A survey of housestaff attitudes towards terminal care education

Medical and surgical housestaff have received little formal training to treat the medical or psychosocial problems associated with terminal illness. That more postgraduate terminal care education is needed is generally not debated but what should be taught and how it should be taught are unresolved issues. This paper presents data from a questionnaire given to 173 internal medical and surgical residents intended to provide information on their perceived needs in this area of education. Questions were developed to address four major areas: (1) whether and how terminal care issues should be taught; (2) residents' perceptions of their clinical competence in this area; (3) how personal issues affect care; (4) the residents' roles vis à vis the dying patient and family. A significant portion of the residents were able to acknowledge the importance of their own experience and the need to personally address these issues during training. Thirty-five percent of the sample indicated the need for more training in treating severe pain and 28% felt the need for more training in treating shortness of breath. About 50% of the sample felt that they needed more training in psychosocial areas. This paper presents a method by which training directors can survey their housestaff's perceptions and needs in this area in order to increase the likelihood that terminal care training will match the learning needs and styles of the particular resident group.