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.

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.

Understanding the impact of academic difficulties among medical students: A scoping review

2021 ◽  
Author(s):  
David Kirtchuk ◽  
Geoffrey Wells ◽  
Tom Levett ◽  
Clare Castledine ◽  
Richard Visser
Keyword(s):  
Medical Students ◽  
Scoping Review ◽  
Academic Difficulties ◽  
The Impact

scholarly journals Dealing with Death: Medical Students' Experiences with Patient Loss

2014 ◽  
Vol 68 (3) ◽  
pp. 207-228 ◽  
Author(s):  
Regina Pessagno ◽  
Carrie E. Foote ◽  
Robert Aponte
Keyword(s):  
Medical Students ◽  
Human Error ◽  
Emotional Responses ◽  
Stress Coping ◽  
Death Rituals ◽  
Dying Patients ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews ◽  
Dying Patient

This article explores medical students' experiences and coping strategies when confronting patient loss in their 3rd and 4th years of their programs. Much of the literature on the impact of patient losses focuses on physicians. This article joins a handful of works aimed at how medical students experience and cope with patient loss. In-depth interviews with 20 medical students provided rich descriptions of their varying experiences coping with death. Consistent with previous work, students experience substantial emotional stress coping with patient deaths, though some were more difficult to bear than others, such as when the dying patient was a child or when treatment errors could have contributed to deaths. Common coping mechanisms included talking through their emotions, thrusting themselves into continuing their rounds, crying, participating in infant death rituals, and turning to religion. When deaths occurred, senior personnel who exhibited empathy toward the deceased and tolerance toward the students' emotional responses were lauded and made the process easier. Also emotionally daunting, in many instances, was dealing with the families of dying patients. Most of the students did not view death as a failure, contrary to much earlier literature, except in instances in which human error or decision making may have played a part in causing the death of a patient.

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.

The potential of a medical student patient navigator program: An analysis of partners against cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 34-34
Author(s):  
Naomi Whittaker ◽  
Helen S. Uong ◽  
Evan Kirschner ◽  
Peter T. Silberstein
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Cancer Patients ◽  
Medical Center ◽  
Death And Dying ◽  
Opportunity To Learn ◽  
Patient Navigator ◽  
Access To Resources ◽  
Patient Resources ◽  
The Impact

34 Background: The Partners Against Cancer (PAC) program pairs first and second year medical student volunteers with individual cancer patients in need at the Division of Hematology/Oncology at Creighton University Medical Center. A review of the scientific literature yields no publications about student run programs at medical institutions pairing students with cancer patients. Methods: Prior to beginning the program, each student completed an entry survey. While in the program, students were asked to submit log entries after each patient encounter. A total of 137 student logs from 30 students were surveyed for themes (e.g. student addressing patient’s physical needs), which were counted. Results: PAC trained 129 medical students about patient resources and matched over 51 patient-student pairs. In the entry surveys, 98.5% of students entering the PAC program wanted to learn more about the psychosocial issues cancer patients experience and their quality of life. Most students (98.5%) wanted to gain more experience talking about death and dying with patients and working with a dying patient. Of reported patient contact, 39% was in clinic, 44% phone, 8% email, and 6% was an inpatient or treatment facility visit. In the log data, students noted helping patients emotionally (85%) and with access to resources or promoting health and compliance (28%). Medical students demonstrated empathy in 75% of logs and gaining knowledge of medicine in 26%. 12% of logs noted schedule conflicts or contact difficulties. Conclusions: PAC is a longitudinal experience where medical students play an active role in their individual patient’s care. Students provide physical assistance to patients, such as helping with access to resources, and emotional assistance by listening to the patient. In return, the student has the opportunity to learn empathy by understanding the impact of chronic and, often terminal, disease on the patient. The challenges of the program have included scheduling difficulties and student confusion with the program. A website and mentor program have been developed to address these issues. Despite challenges, PAC exhibits great potential for enhancements in patient care and medical education, most notably empathy.

scholarly journals The Impact of Artificial Intelligence on Health Equity in Oncology: A Scoping Review

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4934-4934
Author(s):  
Paul Istasy ◽  
Wen Shen Lee ◽  
Alla Iansavitchene ◽  
Ross Upshur ◽  
Bekim Sadikovic ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Health Equity ◽  
Scoping Review ◽  
Clinical Decision Making ◽  
Ethical Issues ◽  
Clinical Decision ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
The Impact

