Purpose: To examine medical school offerings on relating to terminally ill patients between 1975 and 1995.
Method: Three national surveys of U.S. medical schools were conducted in 1975, 1985, and 1995. Totals of 107, 113, and 113 questionnaires were returned (response rates of 95%, 90%, and 93%, respectively). The information sought through the questionnaires included the types of courses on death and dying offered, the numbers of years the courses had been offered, the percentages of students taking the courses, and the professional backgrounds of the instructors.
Results: Overall, from 1975 to 1995 the number of medical school offerings in death education increased. Although the number of full-time courses increased from seven in 1975 to 14 in 1985, it dropped to nine in 1995. The percentage of schools offering occasional lectures and short courses on death and dying, often integrated into other courses, increased from 80% in 1975 to 82% in 1985 to 90% in 1995. While not offering full-time courses on death and dying, many schools noted that they offered three-week courses on ethical issues related to death. A team approach to teaching death education was used by a majority of schools over the two decades (59% in 1975, 62% in 1985, and 76% in 1995). Schools with no formal death education offering decreased from 14 in 1975 to six in 1985 to two in 1995.
Conclusion: The increased emphasis on medical students' learning to deal with death and acquiring communication skills for relating to terminally ill patients and their families should lead to better working relations between physicians and dying patients. The continued use of instructors from outside the medical profession seems to reflect a genuine desire by medical educators to consider the dying patients' needs and to handle ethical issues. Such an increased humanistic emphasis should help both dying patients and students.