Table 5.
Frequency of Ratings of Items Measuring Perceived Competence (1 = Not Competent; 5 = Very Competent) in End-of-Life Care on an Improving Clinician Communication Skills Survey of Medicine Residents (N = 74) at the University of Washington and Medical University of South Carolina, 2007
| Survey item | Rating of 1: No. (%) |
Rating of 2: No. (%) |
Rating of 3: No. (%) |
Rating of 4: No. (%) |
Rating of 5: No. (%) |
|---|---|---|---|---|---|
| Give bad news to a patient about his or her illness | 2 (3) | 6 (8) | 33 (45) | 28 (38) | 5 (7) |
| Conduct family conference | 3 (4) | 15 (20) | 32 (43) | 20 (27) | 4 (5) |
| Elicit a patient’s emotional reaction to his or her illness | 5 (7) | 15 (20) | 27 (36) | 26 (35) | 1 (1) |
| Express empathy | 2 (3) | 4 (5) | 16 (22) | 33 (45) | 19 (26) |
| Respond to a patient asking, “Why did this happen to me?” | 4 (5) | 23 (31) | 23 (31) | 20 (27) | 4 (5) |
| Discuss treatment options—for instance, palliative chemotherapy versus best supportive care | 10 (14) | 11 (15) | 22 (30) | 26 (35) | 5 (7) |
| Respond to patients who deny the seriousness of their illness | 9 (12) | 27 (37) | 26 (35) | 9 (12) | 2 (3) |
| Respond to patients or family members wanting treatments not indicated | 9 (12) | 23 (31) | 28 (38) | 13 (18) | 1 (1) |
| Discuss how a patient can maintain hope | 11 (15) | 25 (34) | 25 (34) | 10 (14) | 3 (4) |
| Discuss code status with a patient | 2 (3) | 6 (8) | 18 (24) | 35 (47) | 13 (18) |
| Discuss code status with family | 0 (0) | 10 (14) | 18 (24) | 34 (46) | 12 (16) |
| Discuss a hospice referral | 4 (5) | 10 (14) | 24 (32) | 28 (38) | 8 (11) |
| Discuss religious and spiritual issues with patients and families | 16 (22) | 21 (28) | 24 (32) | 12 (16) | 1 (1) |
| Elicit a patient’s goals for the end-of-life | 3 (4) | 12 (16) | 31 (42) | 23 (31) | 5 (7) |
| Elicit a patient’s fears for the end-of-life | 6 (8) | 22 (30) | 26 (35) | 16 (22) | 4 (5) |
| Manage pain at the end-of-life | 4 (5) | 13 (18) | 25 (34) | 27 (37) | 5 (7) |
| Deal with conflict between health care professionals | 11 (15) | 14 (19) | 31 (42) | 17 (23) | 1 (1) |