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Development, implementation and evaluation of a terminal and hospice care educational online module for preclinical students
  1. Chung Sang Tse1 and
  2. Matthew S Ellman2
  1. 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr Chung Sang Tse, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA; Tse.Chung{at}


Objectives To explore the application of an online learning tool to teach preclinical medical students terminal and hospice care in a blended curricula.

Methods We created and evaluated a 30 min interactive online module at the Yale School of Medicine. Second-year medical students were randomly assigned to complete the online module or not (control group) prior to attending a required half-day hospice clinical experience. We assessed the students' knowledge and attitudes with a 23-item survey.

Results 152 students (response rate 51%) participated in this study from 2012 to 2014. 56% (n=85) completed the online module, 37% (n=56) did not and 7% (n=11) did not indicate whether they had completed the module or not. Students who completed the online module prior to the hospice experience scored higher (p<0.05, two-way analysis of variance) on 5 out of 8 of the multiple choice questions pertaining to hospice and palliative care, but their attitudes were similar to those who did not complete the online module. Overall, the students felt somewhat uncomfortable caring for dying patients although they regarded it as a physician's duty and felt that palliative/hospice care education is important in medical school.

Conclusions When combined with a mentored clinical hospice experience, an online module appears to enhance the teaching of the dying process and terminal care for preclinical medical students. This online module may prove useful for other institutions.

  • Hospice care
  • Terminal care
  • Education and training

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  • Contributors CST drafted the manuscript, designed the educational intervention, obtained IRB approval, implemented the intervention, evaluated it, and performed the statistical analyses. MSE edited the manuscript, edited the content of the educational intervention, assisted in the implementation and evaluation of the educational intervention. CST procured funding from the Yale School of Medicine Office of Student Research. MSE procured funding from the Alexandra K Munroe Fund.

  • Funding Yale School of Medicine Office of Student Research and Alexandra K Munroe Fund.

  • Competing interests None declared.

  • Ethics approval Yale University Human Subjects Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.