Needs, Expectations, and Concerns of Medical Students Regarding End-of-Life Issues before the Introduction of a Mandatory Undergraduate Palliative Care Curriculum

Background: In the past, implementation of effective palliative care curricula has emerged as a priority in medical education. In order to gain insight into medical students' needs and expectations, we conducted a survey before mandatory palliative care education was introduced in our faculty. Methods: Seven hundred nine students answered a questionnaire mainly consisting of numeric rating scales (0-10). Results: Participants attributed a high importance to palliative care for their future professional life (mean, 7.51 +/- 2.2). For most students, symptom control was crucial (7.72 +/- 2.2). However, even higher importance was assigned to ethical and legal issues (8.16 +/- 1.9). "Self-reflection regarding their own role as a physician caring for the terminally ill along with psychological support" was also regarded as highly important (7.25 +/- 2.4). Most students were moderately concerned at the prospect of being confronted with suffering and death (5.13 +/- 2.4). This emotional distress was rated significantly higher by female students (5.4 +/- 2.4 versus 4.6 +/- 2.4; p<0.001). Seventeen percent of all students rated their distress as being 7 of 10 or higher, which indicates a considerable psychological strain in terms of dealing with end-of-life issues in the future. Professional or personal experience with terminally ill persons lowered these anxieties significantly (4.99 +/- 2.34 versus 5.47 +/- 2.5, p<0.05). Conclusions: Medical students stated a remarkably high interest in learning palliative care competencies. Responding to their specific concerns and needs-especially with regard to the acquisition of emotional coping skills-may be key for the development of successful palliative care curricula.