Death and End of Life: Perceptions Throughout The Career About Death, Palliative Care, and Educational Process

2020 ◽  
pp. 082585972092343
Author(s):  
Maria Luiza Galoro Corradi ◽  
Etienne Duim ◽  
Cibele Isaac Saad Rodrigues
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Medical Students ◽  
Medical School ◽  
End Of Life ◽  
Death And Dying ◽  
Educational Process ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Attending Physicians

Purpose: To evaluate the perception of attending physicians, medical residents, and undergraduate medical students about death and dying, the end of life (EoL), and palliative care (PC) during training and clinical practice, highlighting knowledge gaps, and the changes needed in medical school curricula. Method: Cross-sectional study of 12 attending physicians, residents, and undergraduate medical students randomly selected from a single teaching hospital in São Paulo, Brazil, 2018. Semi-structured interviews were conducted, transcripts were coded in depth, and categorizing analysis was carried out. Results: Three topical categories were recognized: Negative feelings about death and the EoL, importance of PC, and gaps in curricular structure hindering preparedness for PC and EoL communication. Besides differing perspectives depending on their years of experience, all participants strongly endorsed that the current medical school curriculum does not train and support physicians to handle EoL and PC. Conclusions: Medical education plays a fundamental role in the development of knowledge and skills on death, dying, and PC. Such practices should extend throughout the course and be continuously improved after graduates move to clinical practice.

A 40-Year History of End-of-Life Offerings in US Medical Schools: 1975-2015

2016 ◽  
Vol 34 (6) ◽  
pp. 559-565 ◽  
Author(s):  
George E. Dickinson
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
End Of Life ◽  
Geriatric Medicine ◽  
Death And Dying ◽  
Medical Schools ◽  
The United States ◽  
Institute Of Medicine ◽  
Undergraduate Medical Students ◽  
Frequency Distributions

The purpose of this longitudinal study of US medical schools over a 40-year period was to ascertain their offerings on end-of-life (EOL) issues. At 5-year intervals, beginning in 1975, US medical schools were surveyed via a questionnaire to determine their EOL offerings. Data were reported with frequency distributions. The Institute of Medicine has encouraged more emphasis on EOL issues over the past 2 decades. Findings revealed that undergraduate medical students in the United States are now exposed to death and dying, palliative care, and geriatric medicine. The inclusion of EOL topics has definitely expanded over the 40-year period as findings reveal that US undergraduate medical students are currently exposed in over 90% of programs to death and dying, palliative care, and geriatric medicine, with the emphasis on these topics varying with the medical programs. Such inclusion should produce future favorable outcomes for undergraduate medical students, patients, and their families.

Quantifying empathy levels among UK undergraduate medical students: an online survey

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711293
Author(s):  
Sarah Garnett ◽  
Hajira Dambha-Miller ◽  
Beth Stuart
Keyword(s):  
Medical Students ◽  
Health Outcomes ◽  
Medical School ◽  
Curriculum Design ◽  
Online Survey ◽  
Mental Wellbeing ◽  
Reactivity Index ◽  
Free Text ◽  
Undergraduate Medical Students ◽  
Cross Sectional

BackgroundEmpathy is a key health care concept and refers to care that incorporates understanding of patient perspective’s, shared decision making, and consideration of the broader context in which illness is experience. Evidence suggests experiences of doctor empathy correlate with improved health outcomes and patient satisfaction. It has also been linked to job satisfaction, and mental wellbeing for doctors. To date, there is a paucity of evidence on empathy levels among medical students. This is critical to understand given that it is a key point at which perceptions and practices of empathy in the longer term might be formed.AimTo quantify the level of empathy among UK undergraduate medical studentsMethodAn anonymised cross-sectional online survey was distributed to medical students across three universities. The previously validated Davis’s Interpersonal Reactivity Index was used to quantify empathy. The survey also collected information on age, sex, ethnicity, year of medical school training and included a free-text box for ‘any other comments’.ResultsData analysis is currently underway with high response rates. Mean empathy scores by age, sex, year of study and ethnic group are presented. A correlation analysis will examine associations between age and year of study, and mean empathy sores.ConclusionThese data will help to provide a better understanding of empathy levels to inform the provision of future empathy training and medical school curriculum design. Given previous evidence linking experiences of empathy to better health outcomes, the findings may also be significant to future patient care

scholarly journals Depression Among Undergraduate Medical Students

2013 ◽  
Vol 10 (3) ◽  
pp. 56-59 ◽  
Author(s):  
Bibhusan Basnet ◽  
M Jaiswal ◽  
B Adhikari ◽  
PM Shyangwa
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Medical School ◽  
Depression Scale ◽  
Academic Stress ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Prevalence Of Depression ◽  
Inducing Factors ◽  
Major Factors

