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Abstract
Background Undergraduate fourth year medical students attend hospices for two case discussion lecture days as part of a one-week palliative care placement. Prior informal student feedback suggested a potential gap in understanding the aims and ethos of palliative care, responsibilities for non-specialist teams in delivering end of life care and student confidence in discussions around death and dying. This information informed the programme that was generated and delivered on the lecture days. Previous evaluations had focused purely on content and delivery and didn’t identify any potential placement impact on students’ understanding, confidence in and attitudes towards palliative and end of life care.
Aim To implement an impact-based questionnaire to evaluate the outcomes of a one-week palliative care placement for undergraduate medical students on their understanding of and confidence in delivering end of life care.
Methods A literature review identified two validated scales with evidence from similar student cohorts.
The Self–efficacy in Palliative Care Scale (Mason, Ellershaw. Med Educ. 2004;38(10):1103–10; Frey, Gott, Neil. BMJ Support Palliat Care. 2013;3(1):114–9).
The Thanatophobia Scale (Mason, et al, 2004; Frey, et al, 2013).
Relevant components of these scales were identified and the themes amalgamated to generate ten Likert-scale questions. These were completed by students at the start (pre) and end (post) of the placement. Scores were collated for comparison.
Results Six cohorts across the academic year were evaluated and results combined into joint pre and post scores for comparison. These showed a positive increase in scores across all ten questions but highly significant in two domains, those that evaluated confidence in applying relevant skills e.g. communication and recognising dying and those related to understanding the role of palliative care as well as confidence in managing their own emotions.
Conclusion An impact-based questionnaire provides a beneficial evaluation to ensure positive alignment of overall placement aims and structure, with meaningful student outcomes.