Do Doctors Gain More Confidence from a Longer Palliative Medicine Posting?

J Palliat Med. 2017 Feb;20(2):141-146. doi: 10.1089/jpm.2016.0293. Epub 2016 Oct 17.

Abstract

Background: Doctors report inadequate training and lack confidence in providing palliative care. Although palliative care training improves self-assessed competence, it is not known whether the duration of a palliative medicine (PM) posting affects the extent of improvement in confidence.

Objective: The aim of this study was to determine whether the duration of a PM posting affects the extent of improvement in doctors' confidence in various aspects of palliative care.

Methods: This was a retrospective study analyzing doctors' self-rated competence level in different aspects of palliative care at the start and end of a PM posting. The change in scores was analyzed to determine the extent of improvement corresponding to the length of the posting. Seventy-one residents and medical officers participated in the study, which was conducted in a hospital-based palliative care consultative service.

Results: Participants reported low baseline self-rated competence in palliative care. A longer posting duration resulted in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication.

Conclusion: A one-month posting may suffice in training a doctor in basic end-of-life medical issues, but a longer posting duration results in a greater improvement in the doctors' confidence across different domains of palliative care, particularly in end-of-life communication. Trainee doctors in specialties that frequently deal with terminally ill patients should undertake a longer posting in PM to be further equipped with greater confidence to better care for these patients.

Keywords: palliative care; palliative medicine; postgraduate medical education; residency; self-rated competence; training.

MeSH terms

  • Adult
  • Clinical Competence*
  • Education, Medical, Graduate
  • Female
  • Humans
  • Male
  • Palliative Medicine*
  • Physicians / psychology*
  • Self Efficacy*
  • Surveys and Questionnaires