Background  Psychological stress is common in medical school and associated with depression. Medical education is grooming in Nepal, but only few studies are done concerning mental health of medical students. Objective  To assess the prevalence of depression among medical students at different levels of education and find about their stressors. Methods  A cross sectional, questionnaire-based survey was carried out among the undergraduate medical students of B.P.Koirala Institute of Health Sciences, Nepal. 50 students each from Bachelor of Medicine and Bachelor of Surgery (MBBS) first and third year were enrolled in the study conducted between November 2008 to January2009. The depression levels were assessed using Zung depression scale. Students were asked to complete the questionnaire and then the depression levels calculated .The stress inducing factors during their course of medical education were also assessed. Results  The overall prevalence of depression among the students was 29.78 percent. The prevalence of depression in first and third year was 36.74and 22.22 percent respectively. The prevalence of depression was 32.43 percent among female students versus 28.07 percent in male students. Both first and third year students gave high ratings to academic stress and hectic lifestyle as the main stress inducing factors. Conclusion  The prevalence of depression is seen especially in the first year medical students. So, attempts should be made to alleviate the stressors right from the time they join medical school. Since academic stress proved to be one of the major factors, measures to make the academic curriculum more student-friendly are suggested. Kathmandu University Medical Journal | VOL.10 | NO. 3 | ISSUE 39 | JUL- SEP 2012 | Page 56-59 DOI: http://dx.doi.org/10.3126/kumj.v10i3.8021

scholarly journals Pre Clinical- Basic Sciences Teaching Curriculum of a Medical School in a Developing Country -Are We Doing it Right?

2015 ◽  
Vol 9 (2) ◽  
pp. 98-104
Author(s):  
Kushani Rasangika Atukorala ◽  
Piyusha Atapattu
Keyword(s):  
Clinical Practice ◽  
Medical Students ◽  
Clinical Significance ◽  
Clinical Training ◽  
Training Methods ◽  
Basic Sciences ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Clinical Exposure ◽  
Teaching Time

Background: Preclinical teaching of basic sciences provides the basis for the development of clinical reasoning skills and the ability to make management decisions. However, many senior undergraduates, pre-interns and doctors indicate that basic sciences knowledge is poorly recalled and has little relevance to their clinical practice. Objectives: To explore the perceptions of medical students in their clinical years, and pre-interns about the basic sciences courses taught to them in the preclinical years, and to assess how each group rates the applicability of these courses to current clinical training. Methods: A descriptive cross-sectional study was conducted among 118 pre-interns and 146 undergraduate medical students using a self-administered questionnaire, regarding their perceptions on preclinical basic sciences teaching. For statistical analysis chi square test was applied. Results: More than 75% both pre-interns and undergraduates agreed that preclinical teaching was useful and relevant for future clinical work. 50-75% frequently revisited preclinical subjects despite unapparent clinical significance. 55% couldn’t remember most of preclinical content. Physiology was the most retained (76%) and most clinically relevant subject (80%). Majority of (>60%) both the groups suggested more teaching time and >75% suggested concurrent clinical exposure for preclinical teaching. Undergraduates and preinterns differed in that 56% of undergraduates and 37% of pre-interns had studied pre clinical subjects just to pass examinations (p<0.01) Conclusions: Majority of undergraduates and pre-interns felt that preclinical teaching is interesting and relevant for future clinical practice, though recall and clinical significance were suboptimal. Revising teaching methods with interdisciplinary integration, early clinical exposure showing relevance of basic sciences and allocating more teaching time utilizing clinicians should be considered. DOI: http://dx.doi.org/10.3329/jbsp.v9i2.22806 Bangladesh Soc Physiol. 2014, December; 9(2): 98-104

Respecting patient choices: using the ’Go Wish' cards as a teaching tool

2017 ◽  
Vol 8 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Hibah Osman ◽  
Katia El Jurdi ◽  
Ramzi Sabra ◽  
Thalia Arawi
Keyword(s):  
Palliative Care ◽  
Medical Education ◽  
Medical Students ◽  
End Of Life ◽  
Thematic Analysis ◽  
Death And Dying ◽  
Teaching Tool ◽  
Student Reflection ◽  
Second Year ◽  
Self Discovery

