Introduction
There are minimal requirements and few opportunities for exposure to hospice and palliative medicine (HPM) in undergraduate medical curricula1. The University of Michigan Medical School offers a four-week clinical HPM elective for senior students; however, it is limited to one student per month limiting opportunities for exposure. Given this, we developed a novel online, asynchronous elective introducing core HPM concepts to senior medical students.
Methods
During the two-week elective, students completed six modules and identical pre- and post-course surveys. A 5-point Likert scale was used to assess comfort with HPM scenarios in five domains: hospice and palliative care general concepts: serious-illness communication and advance care planning, end-of-life care, symptom management, and medical ethics. Paired t-tests were used to compare matched data for individual questions and overall domain scores.
Results
To date, 12 students have completed the course. Of eight intended specialities, Family Medicine was most common (n=4). Pre- and post- survey results revealed statistically significant improvement in comfort across all domains, with the largest improvement seen in end-of-life care (mean difference 1.97, p < 0.0001). The mean rating for overall course quality was 3.91/5.
Conclusion
Previous work has identified gaps in HPM education for medical students and clinicians at all levels, despite a known desire by these groups for increased education throughout training. An online, asynchronous elective can be a flexible and adaptable tool to increase exposure to HPM and provide students with foundational knowledge prior to starting residency, regardless of intended specialty.
References
Dickinson, George E. “Thirty-Five Years of End-of-Life Issues in US Medical Schools.” American Journal of Hospice and Palliative Medicine®, vol. 28, no. 6, 2011, pp. 412–417., https://doi.org/10.1177/1049909110397608.