By Stacy Fischer, MD, UCHSC Geriatrics Fellow
While at the 2000 American Geriatrics Society meeting in Chicago, IL, Dr. Jean Kutner and I spent an afternoon visiting Michael Preodor, MD, at Horizon Hospice - a PoPCRN site. During our meeting, we discussed the vital role community hospices play in educating health professions students. However, all agreed that the extent and character of the hospices' investment of staff time and resources was largely unknown. The idea for a web-based questionnaire evolved. The main purpose of the survey was to collect descriptive information describing the nature and span of individual hospices' role in the education of health professions students, interns, residents, and fellows. In addition, it was hypothesized that the hospices rarely received financial compensation from the health professions schools/programs, with whom they have mainly informal arrangements.
With the help of the PoPCRN research team, Dr. Preodor, and Kathy Egan of the NHPCO, Dr. Kutner and I developed a comprehensive questionnaire designed to cover the broad scope of hospice's commitment to education. Dr. Cordt Kassner created a web-based survey and all PoPCRN and NHPCO sites were invited to participate. Between December 2001 through March 2001, the study experienced an excellent response rate of 75 hospices from 25 different states. Seventy-one (95%) sites stated that they participated in education activities for health professions students. While analysis of responses is still ongoing, a wealth of information has been gathered.
As anticipated, hospices provide education to a wide range of health professions students including BSN students (73%), associate nursing students (61%), masters level social work or counseling students (61%), RN students (59%), medical students (58%), and medical residents (57%). Even more significant was the extensive staff time devoted to educating these students (range=11-30 hours/week), while less than 3% received any financial compensation. As expected, less than half of the sites had legal contracts or affiliation agreements with the students' home educational institutions. Fifty-five percent had preceptorship or mentorship training for staff, 51% had a separate education department, and 41% had a dedicated position to coordinate student education. Hospice staff that most frequently participated in education were: patient care nurses (84%), social workers/counselors (75%), bereavement counselors (68%), chaplains/pastoral care (60%), directors of nursing (60%) and medical directors (53%). Perhaps the most interesting findings from this survey were the reasons hospices sited for participating in education which included fulfilling a sense of responsibility, increasing awareness about hospice/palliative care and meeting perceived educational needs. Perceived benefits included: increasing the knowledge and awareness of learners, improving patient care, and training potential future staff. Perceived burdens were time and staff burden.
A special thank you to all the sites and individuals who participated in the planning, orchestration, and completion of this survey. We hope to use these results to further the awareness of the assets and needs of hospices in meeting education requirements through institutional and community support.
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