BackgroundIndividuals have different values and priorities that can have an important impact on their medical management. Understanding this concept can help physicians provide medical care that is in line with the goals of their patients. Communicating this message effectively to students is challenging.ObjectiveTo report our experience with using Go Wish cards in the medical education setting.DesignA thematic analysis of student reflection papers using grounded theory.Setting/SubjectsSecond-year medical students participated in an activity using the Go Wish cards as part of a course module on palliative care. The activity aimed to encourage students to reflect on their own choices at the end of life and to highlight that different people have different priorities.ResultsForty-two students (42%) mentioned the Go Wish activity in their reflections on the module. They reported that the activity demonstrated the different priorities at the end of life, it illustrated the importance of providing personalised care, it promoted self-discovery, it transformed their view of death and dying, and it increased their appreciation of the importance of palliative care.ConclusionGo Wish cards can be used to help illustrate the variability in priorities of patients. They can be used as an effective to teach medical students about the importance of considering patient preferences when illness progresses.

scholarly journals Undergraduate palliative care education in the United Arab Emirates: a nationwide assessment of medical school deans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Thana Harhara ◽  
Halah Ibrahim
Keyword(s):  
Palliative Care ◽  
Medical Students ◽  
Medical School ◽  
End Of Life ◽  
United Arab Emirates ◽  
Health Professionals ◽  
End Of Life Care ◽  
Successful Implementation ◽  
Life Care ◽  
High Quality

Abstract Background The provision of comprehensive, high quality palliative care (PC) is a global public health concern. In the United Arab Emirates (UAE), palliative medicine services are limited, and most patients in need of PC are treated in the acute hospital setting, where health professionals of all specialties provide treatment. Improving end-of-life care requires teaching medical students, residents, and other healthcare professionals about PC. The purpose of this study was to assess the current status of PC education in medical schools in the UAE, and to identify barriers to successful implementation of a PC and end-of-life curriculum. Methods The authors conducted semi-structured interviews with deans from all medical schools in the UAE. Data were analyzed using qualitative content analysis. Results All medical school deans in our study recognized the importance of inculcating palliative and end-of-life care into the undergraduate curriculum, but there was substantial variability in implementation, with opportunities for improvement. Barriers to the successful implementation of an undergraduate PC curriculum include (1) lack of student awareness and interest in PC, (2) inconsistent clinical exposure to PC, (3) lack of specialized PC faculty, (4) limited clinical facilities for PC training, (5) lack of a multidisciplinary approach to PC education, and (6) cultural barriers to PC education. Conclusions Understanding challenges to teaching PC in the undergraduate medical curriculum can help inform educational interventions to improve PC knowledge and skills for UAE medical students. Curricular and policy reform are necessary to educate a future generation of health professionals, who can provide high quality palliative care services to UAE patients and their families.

scholarly journals How effective is undergraduate palliative care teaching for medical students? A systematic literature review

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036458
Author(s):  
Jason W Boland ◽  
Megan E L Brown ◽  
Angelique Duenas ◽  
Gabrielle M Finn ◽  
Jane Gibbins
Keyword(s):  
Palliative Care ◽  
Clinical Practice ◽  
Medical Students ◽  
Teaching Method ◽  
Data Extraction ◽  
Grey Literature ◽  
Undergraduate Medical Students ◽  
Care Teaching ◽  
Teaching Interventions ◽  
Meta Analyses

Palliative care is central to the role of all clinical doctors. There is variability in the amount and type of teaching about palliative care at undergraduate level. Time allocated for such teaching within the undergraduate medical curricula remains scarce. Given this, the effectiveness of palliative care teaching needs to be known.ObjectivesTo evaluate the effectiveness of palliative care teaching for undergraduate medical students.DesignA systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Screening, data extraction and quality assessment (mixed methods and Cochrane risk of bias tool) were performed in duplicate.Data sourcesEmbase, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov, Cochrane and grey literature in August 2019. Studies evaluating palliative care teaching interventions with medical students were included.Results1446 titles/abstracts and 122 full-text articles were screened. 19 studies were included with 3253 participants. 17 of the varied methods palliative care teaching interventions improved knowledge outcomes. The effect of teaching on clinical practice and patient outcomes was not evaluated in any study.ConclusionsThe majority of palliative care teaching interventions reviewed improved knowledge of medical students. The studies did not show one type of teaching method to be better than others, and thus no ‘best way’ to provide teaching about palliative care was identified. High quality, comparative research is needed to further understand effectiveness of palliative care teaching on patient care/clinical practice/outcomes in the short-term and longer-term.PROSPERO registration numberCRD42018115257.

