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A survey of physicians' education in caring for the dying: identified training needs
R B Sand1, G F Blackall, J L Abrahm
1Institute for Graduate Clinical Psychology, Widener University, Chester, Pennsylvania, USA.
Background:
Physicians receive limited systematic training in caring for dying people. The majority of training focuses on technical skills.
Methods:
This study surveyed medical students, residents, fellows, and attending physicians to identify physician needs and current types of training in caring for the terminally ill. The study questionnaire was designed to determine whether and when physicians were trained in caring for dying people, the nature of such training, and possible areas to be included in future training. Also requested was a description of a personal experience involving caring for a terminally ill person.
Results:
One hundred twenty-three questionnaires were distributed and 90 were returned. Data indicate a lack of standardized training in dealing with terminally ill people and an expressed need for periodic, continuous training. The training needs to be mandatory, be ongoing, and use multiple formats, including the integration of theoretical information and clinical practice. Physicians in this study desired training in the following topic areas: 1) pain management; 2) death and dying; 3) the quality of life and death; 4) DNR status.
Conclusions:
Physicians in this study indicated a need for more training in how to care for the terminally ill. A model for training should start in medical school and continue throughout one's career. Providing a framework for lifelong professional development that integrates theoretical information and clinical practice with a multidisciplinary approach to patient care should form the basis of a training model.