Improving the Care of Patients With Serious Illness: What Are the Palliative Care Education Needs of Internal Medicine Residents?

Julia L. Frydman, Kevin Hauck, Joseph Lowy, Laura P. Gelfman

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Hospitalized patients with serious illness have significant symptom burden and face complex medical decisions that often require goals of care discussions. Given the shortage of specialty palliative care providers, there is a pressing need to improve the palliative care skills of internal medicine (IM) residents, who have a central role in the care of seriously ill patients hospitalized at academic medical centers. Methods: We conducted an anonymous survey of IM residents at a large, urban, academic medical center to identify which aspects of palliative care trainees find most important and their knowledge gaps in palliative care. The survey measured trainees’ self-assessed degree of importance and knowledge of core palliative care skills and evaluated frequency of completing advance care planning documentation. Results: Overall, 51 (23%) IM residents completed the survey. The majority of trainees considered multiple palliative care skills to be “very important/important”: symptom management, prognostication, introducing the palliative care approach, discussing code status, and breaking serious news. Across these same skills, trainees reported variable levels of knowledge. In our sample, trainees reported completing healthcare proxy forms and Medical Orders for Life-Sustaining Treatment infrequently. Conclusions: IM trainees rated core palliative care skills as important to their practice. Yet, they reported knowledge gaps across multiple core palliative care skills that should be addressed given their role as frontline providers for patients with serious illness.

Original languageEnglish
Pages (from-to)1218-1224
Number of pages7
JournalAmerican Journal of Hospice and Palliative Medicine
Volume38
Issue number10
DOIs
StatePublished - Oct 2021

Keywords

  • core palliative medicine skills
  • internal medicine trainees
  • medical education
  • palliative medicine
  • serious illness communication

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