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Palliative Care Knowledge and Self-Efficacy Among Anesthesiology Residents: A Multi-Institutional Cross-Sectional
Paul E Zimmerman1, Haley M Stone1, Fei Chen1
1The following authors are at the University of North Carolina, Chapel Hill, NC: is an Associate Professor in the Division of Clinical Medicine and a Hospice and Palliative Care Fellow; is Hospice and Palliative Care Fellow and an Internal Medicine Resident; is an Associate Professor in the Department of Anesthesiology and is a Research Assistant Professor in the Department of Anesthesiology. is an Assistant Professorof the Uniformed Services University and practices in the Department of Anesthesia at Brooke Army Medical Center in San Antonio, TX. is an Assistant Professor in the Department of Anesthesiology at Yale University in New Haven, CT. is an Assistant Professor in the Department of Anesthesiology at the University of North Carolina, Chapel Hill, NC, and a Cardiac Anesthesia and Critical Care Medicine Fellow at Duke University Medical Center, Durham, NC. is the Edward A. Norfleet Distinguished Professor in the Department of Anesthesiology at the University of North Carolina, Chapel Hill, NC, and a Cardiac Anesthesia Fellow at Duke University Medical Center, Durham, NC. is an Associate Professor in the Department of Anesthesiology at the University of North Carolina, Chapel Hill, NC, and an Obstetric Anesthesia Fellow at Stanford University in Palo Alto, CA.
Background:
Anesthesiology residents have palliative care (PC) training needs given their role in perioperative medicine. Whereas anesthesiology residency programs have PC training requirements in both curricular guidelines and board certification content, little is known about the PC knowledge of anesthesiology residents. This study aimed to assess anesthesiology residents' baseline PC knowledge and perceived self-efficacy.
Methods:
Anesthesiology residents across 4 institutions completed a knowledge test (KT) and a self-efficacy inventory (SEI). The KT and SEI assessed 5 PC domains: pain and symptom management (PSM); communication (COMM); psychosocial, spiritual, and cultural aspects of care (PSC); terminal care and bereavement (TCB); and PC principles and practice (PCPP). Descriptive statistics were generated to assess overall resident scores and statistical tests (ANOVA for normally distributed outcomes and Kruskal-Wallis nonparametric test for nonnormal outcomes) were used to compare the scores by residency year of training.
Results:
On the KT, residents had the highest scores in the PSC domain, with a median (Q1, Q3) of 100% (100%, 100%), and the lowest scores in PSM, with a median (Q1,Q3) of 50% (0%, 50%). On the SEI, scored on a 4-point Likert scale, residents had the highest perceived self-efficacy in PSM (2.82±0.42) and lowest in TCB (2.55±0.55). Neither KT (p = .571) nor SEI scores (p = .203) increased with additional training with the lowest knowledge and perceived scores in the final year of training.
Conclusions:
This study provides exploratory insights into PC education among anesthesiology residents. By examining both resident competency and confidence, we hope to inform future educational assessment of knowledge and interventions to better prepare anesthesiology residents to incorporate PC principles into patient care.
