Each working group addressed five questions:
How do death and dying manifest themselves in your setting?
What are the tasks of end-of-life care in your setting?
What are the major opportunities and barriers to learning about end-of-life care?
What can be done to improve teaching about end-of-life care in your setting?
What currently available and new resources are needed to facilitate change?
A set of guiding principles for undergraduate medical education provides a framework for the recommendations of all the working groups (Billings and Block, 1997). The recommendations at the end of this chapter address how these principles might be advanced. This report does not make recommendations about the precise content of educational materials or programs, but the general skills and knowledge required are summarized well in the IOM report, Approaching Death (IOM, 1997).
The care of dying persons and their families is a core professional task of physicians. Medical schools have a responsibility to prepare students to provide skilled, compassionate end-of-life care.
The following key content areas related to end-of-life care must be appropriately addressed in undergraduate medical education (NOTE: this list will differ depending on the setting and to some extent, patient population, e.g., children vs. adults.)
Medical education should encourage students to develop positive feelings about dying patients and their families and about the role of the physician in terminal care.
Enhanced teaching about death, dying, and bereavement should occur throughout the span of medical education.
Educational content and process should be tailored to students’ developmental stage.
The best learning grows out of direct experiences with patients and families, particularly when students have an opportunity to follow patients longitudinally and develop a sense of intimacy and manageable personal responsibility for suffering persons.