Communicating With Dying Patients and Their Families: Multimedia Training in End-of-Life Care

2016 ◽  
Vol 34 (7) ◽  
pp. 637-644 ◽  
Author(s):  
Phylliss M. Chappell ◽  
Jennifer Healy ◽  
Shuko Lee ◽  
Glen Medellin ◽  
Sandra Sanchez-Reilly
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Attitude Change ◽  
Positive Attitude ◽  
Death And Dying ◽  
Signs And Symptoms ◽  
Computer Application ◽  
Fisher Exact Test ◽  
Positive Attitudes ◽  
Dying Patients

Background: The need for end-of-life (EOL), high-impact education initiatives to prepare medical students to communicate with dying patients and their families and to cope with issues of death and dying, is well recognized. Methods: Third-year medical students (n = 224), during their ambulatory rotation, completed a multimedia EOL curriculum, which included pre-/posttests, an online case-based module, didactic presentation, and a tablet computer application designed to demonstrate the signs and symptoms seen in the last hours of life for families of dying patients. Pre- and posttests were compared using Pearson χ2 or Fisher exact test, and improvement was measured by weighted κ coefficient. Results: On preintervention surveys, the majority of students demonstrated positive attitudes toward the care of dying patients and their families. Despite this high pretest positive attitude, there was a statistically significant overall positive attitude change after the intervention. The lowest pretest positive attitudes and lowest posttest positive attitude shifts, although all statistically improved, involved addressing the thoughts and feelings of dying patients and in coping with their own emotional response. Conclusions: Medical students exposure to this multimedia EOL curriculum increases positive attitudes in caring for dying patients and their families.

Experiences of a Group of Senior Nursing Students with End of Life Care and Death in Turkey

2020 ◽  
pp. 003022282096123
Author(s):  
Deniz Sanli ◽  
Fatma Iltus
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Life Care ◽  
Death Attitudes ◽  
Positive Attitudes ◽  
Dying Patients ◽  
And Behaviors

Nursing students may feel unprepared to manage the care of dying individuals and may experience anxiety and fear related to death and dying. Preparing nursing students for this situation can help them provide quality care to dying patients. This study aimed to examine the end-of-life care values and behaviors and death attitudes of senior nursing students. In examining these variables, the Values and Behaviors of Intensive Care Nurses for End-of-Life Instrument and the Death Attitude Profile-Revised Scale were used. It was found that the students developed positive attitudes and behavior towards end-of-life care, and that they believed death to be a natural part of life and there is life after death. Students who felt that the information they received during their education was partially sufficient were more likely to have negative death attitudes. It can be recommended that teaching strategies in the education of the nursing students be developed.

scholarly journals The impact of death and dying on the personhood of medical students: a systematic scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chong Yao Ho ◽  
Cheryl Shumin Kow ◽  
Chin Howe Joshua Chia ◽  
Jia Ying Low ◽  
Yong Hao Melvin Lai ◽  
...  
Keyword(s):  
Medical Students ◽  
Scoping Review ◽  
Death And Dying ◽  
Support Mechanism ◽  
Resource Limited ◽  
Dying Patients ◽  
Concurrent Use ◽  
Effective Training ◽  
Longitudinal Support ◽  
The Impact

Abstract Background The re-introduction of medical students into healthcare systems struggling with the COVID-19 pandemic raises concerns as to whether they will be supported when confronted with death and dying patients in resource-limited settings and with reduced support from senior clinicians. Better understanding of how medical students respond to death and dying will inform educationalists and clinicians on how to best support them. Methods We adopt Krishna’s Systematic Evidence Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on the impact of death and dying on medical students. This structured search process and concurrent use of thematic and directed content analysis of data from six databases (Split Approach) enhances the transparency and reproducibility of this review. Results Seven thousand six hundred nineteen were identified, 149 articles reviewed and 52 articles included. The Split Approach revealed similar themes and categories that correspond to the Innate, Individual, Relational and Societal domains in the Ring Theory of Personhood. Conclusion Facing death and dying amongst their patients affect how medical students envisage their personhood. This underlines the need for timely, holistic and longitudinal support systems to ensure that problems faced are addressed early. To do so, there must be effective training and a structured support mechanism.