Abstract Introduction: The expanding use of Artificial Intelligence (AI) in hematology and oncology research and practice creates an urgent need to consider the potential impact of these technologies on health equity at both local and global levels. Fairness and equity are issues of growing concern in AI ethics, raising problems ranging from bias in datasets and algorithms to disparities in access to technology. The impact of AI on health equity in oncology, however, remains underexplored. We conducted a scoping review to characterize, evaluate, and identify gaps in the existing literature on AI applications in oncology and their implications for health equity in cancer care. Methodology: We performed a systematic literature search of MEDLINE (Ovid) and EMBASE from January 1, 2000 to March 28, 2021 using key terms for AI, health equity, and cancer. Our search was restricted to English language abstracts with no restrictions by publication type. Two reviewers screened a total of 9519 abstracts, and 321 met inclusion criteria for full-text review. 247 were included in the final analysis after assessment by three reviewers. Studies were analysed descriptively, by location, type of cancer and AI application, as well as thematically, based on issues pertaining to health equity in oncology. Results: Of the 247 studies included in our analysis, 150 (60.7%) were based in North America, 57 (23.0%) in Asia, 29 (11.7%) in Europe, 5 (2.1%) in Central/South America, 4 (1.6%) in Oceania, and 2 (0.9%) in Africa. 71 (28.6%) were reviews and commentaries, and 176 were (71.3%) clinical studies. 25 (10.1%) focused on AI applications in screening, 42 (17.0%) in diagnostics, 46 (18.6%) in prognostication, and 7 (2.9%) in treatment. 40 (16.3%) used AI as a tool for clinical/epidemiological research and 87 (35.2%) discussed multiple applications of AI. A diverse range of cancers were represented in the studies, including hematologic malignancies. Our scoping review identified three overarching themes in the literature, which largely focused on how AI might improve health equity in oncology. These included: (1) the potential for AI reduce disparities by improving access to health services in resource-limited settings through applications such as low-cost cancer screening technologies and decision support systems; (2) the ability of AI to mitigate bias in clinical decision-making through algorithms that alert clinicians to potential sources of bias thereby allowing for more equitable and individualized care; (3) the use of AI as a research tool to identify disparities in cancer outcomes based on factors such as race, gender and socioeconomic status, and thus inform health policy. While most of the literature emphasized the positive impact of AI in oncology, there was only limited discussion of AI's potential adverse effects on health equity . Despite engaging with the use of AI in resource-limited settings, ethical issues surrounding data extraction and AI trials in low-resource settings were infrequently raised. Similarly, AI's potential to reinforce bias and widen disparities in cancer care was under-examined despite engagement with related topics of bias in clinical decision-making. Conclusion: The overwhelming majority of the literature identified by our scoping review highlights the benefits of AI applications in oncology, including its potential to improve access to care in low-resource settings, mitigate bias in clinical decision-making, and identify disparities in cancer outcomes. However, AI's potential negative impacts on health equity in oncology remain underexplored: ethical issues arising from deploying AI technologies in low-resources settings, and issues of bias in datasets and algorithms were infrequently discussed in articles dealing with related themes. Disclosures No relevant conflicts of interest to declare.

scholarly journals A systematic scoping review on the impact of the COVID-19 quarantine on the psychological wellbeing of medical students.

2021 ◽  
Author(s):  
Divya Vythilingam ◽  
William Atiomo
Keyword(s):  
Medical Students ◽  
Scoping Review ◽  
Full Text ◽  
Negative Impact ◽  
Research Question ◽  
Psychological Wellbeing ◽  
Bibliographic Databases ◽  
Cross Sectional ◽  
The Impact ◽  
Published Research

Background The impact of social isolation, on the psychological wellbeing of medical students, who had to quarantine due to the COVID19 pandemic, is uncertain. A scoping review of the literature was therefore conducted to assess the extent of the published research in this area. Methods The PRISMA ScR guideline, was used to structure this study. A search strategy was carried out across six bibliographic databases. Data from the selected studies were extracted, and the following variables recorded. First author and year of publication, country of study, study design, sample size, focus group, mode of analysing impact of quarantine from COVID19 on mental health and results of the studies. Results A total of 223 articles were identified across the six databases, from which 69 duplicates were excluded resulting in 154 full text articles. Of these, 29 met the inclusion criteria. Following a review of the abstracts of these 29, ten full text articles were identified all of which were cross sectional studies. Sample sizes ranged from 182 to 860 students and all studies used a variety of self administered questionnaires to measure psychological wellbeing. Eight of the 10 articles showed that quarantine had a negative impact on the psychological wellbeing of medical students. Conclusion. The evidence is small but growing. Quarantine because of the COVID19 pandemic appears to have had a negative impact on the psychological wellbeing of medical students. There is a need for more studies to further evaluate this research question.

