Resident physicians provide the most physician care to intensive care unit (ICU) patients. The body of literature about residents’ palliative and end-of-life care (PC/EOLC) experiences in the ICU is limited. To our knowledge, this is the first study to assess resident physicians in multiple specialties regarding PC/EOLC in the ICU.
Methods:
A Web-based survey was developed and administered to all resident physicians in a single academic institution who had completed at least 1 dedicated ICU rotation.
Results:
Residents reported moderate comfort in dealing with end-of-life (EOL) issues and felt somewhat prepared to care for critically ill patients at the EOL. Feedback should be provided to residents regarding their PC/EOLC skills, and education should be tailored to residents rotating in the ICU.
DeVitaMAArnoldRMBarnardD. Teaching palliative care to critical care medicine trainees. Crit Care Med. 2003;31(4):1257–1262.
2.
AngusDCBarnatoAELinde-ZwirbleWT. Use of intensive care at the end of life in the United States: an epidemiologic study. Crit Care Med. 2004;32(3):638–643.
3.
WengerNSPearsonMLDesmondKA. Changes over time in the use of do not resuscitate orders and the outcomes of patients receiving them. Med Care. 1997;35(4):311–319.
4.
PrendergastTJLuceJM. Increasing incidence of withholding and withdrawal of life support from the critically ill. Am J Respir Crit Care Med. 1997;155(1):15–20.
5.
GerstelEEngelbergRAKoepsellTCurtisJR. Duration of withdrawal of life support in intensive care unit and association with family satisfaction. Am J Respir Crit Care Med. 2008;178(8):798–804.
6.
CookDRockerGMarshallJ. Withdrawal of mechanical ventilation in anticipation of death in the intensive care unit. N Engl J Med. 2003;349(12):1123–1132.
7.
TruogRDCampbellMLCurtisJR. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American college of critical care medicine. Crit Care Med. 2008;36(3):953–963.
8.
LeClaireMMOakesJMWeinertCR. Communication of prognostic information for critically ill patients. Chest. 2005;128(3);1728–1735.
9.
MullanPDWeissmanDEAmbuelBvon GuntenC. End-of-life care education in internal medicine residency programs: an interinstitutional study. J Palliat Med. 2002;5(4):487–496.
10.
WilliamsDMFisicaroTVeloskiJJBergD. Development and evaluation of a program to strengthen first year residents’ proficiency in leading end-of-life discussions. Am J Hosp Palliat Care. 2011;28(5):328–334.
11.
SzmuilowiczENeelyKJSharmaRKCohenERMcGaghieWCWayneDB. Improving residents’ code status discussion skills: a randomized trial. J Palliat Med. 2012;15(7):768–774.
12.
KlaristenfeldDDHarringtonDTMinerTJ. Teaching palliative care and end-of-life issues: a core curriculum for surgical residents. Ann Surg Oncol. 2007;14(6):1801–1806.
13.
BradleyCTWebbTPSchmitzCCChipmanJGBraselKJ. Structured teaching versus experiential learning of palliative care for surgical residents. Am J Surg. 2010;200(4):542–547.
14.
MinorSSchroderCHeylandD. Using the intensive care unit to teach end-of-life skills to rotating junior residents. Am J Surg. 2009;197(6):814–819.
15.
UryWABerkmanCSWeberCM. Assessing medical students’ training in end-of-life communication: a survey of interns at one urban teaching hospital. Acad Med. 2003;78(5):530–537.
16.
DanisMFedermanDFinsJJ. Incorporating palliative care into critical care education: principles, challenges, and opportunities. Crit Care Med. 1999;27(9):2005–2013.
17.
BlockSDSullivanAM. Attitudes about end-of-life care: a national cross-sectional survey. J Palliat Med. 1998;1(4):347–355.
18.
SchroderCHeylandDJiangXRockerGDodekP, Canadian Researchers at the End of Life Network. Education medical residents in end-of-life care: insights from a multicenter survey. J Palliat Med. 2009:12(5):459–470.
19.
KoppVJShaferA. Anesthesiologists and perioperative communication. Anesthesiology. 2000;93(2):548–555.
20.
LevinsonWChaumetonN. Communication between surgeons and patients in routine office visits. Surgery. 1999;125(2):127–132.
21.
AxelrodDAGooldSD. Maintaining trust in the surgeon-patient relationship: Challenges for the new millennium. Arch Surg. 2000;135(1):55–61.
22.
GormanPJMeierAHRawnCKrummelTM. The future of medical education is no longer blood and guts, it is bits and bytes. Am J Surg. 2000;180(5);353–356.
23.
CurlinFAChinMHSellergrenSARoachCJLantosJD. The association of physicians’ religious characteristics with their attitudes and self-reported behaviors regarding religion and spirituality in the clinical encounter. Med Care. 2006;44(5):446–453.
24.
DaalemanTPVandeCreekL. Placing religion and spirituality in end-of-life care. JAMA. 2000;284(19):2514–2517.
25.
SullivanAMLakomaMDBlockSD. The status of medical education in end-of-life care: a national report. J Gen Intern Med. 2003;18(9):685–695.
26.
EndeJ. Feedback in clinical medical education. JAMA. 1983;250(6):777–781.
