End of life care alters medical student attitudes to practice

Earlier exposure to palliative care can enhance junior doctors' professionalism, focus on and communication with all patients, and other important aspects of care, according to a study from the University of Adelaide.

Palliative care is the provision of support for patients with life-threatening illnesses who are approaching the end of their lives.

In a survey of a group of Adelaide medical students who had spent one of their clinical electives working in palliative care, researchers in the University's School of Medicine found that students had benefited greatly from their experience. The results of the study are published in this month's issue of the journal Academic Medicine.

"End of life can be very challenging not only for patients and their families, but also for staff and students involved in their care," says corresponding author Dr Greg Crawford, who is Associate Professor of Palliative Medicine at the University of Adelaide.

"However, based on the results of our sample group the feedback from students has been extremely positive," he says.

Associate Professor Crawford says two main themes were identified in the study:

"The first theme is that students were initially apprehensive about the issue of death and dying, but each of the students felt that their learning experiences gave them a sense of control over their interactions with patients and families. It helped to develop their
confidence," he says.

"The second main theme is that students gained a stronger sense of perspective about the practice of medicine. This positive influence not only was present when caring for patients at the end of life but also influenced the students' overall identity as medical practitioners.

"As a result, we've seen enhanced competencies of professionalism, patient-centered medicine, psychosocial and spiritual aspects of palliative care, communication, teamwork, and self-awareness," he says.

Associate Professor Crawford says learning palliative medicine could help to make a difference to the training of all medical students.

"Not all Australian medical students are currently exposed to palliative care. However, physicians trained in palliative medicine may be better prepared to contribute to a healthcare system that is person-centered, and it may help to make their careers more personally fulfilling," he says.