Health Education Specialists’ Attitudes toward End-of-Life Education And Planning

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Aaron J Kruse-Diehr ◽  
Amy Piontek
Keyword(s):  
Health Education ◽  
End Of Life ◽  
Death And Dying ◽  
Geographic Location ◽  
Community Outreach ◽  
Older Individuals ◽  
Attitudinal Differences ◽  
Positive Attitudes ◽  
Certified Health Education Specialists ◽  
Life Education

This study explored attitudinal differences of Certified Health Education Specialists (CHES) and Master Certified Health Education Specialists (MCHES) toward providing end-of-life education. From a national CHES/MCHES list, we stratified health education specialists by geographic location then randomly selected participants. In our sample (N = 373), older individuals, those who cared for terminally ill persons/families, and those who had death and dying education had more positive attitudes toward providing end-of-life education. We offer three approaches to address the advance care-planning crisis: 1) providing additional end-of-life education to medical professionals, 2) assisting medical schools with incorporating experiential learning, and 3) community outreach.

Corresponding about death: Analyzing letters from patients with cancer to medical students.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 11021-11021
Author(s):  
Tianyi Zhang ◽  
Mekaleya Tilahun ◽  
Cynthia Perlis ◽  
Sam Brondfield
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Death And Dying ◽  
Severe Illness ◽  
Clinical Environment ◽  
Patients With Cancer ◽  
Coping Process ◽  
Award Winning ◽  
Multiple Paths ◽  
One Year

11021 Background: Clinicians frequently discuss death and dying with patients who have cancer. However, the doctor-patient hierarchy and the unfamiliar clinical environment may prevent these patients from discussing death and dying authentically. Patients may feel more comfortable expressing themselves when given the time and space to write at home. Firefly, an award-winning program at UCSF, facilitates written correspondence between patients with cancer and medical students over the course of one year. Firefly’s archive contains thousands of patient letters and constitutes a unique resource for analyzing authentic patient expression outside of the clinical context. The aim of the current study is to improve curricula pertaining to severe illness and end-of-life by providing educators with an analysis of authentic patient perspectives about death and dying expressed in these letters. Methods: We (two medical students, an expressive artist, and an oncologist) read all Firefly letters written by patients between 2014 and 2019 and identified 12 patients whose letters meaningfully discussed death or dying. We performed a thematic analysis of these letters using the Buckman three-stage model of dying as a reference. Results: Four themes emerged: turmoil; grief; making peace; and past, present and future. The first three themes aligned with the Buckman stages. The fourth theme—past, present and future—spanned the three stages and also elaborated the Buckman model by describing multiple paths that patients may take after passing through these stages. Conclusions: The authentic ways in which patients with cancer discussed death and dying in their letters provided deep insight into their coping process. The Buckman model appears useful for framing death and dying from the patient perspective but may not fully reflect modern oncologic care in which many patients live for years beyond a severe or terminal diagnosis. Educators can use the identified themes to shape medical school curricula pertaining to severe illness and end-of-life care.

The Contribution of Death-Related Experiences to Health Care Providers' Attitudes toward Dying Patients: II. Medical and Nursing Students with No Professional Experience

1993 ◽  
Vol 26 (3) ◽  
pp. 181-205 ◽  
Author(s):  
Sandor B. Brent ◽  
Mark W. Speece ◽  
Marie F. Gates ◽  
Manju Kaul
Keyword(s):  
Medical Students ◽  
Nursing Students ◽  
Health Care Providers ◽  
Professional Education ◽  
Death And Dying ◽  
Professional Experience ◽  
Care Providers ◽  
Professional Career ◽  
Dying Patients ◽  
Attitude Measures

