An interdisciplinary educational program to improve knowledge and attitudes about an end-of-life symptom management protocol

Prior studies show that clinicians have knowledge deficits and attitudinal concerns about caring for dying patients. We tested an education program designed to improve perspectives regarding end-of-life symptom management in the context of implementing an end-of-life symptom management order protocol. The case-based, interactive multidisciplinary educational program included practice with decision making, family discussion, and order writing. Clinicians completed a questionnaire before and after the program that assessed comfort with and attitudes toward symptom control at the end of life and knowledge about use of the end-of-life symptom management order protocol. Of 381 clinicians participating in the educational intervention, 297 completed pre- and post-educational program surveys. Most were nurses. Knowledge and comfort in caring for a dying patient were higher after the intervention (P < .001). Attitudes about end-of-life symptom management also changed significantly: After the educational program, clinicians were less likely to equate end-of-life symptom management with euthanasia or to believe that symptom management should aim to treat the family of an asymptomatic patient. After the program, clinicians were less likely to perceive that the end-of-life symptom management order protocol aimed to conserve healthcare resources or to shorten the dying process. Clinician knowledge, attitudes, and comfort regarding end-of-life symptom management improved with an interdisciplinary, interactive educational intervention.