A national survey of medical students and educators at Korean medical schools, examining the impact of end-of-life care education provided to Korean medical students based on their attitudes.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 55-55
Author(s):  
Do Yeun Kim ◽  
Kyong-Jee Kim ◽  
Sung Joon Shin ◽  
Dae Seog Heo ◽  
Soon-Nam Lee ◽  
...  
Keyword(s):  
Medical Students ◽  
End Of Life ◽  
Death And Dying ◽  
Medical Schools ◽  
Physical Symptoms ◽  
Advanced Directives ◽  
Care Education ◽  
Medical Educators ◽  
Eol Care ◽  
The Impact

55 Background: This study explored the current state of end-of-life (EoL) care education provided to Korean medical students and their self-rated attitudes toward EoL-related education. Methods: An anonymous survey was given to fourth year medical s tudents and the principle EoL care educators at all 41 Korean medical schools. The medical educators were asked to identify the EoL care-related topics that they usually teach students. Both students and medical educators completed seven items regarding self-perceived attitudes. Results: In total, 23 medical educators (56.1%) and 1,545 medical students (46.3%) responded. Of nine topics related to EoL care, the most frequently taught topics were delivering bad news (100%) and managing physical symptoms (74.1%), whereas setting treatment goals was taught the least frequently (37.0%). Approximately half of the educators taught the withdrawal of life-sustaining devices (59.3%), death and dying (55.6%), and advanced directives (55.6%). When the medical students were dichotomized into groups taught at least six topics (n = 815) versus five or fewer topics (n = 729), the group taught at least six topics expressed more satisfaction with EoL care education and they considered EoL care-related issues during their clerkship rotations. They also had fewer negative answers when they were asked about their readiness to practice EoL care. Conclusions: EoL education is inadequate for Korean medical students. However, medical students who were more fully instructed in this topic reported self-rated competency regarding EoL care-related issues. Further research should develop an education system that provides sufficient knowledge and training in EoL care for Korean medical students.

scholarly journals Nurses' early and ongoing encounters with the dying and the dead: a scoping review of the international literature

2020 ◽  
Vol 26 (6) ◽  
pp. 310-324
Author(s):  
Kerry Jones ◽  
Jan Draper ◽  
Alison Davies
Keyword(s):  
Scoping Review ◽  
Death And Dying ◽  
International Literature ◽  
Dead Body ◽  
Good Communication ◽  
Dying Patients ◽  
The Dead ◽  
Care Relationships ◽  
The Uk ◽  
Meta Analyses

Background: End-of-life care is high on policy and political agendas in the UK and internationally. Nurses are at the forefront of this, caring for dying patients, ‘managing’ the dead body, and dealing with the corporeal, emotional and relational dimensions of death. Little is known about nurses' prior or early professional experiences of and reactions to death, dying and the corpse and how these might influence practice. Aims: To appraise the international literature on nurses' early experiences of death, dying and the dead body, to better understand how these might influence subsequent practice, and how this might inform our teaching of death, dying and last offices. Methods: A scoping review was undertaken of peer-reviewed publications between, 2000 and 2019, which included nurses working in hospital, care homes and the community. Medline, PubMed, PsychINFO and CINAHL databases were searched and 23 papers meeting the inclusion criteria were read. Arksey and O'Malley's (2005) five-stage approach was adopted to scope the relevant international literature, using where relevant the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Selected papers were independently reviewed and subjected to thematic analysis, leading to the generation of five overarching themes. Results: The five themes were: different philosophies of care; relationships; knowledge; impact of death; and giving care. The studies came from diverse geographical locations across different settings and were primarily qualitative in design. Conclusions: Students and registered nurses are impacted both positively and negatively by their early encounters with death and dying. Good communication with patients, families and between professionals, understanding of what constitutes a ‘good’ death, and high-quality mentorship and support were of particular importance.

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