Beginning medical and nursing students with no professional death-related experience were compared in order to discover the attitudes they bring to their respective careers prior to their professional education and socialization. Hypotheses were derived from psychological models for the effects of professional choice, gender, and non-professional experience on these attitudes. On five of the six attitude measures female nursing students expressed a more positive attitude than cither male or female medical students, as predicted. However, contrary to expectation, the attitudes of the female medical students were not more positive than those of the male medical students on any of these measures. Hours of death-and-dying coursework and general life experience exerted a significant influence on attitudes toward talking to dying patients about death and dying but not on any of the other attitude measures. These data also suggest the existence of an underlying attitude structure, representing these students' Overall Attitude toward caring for dying patients, which remains stable across group differences in professional career choice, gender, and death-related experience. The original theoretical models were enriched and revised in the light of these findings.

scholarly journals Exposure to Death is Associated with Positive Attitudes and Higher Knowledge About End-of-Life Care in Graduating Medical Students

2008 ◽  
Vol 11 (9) ◽  
pp. 1227-1233 ◽  
Author(s):  
Wendy G. Anderson ◽  
Jillian E. Williams ◽  
James E. Bost ◽  
David Barnard
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Positive Attitudes

scholarly journals End-of-life education in the pre-registration nursing curriculum: Patient, carer, nurse and student perspectives

2010 ◽  
Vol 17 (4) ◽  
pp. 317-326 ◽  
Author(s):  
Joyce Cavaye ◽  
Jacqueline H. Watts
Keyword(s):  
End Of Life ◽  
Quality Care ◽  
Death And Dying ◽  
Nurse Education ◽  
Nursing Curriculum ◽  
Nurse Training ◽  
Dying Patients ◽  
National Priority ◽  
The Uk ◽  
Eol Care

Providing good quality care for dying patients has been highlighted as a national priority in the UK. The Department of Health’s end-of-life (EOL) care strategy outlines how patients should be cared for to ensure that they experience a ‘good death’. Nurses have an important role to play in the delivery of EOL care and need to be knowledgeable about the palliation of symptoms and the social context of death and dying. Traditionally, the pre-registration nursing curriculum has had a limited emphasis on EOL care. While there have been significant developments in nurse education in the last decade, the amount of EOL content in nurse education remains inadequate. Drawing on literature mainly from the UK and USA, this review explores from the perspectives of students, newly qualified nurses, patients and carers the outcomes of EOL education. It reviews the evidence to determine whether newly qualified nurses are adequately prepared to deliver quality care to patients at the end of their lives. The evidence suggests that despite a greater emphasis on EOL care in nurse training, adequately preparing nurses remains a challenge to educators.

scholarly journals An Integrated Literature Review of Death Education in Pre-Registration Nursing Curricula: Key Themes

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Joyce Cavaye ◽  
Jacqueline H. Watts
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Bibliographic Databases ◽  
Life Care ◽  
Death Education ◽  
Organisation Of Care ◽  
Nursing Curricula ◽  
Dying Patients

Recent policy has raised the profile of end-of-life care internationally, with the aim of increasing access to quality care for everyone experiencing life-limiting illness. This reflects an international shift in the provision of palliative care to encompass chronic conditions other than cancer. Nurses have an important role in delivering this care and need to be equipped with particular knowledge and skills. However, pre-registration nursing curricula have traditionally had a limited emphasis on death and dying and nurses report feeling unprepared to care for dying patients. This has led to claims that death education in pre-registration curricula is inadequate. This integrated review explores the published literature that reports on death education within pre-registration nurse education. Presenting an international overview, the aim of the review is to contribute to knowledge about the nature and extent of death education in pre-registration curricula. In the context of this paper, death education encompasses both palliative and end-of-life care. Electronic searches of major bibliographic databases found inconsistencies across educational provision with variations in quantity, content, and approach. Despite an increasing amount of death education in pre-registration curricula, there remains a deficit in key areas such as knowledge, skills, organisation of care, and teamwork.

