What factors are important in increasing junior doctors' willingness to provide palliative care in Taiwan? An educational intervention study

Purpose: To explore the factors that influence the willingness of junior doctors to provide palliative care in future clinical practice and to evaluate the effect of palliative care education in ameliorating these factors. Methods: A 2-week clinical training course consisting of clinical patient care, multidisciplinary team meetings, home visits, and lecture series was conducted for interns in a palliative care unit of a university hospital. A structured self-report questionnaire was administered before and after the training. Results: One hundred forty-seven interns were enrolled and completed the questionnaire, which demonstrated significant improvements in knowledge and beliefs toward palliative care after the training (p < 0.001). Although the interns' willingness to provide palliative medical care was influenced by relatives' support before the training (odds ratio [OR] = 3.861, 95% confidence intgerval [CI] = 1.217-12 .243), this relationship vanished after training. A higher willingness to provide home visits was noted in participants who received palliative care education at medical school. In contrast, information received from mass media was shown to be negatively correlated with willingness. After the training, the only independent variable that was positively correlated with interns' willingness to provide home visits was their own beliefs on palliative care (OR = 1.074, 95% CI = 1.058-8.089). Conclusions: Educating junior doctors to build positive beliefs toward palliative care is strongly encouraged. Palliative care education contributes to increased junior doctors' willingness toward providing palliative care, which suggests that this kind of training course should be emphasized in medical education