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A Hospice Rotation for Military Medical Residents: A Mixed Methods, Multi-Perspective Program Evaluation.

Krista L Harrison1, Jackelyn Y Boyden2, Virginia B Kalish3

  • 11 Division of Geriatrics, School of Medicine, University of California , San Francisco, California.

Journal of Palliative Medicine
|May 4, 2016
PubMed
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A one-week hospice and palliative medicine (HPM) rotation improved military residents' knowledge and attitudes. This training addresses the significant physician shortage in HPM care.

Area of Science:

  • Medical Education
  • Palliative Care
  • Military Health Systems

Background:

  • A significant shortage of hospice and palliative medicine (HPM) physicians exists in the U.S.
  • The military graduate medical education system trains 15% of U.S. residents and presents a potential source for HPM physicians.
  • A community-based HPM organization developed a one-week rotation for military residents.

Purpose of the Study:

  • To evaluate the effectiveness of a one-week community HPM rotation for military medical residents.
  • To assess the impact of the rotation on residents' knowledge, attitudes, and comfort levels in HPM.

Main Methods:

  • A mixed-methods program evaluation was conducted from 2011 to 2013.
  • Data were collected from residents, military program liaisons, and hospice preceptors.

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  • Quantitative data included pre- and post-tests on Graduate Medical Education competencies; qualitative data included resident essays and interviews.

    • Main Results:

    • The rotation significantly increased military residents' knowledge, attitudes, and comfort with HPM.
    • Pre- and post-test scores showed improvements in five key learning areas.
    • Qualitative feedback revealed a greater appreciation for HPM and improved understanding of pain and symptom management.

    Conclusions:

    • A one-week community hospice rotation positively impacts military residents' knowledge and attitudes towards HPM.
    • This rotation model shows promise for training future HPM physicians from the military resident population.