Can e-learning help surface or change medical students' attitudes towards palliative care, death and dying?

Aims e-Learning tutorials are usually used to teach knowledge and skills in medicine. Professional attitudes are important in many areas of medicine, but particularly so in palliative care, where seeing death as failure, therapeutic nihilism, avoiding dying patients and fears about opioids can all influence patient care adversely. The literature suggests that medical students have misconceptions about palliative care, and articulate anxieties and expectations similar to those of the lay public. No studies have explored the use of e-learning tutorials and attitudes. Methods: e-learning tutorials were produced by final year medical students about palliative care topics of their choice and developed further by the departments of Palliative Medicine and Medical Education. The authors performed a mixed methods study to evaluate whether these tutorials enable students to consider their attitudes and/or teach attitudes. As part of each e-learning tutorial, students were asked to write reflective notes on what they had learnt.

Results 133 students wrote 1012 reflective comments on five tutorials. The authors analysed 499 of these comments using a qualitative coding system. 322 (65%) of the 499 responses written by senior medical students revealed reflection on an attitude relevant to the scenarios presented within the e-learning tutorials. Of these 43% made a general reflection on a relevant attitude, 37% reflected on their own attitude/s and 19% indicated a change in their attitude following the e-learning tutorial.

Conclusion Our findings suggest that e-learning can surface attitudes and may encourage attitudinal change about palliative care for final year medical students. The results of this reflective analysis will be presented and discussed.