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Background: Quality improvement is one of the core contents in business schools and business administration programs. Nowadays, practice-based learning and improvement is listed as one of 6 competency domains for graduate medical education.

To introduce the concept early in medical training is important.

Summary of work: We have conducted a quality improvement program (known as A to A+) for 4 years for medical students of year 1 or 2. The program is composed of 8 interactive lectures and 8 weeks of small group tutorials. The lectures cover the aspects of principle of priority setting, time management, PDCA (plan-do-check-action) theory, SWOT (strength-weakness-opportunity-threat) analysis, quality management, learning theory, research quality and patient care quality. Students are then assigned into small groups with tutors. They can practice applying knowledge learned on a self-determined project to demonstrate the improvement in quality. Summary of results: This program has been listed in the top 3 most popular courses in our university since its launch. Students gave positive feedbacks on the effectiveness of learning, including the improvement of academic marks or extracurricular activities. Over 20 projects have been introduced through the program in the 4 years.

Conclusions: Quality management concepts are important in modern medical education. The key concepts of quality management can be effectively taught through interactive lectures and small group tutorials.

Take-home messages: Quality improvement concept is a core element in competency of medical education. Introducing the learning early in medical education is beneficial for both academic achievement and extra­curricular activity success. Long term follow-up is mandatory to prove its effectiveness in future clinical practices.

8DD/11

Factors associated with knowledge and attitude towards palliative and end of life care in medical students in Thailand

Saranya Prathaithep (Sanpasitthiprasong Hospital, Medicine, 285 Satholamark Road, Sansook District, Varinchamrab, Ubon Ratchathani 34190, Thailand) Parinya Chamnan (Sanpasitthiprasong Hospital, Social Medicine, Ubon Ratchathani, Thailand)

Background: Palliative and end of life care recently has been taught in clinical year medical students in Sanpasitthiprasong hospital. The present study aimed to examine the theoretical knowledge and attitude in palliative and end of life care among clinical year medical students, and to examine factors associated with their knowledge and attitude. Summary of work: 79 4th-6th year medical students were invited to answer the self-administered questionnaire, which included information on students' characteristics, experience caring relatives who were dying, theoretical knowledge and attitude towards palliative and end of life care. Experience of caring of their dying relatives was presented in percentages. Median (interquartile range, IQR) knowledge and attitude scores, and high score was defined as more

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than 80% of total score. Factors associated with the knowledge and attitude was examined using logistic regression.

Summary of results: The median age (IQR) of the students was 23.5 (23.0-24.5) years, with 42% being male. 29 students (37%) reported having cared for their relatives who were dying. The median knowledge score (IQR) was 4 (3-5) out of 8. The median attitude score (IQR) was 38 (34-40) out of 50. Eight students (10.1%) and 28 students (35.4%) had high knowledge and attitude scores respectively. Having had dying relatives and experience of caring for the relatives who were dying were not associated with the knowledge and attitude (p > 0.05).

Conclusions: Students' knowledge in palliative and end of life care was moderate, while their attitude was fairly good. The experience of caring for the relatives who were dying was not linked to students' knowledge and attitude. The highest scores observed in Y