Assessment of resident performance in a hospital-based palliative care unit

Nurses and medical residents in the University of Massachusetts Medical Center were asked to evaluate the performance of the residents in the University Hospital's 10-bed hospice using nine criteria. Thirty-one residents (18 interns and 13 third year residents) and 16 nurses responded. Nurses evaluated resident performance with respect to most criteria lower than residents evaluated themselves. Some of the findings were significant. A finding on which all agreed was that house staff had the greatest difficulty knowing when to stop medical treatment on terminally ill patients. Comments from both residents and nurses showed that the rotation provided an important and unique learning experience despite attendant distress for residents. In addition, nurses, who had been unenthusiastic about resident presence previously, now valued these physicians' contributions to patient care and would not choose to return to the pre-house staff days.