# Observational Study on Enhancing End-of-Life Care Competence Through OSCE: Educational Implications

## TL;DR

This study shows that while medical students are good at diagnosing end-of-life issues, they struggle with communication and ethical aspects, suggesting a need for better training in these areas.

## Contribution

The study introduces a specialized OSCE station to evaluate end-of-life care competencies and highlights gaps in communication and ethical training.

## Key findings

- Students showed high proficiency in diagnostic competencies for end-of-life care.
- Significant variability was found in communication and ethical decision-making skills.
- Items related to ethical-legal considerations were more challenging for students.

## Abstract

End-of-life care training is a critical component of medical education, yet gaps remain in adequately preparing students for these complex interactions. Objective Structured Clinical Examinations (OSCEs) have emerged as a vital tool to assess clinical competence in real-world scenarios. This study aimed to evaluate medical students’ competencies in palliative care using a specialized OSCE station focused on end-of-life skills. A cohort of 118 final-year medical students at the University of Cádiz completed an OSCE that tested abilities in diagnosis, communication, ethical decision-making, and professionalism. Students demonstrated high proficiency in diagnostic competencies, particularly in identifying underlying pathologies and managing refractory symptoms. However, significant variability emerged in skills related to communication, managing advance directives, and obtaining informed consent for palliative sedation. Statistical analyses revealed areas of both strength and challenge, with items related to ethical-legal considerations showing higher difficulty and variability among students. Our findings underscore the need for curricular enhancements that integrate technical training with ethical and communicative aspects of palliative care. Improving student preparation in these domains is essential to equip future physicians with the holistic skills necessary for compassionate end-of-life care.