Knowledge, Attitudes and Practices of Palliative Care among Postgraduate Medical Students: A Multicentre Cross-sectional Study from Kolhapur, India

Introduction: Palliative care is a multidisciplinary approach designed to enhance the quality of life of patients with lifelimiting illnesses. Despite its growing importance, palliative care remains insufficiently represented within Indian postgraduate medical training, leading to gaps in knowledge, attitudes, and clinical practice. Aim: To assess the Knowledge, Attitude, and Practice (KAP) of postgraduate medical students regarding palliative care in selected medical Institutions across Maharashtra, Karnataka, and Goa. Materials and Methods: This multicentre, cross-sectional observational study was conducted between August 2021 and January 2022 in tertiary care medical colleges across Maharashtra, Karnataka, and Goa, India A structured, validated online questionnaire was distributed to 1st-, 2nd-, and 3rd-year postgraduate students using Google Forms and Survey Monkey. The survey captured demographic characteristics, levels of KAP, and previous exposure or training in palliative care. Data were analysed using EpiInfo version 7.2. Descriptive statistics summarised variables; Chi-square and Fisher’s exact tests assessed associations between categorical variables; Student’s t-test and one-way Analysis of Variance (ANOVA) were applied to continuous variables. Principal Component Analysis (PCA) and K-means clustering were used to identify learner profiles. A p-value <0.05 was considered statistically significant. Results: Of 500 invited students, 345 (69.0%) responded, and analysis was performed on these respondents (n=345). Most participants were aged 24-35 years, 87 (25.22%), with balanced gender distribution males, 179 (51.87%), females, 166 (48.13%). Internal medicine, dental sciences, and orthopaedics were the most represented specialties. Knowledge levels were predominantly average in 182 students (52.75%), attitudes were largely neutral in 194 students (56.23%), and practice levels were moderate in 168 (48.7%) of respondents. Misconceptions persisted, particularly regarding opioid use and the World Health Organisation (WHO) analgesic ladder. Practical exposure was limited, with only 46.96% having participated in palliative rounds. PCA revealed three distinct learner clusters varying in readiness and confidence. Conclusion: Although foundational knowledge was adequate, gaps in attitude, misconceptions, and limited clinical exposure highlight the need for structured, competency-based palliativecare training within postgraduate curricula.