Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice
Effective approaches to teaching attitudes, knowledge, and skills to resident physicians in primary care that can be implemented in any residency program are needed. We examined the feasibility and impact of a single palliative care residency curriculum, including a clinical rotation with a hospice...
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| Veröffentlicht in: | American journal of hospice & palliative medicine 2017-09, Vol.34 (8), p.713-720 |
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| container_title | American journal of hospice & palliative medicine |
| container_volume | 34 |
| creator | von Gunten, Charles F. Mullan, Patricia B. Nelesen, Richard Garman, Karen McNeal, Helen Savoia, Maria Muchmore, Elaine Ikeda, Tyson Amundson, Stan McKennett, Marianne Diamant, Joel Pepper, Patricia Gray, Cynthia Weissman, David |
| description | Effective approaches to teaching attitudes, knowledge, and skills to resident physicians in primary care that can be implemented in any residency program are needed. We examined the feasibility and impact of a single palliative care residency curriculum, including a clinical rotation with a hospice program, across 5 cohorts of residents in 7 divergent primary care residency programs (both family medicine and internal medicine). The didactic content was drawn from the national Education for Physicians on End-of-Life Care Project. A total of 448 residents completed the curriculum. A large effect size was seen in measures of knowledge change (*Cohen d = .89) when compared to a national sample of primary care residency programs. Additionally, measures of confidence to perform palliative care skills and ethical concerns also improved significantly (P < .001). A frequent comment is wishing the rest of medicine were like that experienced in the hospice setting. In a separate, ancillary evaluation, the average length of stay of patients enrolled in hospice care was 18.5 days longer for the alumni of this program when compared to physicians referring for hospice care who hadn’t experienced the curriculum. |
| doi_str_mv | 10.1177/1049909116655767 |
| format | Article |
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We examined the feasibility and impact of a single palliative care residency curriculum, including a clinical rotation with a hospice program, across 5 cohorts of residents in 7 divergent primary care residency programs (both family medicine and internal medicine). The didactic content was drawn from the national Education for Physicians on End-of-Life Care Project. A total of 448 residents completed the curriculum. A large effect size was seen in measures of knowledge change (*Cohen d = .89) when compared to a national sample of primary care residency programs. Additionally, measures of confidence to perform palliative care skills and ethical concerns also improved significantly (P < .001). A frequent comment is wishing the rest of medicine were like that experienced in the hospice setting. In a separate, ancillary evaluation, the average length of stay of patients enrolled in hospice care was 18.5 days longer for the alumni of this program when compared to physicians referring for hospice care who hadn’t experienced the curriculum.</description><identifier>ISSN: 1049-9091</identifier><identifier>EISSN: 1938-2715</identifier><identifier>DOI: 10.1177/1049909116655767</identifier><identifier>PMID: 27353516</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Attitude of Health Personnel ; Clinical Competence ; Communication ; Curriculum ; Family Practice - education ; Female ; Health Knowledge, Attitudes, Practice ; Hospice Care - methods ; Hospice Care - organization & administration ; Humans ; Internal Medicine - education ; Internship and Residency - organization & administration ; Male ; Nursing ; Pain Management - methods ; Palliative Care - methods ; Palliative Care - organization & administration ; Patient Care Planning</subject><ispartof>American journal of hospice & palliative medicine, 2017-09, Vol.34 (8), p.713-720</ispartof><rights>The Author(s) 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-f42681a0604083fd5db70f1eb4c7d0fd46e0ebd9f9ee5e4320efe5bf9dd8cd103</citedby><cites>FETCH-LOGICAL-c337t-f42681a0604083fd5db70f1eb4c7d0fd46e0ebd9f9ee5e4320efe5bf9dd8cd103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/1049909116655767$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/1049909116655767$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27353516$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>von Gunten, Charles F.</creatorcontrib><creatorcontrib>Mullan, Patricia B.</creatorcontrib><creatorcontrib>Nelesen, Richard</creatorcontrib><creatorcontrib>Garman, Karen</creatorcontrib><creatorcontrib>McNeal, Helen</creatorcontrib><creatorcontrib>Savoia, Maria</creatorcontrib><creatorcontrib>Muchmore, Elaine</creatorcontrib><creatorcontrib>Ikeda, Tyson</creatorcontrib><creatorcontrib>Amundson, Stan</creatorcontrib><creatorcontrib>McKennett, Marianne</creatorcontrib><creatorcontrib>Diamant, Joel</creatorcontrib><creatorcontrib>Pepper, Patricia</creatorcontrib><creatorcontrib>Gray, Cynthia</creatorcontrib><creatorcontrib>Weissman, David</creatorcontrib><title>Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice</title><title>American journal of hospice & palliative medicine</title><addtitle>Am J Hosp Palliat Care</addtitle><description>Effective approaches to teaching attitudes, knowledge, and skills to resident physicians in primary care that can be implemented in any residency program are needed. We examined the feasibility and impact of a single palliative care residency curriculum, including a clinical rotation with a hospice program, across 5 cohorts of residents in 7 divergent primary care residency programs (both family medicine and internal medicine). The didactic content was drawn from the national Education for Physicians on End-of-Life Care Project. A total of 448 residents completed the curriculum. A large effect size was seen in measures of knowledge change (*Cohen d = .89) when compared to a national sample of primary care residency programs. Additionally, measures of confidence to perform palliative care skills and ethical concerns also improved significantly (P < .001). A frequent comment is wishing the rest of medicine were like that experienced in the hospice setting. In a separate, ancillary evaluation, the average length of stay of patients enrolled in hospice care was 18.5 days longer for the alumni of this program when compared to physicians referring for hospice care who hadn’t experienced the curriculum.