The preparedness of students to discuss end-of-life issues with patients

Acad Med. 1998 Apr;73(4):418-22. doi: 10.1097/00001888-199804000-00015.


Purpose: To explore how well medical schools prepare students to address end-of-life issues with their patients.

Method: In 1997, the authors surveyed 226 fourth-year students at Georgetown University School of Medicine and Mayo Medical School, assessing relevant knowledge, experiences, and attitudes, and the students' sense of preparedness to address end-of-life issues.

Results: Seventy-two percent (162) of the eligible students responded. Almost all (99%) recognized the importance of advance directives and anticipated discussing end-of-life issues with patients in their practices (84%). However, only 41% thought their education regarding end-of-life issues had been adequate, only 27% had ever discussed end-of-life issues with a patient themselves, and only 35% thought they had had adequate exposure and education regarding advance directives. Eighty percent favored more education about end-of-life issues. Educational exposure to end-of-life issues and to role models, ability to correctly define an advance directive, number of end-of-life discussions witnessed, and age all were associated the students' sense of preparedness to discuss advance directives with patients.

Conclusion: Most of the students felt unprepared to discuss end-of-life issues with their patients, but wanted to learn more. The factors associated with a sense of preparedness suggest several possible, easily made, educational interventions, but further research is required to understand the scope of the problem and to implement curricular modifications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Care Planning*
  • Advance Directives*
  • Age Factors
  • Attitude of Health Personnel
  • Attitude to Death
  • Communication*
  • Curriculum
  • Death*
  • District of Columbia
  • Education, Medical*
  • Ethics Consultation
  • Ethics, Medical
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Internship and Residency
  • Learning
  • Logistic Models
  • Male
  • Minnesota
  • Physician-Patient Relations*
  • Physicians
  • Professional-Family Relations
  • Students, Medical*
  • Suicide, Assisted
  • Terminally Ill