Impacts on first-year medical students resulting from an innovative palliative care course with home and hospice experiences

Inadequate preparation of physicians to provide quality medical care to patients and families at the end-of-life remains a major social problem. Medical schools have begun to address this issue in their curricula. This study was designed to provide information concerning changes in students resulting from an elective palliative care course with home and hospice experiences to palliative care leaders and educators responsible for the education of future physicians.;Impacts of a 12-week elective course designed to integrate palliative care medicine principles and practices with hospice and home-based experiences was studied for two cohorts of students. Changes in knowledge, attitudes and beliefs related to palliative care were obtained from an initial pre-medical school survey, a post-course questionnaire, a focus group discussion, and term paper narratives.;Students completing the course indicated: (1) increased understanding of illness and suffering, and altered perceptions about how to "think like a doctor," (2) increased self-confidence in dealing with terminally ill patients, and (3) the importance of respect for spiritual and religious beliefs of patients as they deal with their own death.;Students found the non-medical, personal, hospice experience with a patient and family as the most important part of the course. Opportunities to reflect on their experiences with faculty and other students in small group discussions and writing assignments were viewed as valuable, as was faculty role modeling. Overall, the results are promising for including such a course into the medical school curriculum, but more study is needed of student's views as they continue through and complete their medical training.