</description><subject>Attitude of Health Personnel</subject><subject>Clinical Competence</subject><subject>Communication</subject><subject>Curriculum</subject><subject>Family Practice - education</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Hospice Care - methods</subject><subject>Hospice Care - organization & administration</subject><subject>Humans</subject><subject>Internal Medicine - education</subject><subject>Internship and Residency - organization & administration</subject><subject>Male</subject><subject>Nursing</subject><subject>Pain Management - methods</subject><subject>Palliative Care - methods</subject><subject>Palliative Care - organization & administration</subject><subject>Patient Care Planning</subject><issn>1049-9091</issn><issn>1938-2715</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kM1LxDAUxIMofqzePUmOHraaNG3THpei7qKg-IHHkiYvmjVt1yRV_O-NrHoQPL2B-c3AG4QOKTmhlPNTSrKqIhWlRZHnvOAbaJdWrExSTvPNqKOdfPk7aM_7JSEszTK6jXZSznKW02IXhRtnOuE-cC0c4FvwRkEfPF50Kze8Ab7sh3cL6gmm-O7FWOuneBaCCaOCKEWv8I0TMhgJeKYDOCxwbU1vpLC4Hp0zcrRjhx9NeI7WfPCriO6jLS2sh4PvO0EP52f39Ty5ur5Y1LOrRDLGQ6KztCipIAXJSMm0ylXLiabQZpIrolVWAIFWVboCyCFjKQENeasrpUqpKGETdLzujb-8juBD0xkvwVrRwzD6hpZpwUlZpWVEyRqVbvDegW5W62EaSpqvrZu_W8fI0Xf72HagfgM_40YgWQNePEGzHEbXx2__L_wE28GHUQ</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>von Gunten, Charles F.</creator><creator>Mullan, Patricia B.</creator><creator>Nelesen, Richard</creator><creator>Garman, Karen</creator><creator>McNeal, Helen</creator><creator>Savoia, Maria</creator><creator>Muchmore, Elaine</creator><creator>Ikeda, Tyson</creator><creator>Amundson, Stan</creator><creator>McKennett, Marianne</creator><creator>Diamant, Joel</creator><creator>Pepper, Patricia</creator><creator>Gray, Cynthia</creator><creator>Weissman, David</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201709</creationdate><title>Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice</title><author>von Gunten, Charles F. ; Mullan, Patricia B. ; Nelesen, Richard ; Garman, Karen ; McNeal, Helen ; Savoia, Maria ; Muchmore, Elaine ; Ikeda, Tyson ; Amundson, Stan ; McKennett, Marianne ; Diamant, Joel ; Pepper, Patricia ; Gray, Cynthia ; Weissman, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-f42681a0604083fd5db70f1eb4c7d0fd46e0ebd9f9ee5e4320efe5bf9dd8cd103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Attitude of Health Personnel</topic><topic>Clinical Competence</topic><topic>Communication</topic><topic>Curriculum</topic><topic>Family Practice - education</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Hospice Care - methods</topic><topic>Hospice Care - organization & administration</topic><topic>Humans</topic><topic>Internal Medicine - education</topic><topic>Internship and Residency - organization & administration</topic><topic>Male</topic><topic>Nursing</topic><topic>Pain Management - methods</topic><topic>Palliative Care - methods</topic><topic>Palliative Care - organization & administration</topic><topic>Patient Care Planning</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>von Gunten, Charles F.</creatorcontrib><creatorcontrib>Mullan, Patricia B.</creatorcontrib><creatorcontrib>Nelesen, Richard</creatorcontrib><creatorcontrib>Garman, Karen</creatorcontrib><creatorcontrib>McNeal, Helen</creatorcontrib><creatorcontrib>Savoia, Maria</creatorcontrib><creatorcontrib>Muchmore, Elaine</creatorcontrib><creatorcontrib>Ikeda, Tyson</creatorcontrib><creatorcontrib>Amundson, Stan</creatorcontrib><creatorcontrib>McKennett, Marianne</creatorcontrib><creatorcontrib>Diamant, Joel</creatorcontrib><creatorcontrib>Pepper, Patricia</creatorcontrib><creatorcontrib>Gray, Cynthia</creatorcontrib><creatorcontrib>Weissman, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of hospice & palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>von Gunten, Charles F.</au><au>Mullan, Patricia B.</au><au>Nelesen, Richard</au><au>Garman, Karen</au><au>McNeal, Helen</au><au>Savoia, Maria</au><au>Muchmore, Elaine</au><au>Ikeda, Tyson</au><au>Amundson, Stan</au><au>McKennett, Marianne</au><au>Diamant, Joel</au><au>Pepper, Patricia</au><au>Gray, Cynthia</au><au>Weissman, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice</atitle><jtitle>American journal of hospice & palliative medicine</jtitle><addtitle>Am J Hosp Palliat Care</addtitle><date>2017-09</date><risdate>2017</risdate><volume>34</volume><issue>8</issue><spage>713</spage><epage>720</epage><pages>713-720</pages><issn>1049-9091</issn><eissn>1938-2715</eissn><abstract>Effective approaches to teaching attitudes, knowledge, and skills to resident physicians in primary care that can be implemented in any residency program are needed. 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| ispartof | American journal of hospice & palliative medicine, 2017-09, Vol.34 (8), p.713-720 |
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| subjects | Attitude of Health Personnel Clinical Competence Communication Curriculum Family Practice - education Female Health Knowledge, Attitudes, Practice Hospice Care - methods Hospice Care - organization & administration Humans Internal Medicine - education Internship and Residency - organization & administration Male Nursing Pain Management - methods Palliative Care - methods Palliative Care - organization & administration Patient Care Planning |
| title | Primary Care Residents Improve Knowledge, Skills, Attitudes, and Practice After a Clinical Curriculum With a Hospice |
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