Factors That Influence Attitudes Toward End-of-Life Care Among Medical Students: Nationwide Survey for Fourth-Year Korean Medical Students

Abstract

Background: Positive attitudes for end-of-life (EOL) care along with adequate education are key factors for the provision of quality EOL care. This national study was conducted to identify the factors that influence attitudes toward EOL care on medical students. Method: An anonymous survey was designed and administered to fourth-year medical students at all 41 medical schools in Korea. Topics related to EOL care were assessed in classroom teaching, bedside teaching, and feedback experiences during clinical clerkships. Seven questions for self-rated attitudes and affecting factors were analyzed toward EOL care. Results: With a response rate of 49.2%, the median number of topics recognized by the students as having been delivered was 5 of 11 topics in classroom lectures and 1 of 8 topics in clinical experience. Although few (21.2%) participants indicated that they felt ready for EOL care practice, nevertheless, most felt that they should have adequate knowledge of and preparation for clinical competency in EOL care. Several parameters including respondent's demographics and exposure to EOL care topics in classroom and in bedside teaching influenced the responses to all 7 attitude questions. However, having more than 1 bedside experience was the only factor positively affecting all attitudinal measures. Conclusions: Clinical experience related to EOL care seems to be the utmost priory in fostering positive attitudes and competency among medical students.

Undergraduate palliative care education in the United Arab Emirates: a nationwide assessment of medical school deans

“…Our findings are consistent with reports from medical schools worldwide, which document deficits in PC and EOL education [9,10]. The study adds to the literature by providing the perceptions and intentions of medical school deans, and identifying barriers they faced in providing PC education.…”

“…Lecture-based teaching alone, which was reported to be the primary mode of PC teaching by our respondents, may not be as effective as direct experience in changing a student's attitude toward EOL care. Studies have shown that clinical exposure during clerkship is the most critical factor positively impacting perceptions of EOL treatment [9,10]. However, deans in our study described significant gaps in clinical exposure to PC.…”

“…Although there is limited published data for the UAE, cancer is the third leading cause of death in the country, and as most deaths occur in the hospital, it is likely that UAE physicians care for a large number of terminal patients [8]. Despite its importance for future physicians, PC concepts are largely omitted from university curricula worldwide [9,10]. Even in countries in which PC is mandated as part of the health education curriculum, multinational studies report inadequate education and training in EOL care, leaving a majority of medical graduates feeling poorly prepared for these tasks [9,10].…”

“…Despite its importance for future physicians, PC concepts are largely omitted from university curricula worldwide [9,10]. Even in countries in which PC is mandated as part of the health education curriculum, multinational studies report inadequate education and training in EOL care, leaving a majority of medical graduates feeling poorly prepared for these tasks [9,10].…”

Palliative care education in the Asia Pacific: Challenges and progress towards palliative care development

“…In a recent study, many students had limited bedside experience and feedback from a clinical supervisor in end-of-life care (EOL) curricula; with students appearing to need more clinical experiences and feedback as these are paramount to the competencies of medical students. 19 EOL care education in Korea is yet to meet increased learning needs, and it varies greatly depending on the medical school (2-36 hours). Students feel the need for HPC education, but do not believe the current education is sufficient.…”