MedEdPORTAL (Dec 2011)
Medicare Hospice Benefit Game
Abstract
Abstract One of the most significant barriers for patients receiving hospice services is the lack of medical providers' knowledge of what hospice is and what it offers. The AAMC lists “presenting palliative care (including hospice) as a positive, active treatment option for a patient with advanced disease” as one of its minimum competencies for medical students. Yet few physician trainees are provided with formal end-of-life care training. The Medicare Hospice Benefit (MHB) Game is a competency-based educational tool designed to evaluate physician trainee's knowledge of the MHB and their comfort describing services provided by the MHB while educating them in an interactive format. Internal medicine interns (n = 24) at the University of Utah have played the game during their geriatrics rotation. The interns completed a pregame survey, which assessed their self-reported knowledge of the MHB and their comfort describing the MHB to patients. The interns were given 10–15 minutes to sort a set of 30 cards with statements about the MHB into a true or false pile and record the statements they mis-categorize on an answer sheet. Detailed answers were distributed and a preceptor led a 30–45 minute long interactive discussion about the MHB. At the conclusion of the session, the interns completed a postgame survey assessing changes in their knowledge and comfort. Both pre- and postgame surveys utilized a 7-point Likert type scale for measurement. Prior to playing the game, the interns' self-reported comfort describing services provided by the MHB was low (2.2, ± 1.1). This was congruent with the objective assessment of the interns' knowledge of the MHB as measured by the mean game score of 63.9% (± 8.9). The baseline knowledge scores of interns who played the game after completing a substantial portion of their internship were no better than those who played at the beginning. After playing the MHB game the intern's self-reported comfort describing the MHB improved to (5.9, ± 0.9), they strongly agreed that the game added to their knowledge of the MHB (6.4 ± 0.7) and was enjoyable (6.0, ± 1.1). The game is best played in small groups and is difficult to play with groups of more than 15 people.
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