first lecture in geriatrics (9.th semester, 5th year students) at the beginning of the semester in April and Octobre 2011 and April 2012 the students received a shortened german version of the survey “status of medical education in end-of-life Care“ (Sullivan et al 2003, modified with permission of Susan Block). Results are compared with the Data from 62 US medical schools (n=1.455, Sullivan 2003). Results: The questionnaire was given to all 370 students in the first obligatory class on geriatrics. 360 students returned the completed questionnaire (97,2%). Gender: 58% female, 42% male students, median age 25,1 years (22 – 39 years) 20,5% students with another professional education before starting medical education Amount of pre-clinical training Würzburg US Britain 2012 2003 2007* Managing a patient ….with sepsis 3,9 6,3 5,7 …. at the end of life 2,9 3,9 4,6 …. with systemic lupus 3,0 6,2 4,1 graded 0 (none) to 10 (a lot), median in percent *Hammel et al 2007 Conclusion: Students consider the care for critically ill patients a very important task for the physician. The self reported amount of pre-clinical training in managing patients with sepsis, lupus or at the end of life is in generally less than reported by final year students in US or Britain. Even worse than the ability to alleviate symptoms they appreciate their ability to provide psychosocial / spiritual / cultural care at the end of life and for end-of life decisions. Positive effect of the communication training is seen. Training in palliative care seems to be necessary. In the 5th year of medical education the palliative care curriculum will be realized by the team of the palliative care ward togethet with pain specialists (seminary in 5th year) and general practitioners. Lectures will consider the self reported deficits supplemented by multidisciplinary teaching in smaller groups using role plays with standardized patients and other interactive teaching elements. The survey will be repeated at the end of the final year of medical education. References: Sullivan A, Lakoma M, Block S (2003) The Status of Education in End-of-Life Care J Gen Intern Med 2003;18:685-695 Hammel J, Sullivan A, Block S, Twycross R (2007) End-of-Life and Palliative Care Education for Final-Year Medical Students: A Comparison of Britain and the United States, Journal of Palliative Medicine 10:1356-1366