• J Gen Intern Med · Aug 2008

    Randomized Controlled Trial Multicenter Study

    Using a pocket card to improve end-of-life care on internal medicine clinical teaching units: a cluster-randomized controlled trial.

    • Joseph Mikhael, Lindsay Baker, and James Downar.
    • Division of Hematology-Oncology, Mayo Clinic, Arizona 85259, USA. mikhael.joseph@mayo.edu
    • J Gen Intern Med. 2008 Aug 1;23(8):1222-7.

    BackgroundEnd-of-life care is suboptimally taught in undergraduate and postgraduate education in Canada. Previous interventions to improve residents' knowledge and comfort have involved lengthy comprehensive educational modules or dedicated palliative care rotations.ObjectiveTo determine the effectiveness of a cheap, portable, and easily implemented pocket reference for improving residents' knowledge and comfort level in dealing with pain and symptom management on the medical ward.DesignCluster-randomized controlled trial conducted from August 2005 to June 2006.SettingMedical clinical teaching units (CTUs) in 3 academic hospitals in Toronto, Canada.ParticipantsAll residents rotating through the medical CTUs who consented to participate in the study.InterventionResidents at 1 hospital received a pocket reference including information about pain and symptom control, as well as 1-2 didactic end-of-life teaching sessions per month normally given as part of the rotation. Residents at the other 2 hospitals received only the didactic sessions.Main Outcome MeasuresA 10-question survey assessing knowledge and comfort level providing end-of-life care to medical inpatients, as well as focus group interviews.ResultsOne hundred thirty-six residents participated on 3 CTUs for a participation rate of approximately 75%. Comfort levels improved in both control (p < .01) and intervention groups (p < .01), but the increase in comfort level was significantly higher in the intervention group (z = 2.57, p < .01). Knowledge was not significantly improved in the control group (p = .06), but was significantly improved in the intervention group (p = .01). Greater than 90% of residents in the intervention group used the card at least once per week, and feedback from the focus groups was very positive.ConclusionsOur pocket card is a feasible, economical, and educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on CTUs.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…