The Effect of Geriatric and Palliative Medicine Education on the Knowledge and Attitudes of Internal Medicine Residents

Background: The Accreditation Council of Graduate Medical Education (ACGME) currently requires Internal Medicine (IM) GME programs to incorporate educational opportunities for training and structured experiences in Palliative and Hospice Medicine. Miscomprehension of the differences between palliative medicine and hospice care is a barrier for IM residents ordering palliative consults as many residents may underutilize palliative medicine if a patient is not appropriate for hospice. Objective: This educational performance improvement (PI) project assessed 3 domains, including Medical Knowledge (MK) of palliative versus hospice medicine at baseline and following a single didactic session. Additionally, the number of palliative consults ordered was used as a surrogate for interpersonal and communication skills (ICS) and patient care (PC) domains. Methods: An 8-question survey and 30-minute didactic session were created based upon experientially-determined issues most confusing to IM residents. Participants included 33 IM residents (PGY-1s-3 s) from July 2018 (first cohort) and 32 (PGY-1 s and any PGY-2s-3 s who did not participate in the first cohort) from July 2019 (second cohort). Results: 65 of a possible 73 residents participated (89% response rate) Pre-test Questions 5, 6, and 8 correct responses were <50% in both cohorts with average scores, respectively, of 43.1%, 35.4%, and 40%. Residents improved on the post-test for Q5, 6, 8 to, respectively, 80%, 86.7%, and 48.3% (t = 7.68, df = 59, p < 001). Correct Q1 responses declined in the first cohort, but clarification for the second cohort improved from pre-test (36.4%) to post-test (65.5%). The total number of palliative consults placed by IM residents increased as well. Conclusions: Baseline MK of palliative versus hospice medicine was <50% on 4/8 questions. A brief educational session significantly improved residents’ short-term comprehension and increased the number of palliative consults.

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The Effect of a 12-Month Longitudinal Long-Term Care Rotation on Knowledge and Attitudes of Internal Medicine Residents About Geriatrics

Journal of the American Medical Directors Association ◽

10.1016/j.jamda.2006.05.009 ◽

2007 ◽

Vol 8 (2) ◽

pp. 105-109 ◽

Cited By ~ 11

Author(s):

E BAUM ◽

K NELSON

Keyword(s):

Internal Medicine ◽

Long Term Care ◽

Term Care ◽

Knowledge And Attitudes ◽

Internal Medicine Residents

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Critical Care Education During Internal Medicine Residency: A National Survey

Journal of Graduate Medical Education ◽

10.4300/jgme-d-10-00023.1 ◽

2010 ◽

Vol 2 (4) ◽

pp. 555-561 ◽

Cited By ~ 9

Author(s):

Khalid F. Almoosa ◽

Linda M. Goldenhar ◽

Jonathan Puchalski ◽

Jun Ying ◽

Ralph J. Panos

Keyword(s):

Internal Medicine ◽

United States ◽

Critical Care ◽

Intensive Care ◽

Teaching Methods ◽

The United States ◽

Internal Medicine Residency ◽

Critical Care Medicine ◽

Internal Medicine Residents ◽

Medicine Education

Abstract Background Current training practices and teaching methods for critical care medicine education during internal medicine residency have not been well described. This study explored critical care medicine education practices and environments for internal medicine residents in the United States. Methods A web-based survey recruited Pulmonary and Critical Care Medicine fellowship program directors involved with internal medicine residency programs at academic institutions in the United States. Results Of 127 accredited Pulmonary and Critical Care Medicine programs in 2007, 63 (50%) responded. Demographics of the intensive care units varied widely in size (7–52 beds), monthly admissions (25–300 patients), and presence of a “night float” (22%) or an admissions “cap” (34%). All programs used bedside teaching, and the majority used informal sessions (91%) or didactic lectures (75%). More time was spent on resident teaching in larger (≥20 bed) medical intensive care units, on weekdays, in programs with a night-float system, and in programs that suspended residents' primary care clinic duties during their intensive care unit rotation. Conclusions Although similar teaching methods were used within a wide range of training environments, there is no standardized approach to critical care medicine education for internal medicine residents. Some survey responses indicated a correlation with additional teaching time.

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