scholarly journals Compassion Fatigue in Hospice Nursing: A Program Development

2017 ◽  
Author(s):  
David Carroll
Keyword(s):  
New England ◽  
End Of Life ◽  
Compassion Fatigue ◽  
Death And Dying ◽  
Signs And Symptoms ◽  
Continuous Exposure ◽  
Turnover Rates ◽  
High Turnover ◽  
Hospice Nurses ◽  
Prevention Interventions

<p>Hospice nursing is an important aspect of health care. Hospice nursing is a specialized field in which patients are cared for at the end of life and an important aspect of healthcare. Because the care hospice nurses provide comes at the end of life, they are continuously exposed to death, dying, pain and suffering. Numerous studies have documented that continuous exposure to trauma, death and dying may result in compassion fatigue (CF). Compassion fatigue can lead to a physical and emotional toll on nurses resulting in low staff satisfaction , high turnover rates, and reduced quality of care. The 1 purpose of the project was to develop and implement an educational program about CF for hospice nursing staff at Care New England Visiting Nurse Association (VNA). First, a comprehensive needs assessment was conducted and then an educational intervention was developed based on those results and the review of the literature. It was hoped that as a result of the program hospice nurses' knowledge and understanding of CF, its signs and symptoms and prevention interventions that might minimize or prevent the effects of CF would be learned. Sixty-seven percent of eligible nurses (n=8) participated in the intervention. The participants were asked to complete a post program survey and evaluating the program positively and strongly agreed that they benefitted from it. All eight participants stated that there knowledge of compassion fatigue and selfcare techniques had improved.</p>

Non-graduate and graduate entry medical students attitudes to psychiatry

2013 ◽  
Vol 30 (4) ◽  
pp. 245-254 ◽  
Author(s):  
S. M. Pillay ◽  
F. Sundram ◽  
D. Mullins ◽  
N. Rizvi ◽  
T. Grant ◽  
...  
Keyword(s):  
General Practice ◽  
Medical Students ◽  
Career Choice ◽  
Positive Attitude ◽  
Graduate Entry ◽  
Positive Attitudes ◽  
Follow Up Studies ◽  
Before And After ◽  
Students Attitudes

ObjectiveGraduate entry medical students’ views of psychiatry may differ from those of school leavers. This study hypothesised that (i) exposure to a psychiatry attachment is associated with a positive change in attitudes towards psychiatry in both graduate entry and non-graduate entry students, (ii) graduate entry students exhibit a more positive attitude to psychiatry compared to non-graduate entry students and (iii) graduate entry students are more interested in a career in psychiatry than non-graduate entry students.MethodsIn this study 247 medical students (118 females and 129 males) completing their psychiatry rotation were invited to complete questionnaires examining career choice, attitudes to psychiatry and career attractiveness for a range of specialties including surgery, medicine, general practice and psychiatry before and after their psychiatry attachment. Questionnaires were distributed prior to commencement of their attachment and redistributed on the final day of the attachment.ResultsOf the 165 participants in the study, 75 students entered medicine via the traditional route (without a primary degree), 49 entered via the graduate entry programme and 41 had a primary degree. Overall, medical students displayed positive attitudes towards psychiatry. However, while there was an improvement in attitudes towards psychiatry and the career attractiveness of psychiatry on completion of the rotation, no differences were found between graduate and non-graduate entry students. Psychiatry and general practice had lower ratings for career attractiveness than other specialities. No significant changes were found in the first and second choice of specialty.ConclusionOur results show that improvements in attitude and career attractiveness do not necessarily correlate with increased choice of psychiatry as a specialty. Graduate entry has been considered a possible opportunity for increasing recruitment in psychiatry but our results suggest that this may not be the case. Follow-up studies are required to determine whether career attractiveness correlates with future career choice.

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