Purpose: To assess knowledge and associated factors in palliative care. Methods: Self-administered survey of 88 internal medicine house officers in 1996. Results: Twenty-one interns and 36 residents completed the survey for a response rate of 65%. Most house officers reported 1-5 hours of prior formal training in palliative care, 1-5 hours in pain management, and 6-20 hours in ethics. The mean knowledge score was 75% correct (SD=8); pain management scores were lowest (70%). Overall, interns had a significantly lower mean score than residents (70% vs. 77%; p=0.001). In multivariate analysis, only the year of residency was significantly associated with knowledge score; prior formal training in palliative care, pain management, or ethics was not. One third of house officers rated themselves as "not at all" or "only slightly" at ease in caring for a dying patient. These self-ratings were not associated with prior training or knowledge, but were higher in residents compared to interns. Conclusions: Palliative care knowledge and ease with dying patients were higher in later years of residency but were not associated with prior formal palliative care training. These data highlight the continued need to evaluate and improve training in palliative care and pain management.
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