Improving Comfort With Palliative Care Concepts: A Longitudinal Didactic Curriculum for Internal Medicine Residents

The steady increase in the number of older, chronically ill patients and resultant need for improved access to palliative care demonstrates the importance of equipping trainees from all medical specialties with essential palliative care skills. There is a specific need for this sort of education among internal medicine providers who manage a broad range of diseases and stages of disease. To improve acumen with palliative care principles, we developed a three-part noontime lecture series for internal medicine interns, the first of its kind at our institution. These lectures equipped trainees with basic understanding of the scope and makeup of a palliative care consult team, and instilled basic palliative care-focused skills in goal-of-care conversations, discussing code status, opioid pain management in the setting of serious illness, hospice, and prognostication. Before each lecture, interns indicated their comfortability in performing certain skills via an online survey with Likert-style responses (1 = not at all comfortable, 5 = very comfortable). At the conclusion, interns were re-administered the online survey and asked to rate their comfort level after the educational intervention. Bivariant and descriptive analysis and effect size tests compared the responses between the pre- and post-lecture surveys. Our results indicated a statistically significant improvement in comfort across almost all domains. These findings suggest that longitudinal curricula in palliative care may be beneficial in equipping internal medicine interns with essential palliative care skills.