scholarly journals Assessing empathy among undergraduate medical students: a cross sectional analysis using the Jefferson scale in a medical school in Coastal Karnataka

2018 ◽  
Vol 5 (3) ◽  
pp. 953 ◽  
Author(s):  
Suma Nair ◽  
Ranjitha S. Shetty ◽  
Swati Guha ◽  
Zari Anjum ◽  
Asha Kamath
Keyword(s):  
Medical Students ◽  
Medical School ◽  
School Curriculum ◽  
Cross Sectional Study ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
First Year Students ◽  
Doctor Patient Communication ◽  
Empathy Score ◽  
Student Version

Background: Empathy has been shown to improve the physician’s diagnostic skills as well as enhance the quality of communication with the patient. Empathy being an integral component of patient care, this study was designed to measure empathy levels among undergraduate medical students and to identify the factors associated with it in this population. Methods: This cross sectional study was carried out among 437 medical students including interns on the rolls of a medical school in coastal Karnataka. The students were administered a psychometrically validated Jefferson Scale of Empathy–Student Version (JSE-S) questionnaire, to measure various components of empathy. Responses were indicated on a seven point Likert scale and total scores ranged from 20–140, with higher values indicating higher levels of empathy. Results: Mean empathy score among the participants was 100.5±14.8, with significantly higher score being reported by females than males [101.9 vs. 97.3, p=0.002] and by first year students compared to third year students [105.2 vs. 95.3, p<0.01]. Empathy scores showed a declining trend as the students progressed through the medical school (p=0.002). Conclusions: Although the study showed higher empathy level among female medical students, there appeared a declining score among both genders as the years of study progressed with a marginal increase during the internship phase. This necessitates the need for incorporating caregiving as an integral part of the medical school curriculum by stressing on doctor- patient communication skills, which in turn could aid medical students become compassionate physicians. 

scholarly journals Cross-sectional questionnaire study to gather the teaching preferences and expectations of UK undergraduate medical students for culinary medicine learning

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036410
Author(s):  
Jessica Ying-Yi Xie ◽  
Shoba Poduval ◽  
Victoria Vickerstaff ◽  
Sophie Park
Keyword(s):  
Quantitative Analysis ◽  
Medical Students ◽  
Medical School ◽  
Multiple Choice ◽  
Free Text ◽  
Undergraduate Medical Students ◽  
Cross Sectional ◽  
Culinary Medicine ◽  
Teaching Preferences ◽  
Perceived Relevance

AimTo determine undergraduate medical students’ teaching preferences and expectations for Culinary Medicine (CM) learning with a view to informing development of a CM course at a UK medical school.SettingA single, urban UK medical school.Participants180 undergraduate medical students.Study designA cross-sectional questionnaire study collecting quantitative and qualitative (free-text) data.Methods and outcome measuresAn online questionnaire consisting of 16 questions of various styles (Likert-type, multiple choice and free-text). Quantitative analysis of multiple choice and Likert-type scale questions was conducted. Qualitative thematic analysis was used to analyse the free-text responses and identify themes.ResultsThree core themes related to students’ understanding of CM were identified: (1) ‘CM Learning’: students’ perceived relevance of CM knowledge, perceived relevance of CM to healthcare and their expectations for teaching; (2) ‘The Relationship between Food and Health’: links between diet, social factors and health; and (3) ‘Evidence-based Medicine’: students’ perceptions about scientific principles underlying CM. Quantitative analysis revealed that, although 83% of students felt that learning CM is important for their future clinical practice, 56% felt unable to take a dietary history. 73% of students were dissatisfied with the quality, and 78% were dissatisfied with the quantity, of existing medical school teaching understood to be relevant to CM. Topics that students would like to be taught on a CM course included weight management and portion control. Students felt that problem-based style learning would be the most appropriate method for delivering CM teaching.ConclusionsThis study revealed that medical students felt their dietary counsulting skills could be improved with further clinically relevant teaching in the undergraduate medical curriculum. Students’ preferences for CM learning have been taken into consideration in the development of a CM course for fifth-year undergraduate students at a UK medical school, which is delivered during their General Practice placement.

Sign in / Sign up

Export Citation Format

Share Document