Background The aim was to determine confidence levels of Foundation Year 1 and 2 trainees in managing palliative care patients, intervene to provide further support in highlighted areas and measure the impact of this support. Literature reviews demonstrate junior doctors from a range of specialties feeling ‘unprepared and unsupported in providing palliative care’.1
Methods Confidence levels were measured using a questionnaire prior to intervention at the beginning of the foundation year completed by 37 foundation trainees across various specialties. A teaching intervention was created from these results, of which 31 foundation trainees attended, and the same questionnaire completed for comparison.
Results The ‘Before Intervention’ questionnaire showed that a high proportion of trainees were ‘uncertain’ or ‘very uncertain’ in a range of palliative skills. 45% ranked this regarding who to ask for palliative care advice, 29% for how to have end of life conversations with NOK/family, 19% for advance care planning conversations, 35% for rationalizing medications and 61% for syringe driver commencement.
After the teaching intervention, only 4% of foundation doctors said they felt uncertain seeking palliative care advice. There was a large increase in confidence for talking to patients and relatives about dying. The proportion who felt ‘confident’ increased by 49%, and those who felt ‘uncertain-very uncertain’ decreased by 25%. Advance care planning conversations were deemed more achievable – those in the uncertain category decreased by 15.5%. Uncertainty about syringe driver commencing decreased to 12%.
Conclusions Medical education has an important role in palliative care and has demonstrated to have a positive impact on the foundation doctor’s confidence in delivering care. The aim will be to re-measure confidence levels after a period of clinical practice to determine long term impact of teaching, identify further areas to support the foundation doctors and employing appropriate education methods for the the wider multidisciplinary team.
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